Degenerative Disc Disease

Our spines take a lot of use – and abuse – over the years. Unfortunately, this leads to a very common condition called degenerative disc disease. It is one of the most common spinal issues due to age, and affects most adults. Not only can symptoms be painful, but the breakdown of our spinal discs can lead to additional conditions, all of which can lead to a reduction in a person’s quality of life. The Nevada Advanced Pain Specialists in the Reno, Sparks and Carson City areas can help to provide treatment that not only reduces symptoms but also increases normal function and mobility of the spine. 

What is Degenerative Disc Disease?

Degenerative disc disease (DDD) is the breakdown or degeneration of our spinal discs. Spinal discs are rubbery cushions that are located between each 33 vertebrae in the spine. These intervertebral discs act as a shock absorber and allow a person to comfortably move, bend, twist, etc. 

When the discs wear down, the vertebrae rub against each other, which can lead to pain. Additionally, without the discs, or the full composition of the discs, pressure is no longer evenly spread throughout the spine, which can also lead to pain as well as additional complications. Every person can expect some level of disc degeneration over time, simply due to use. Disc degeneration is one of the most common causes of low back pain and neck pain. 

What Causes Degenerative Disc Disease? 

Age is the No. 1 reason why a person will experience degenerative disc disease. However, while most adults can expect to have some sort of disc degeneration, not all adults experience the same symptoms. 

Pain is the most common symptom. For those who do experience pain symptoms, there is generally a process that occurs:

• There is an acute injury to the disc that causes inflammation and disc compression. 
• This leads to instability to the spine and flare-ups of pain
• The person seeks treatment, pain improves and fewer flare-ups occur

In addition to normal wear and tear over the years, there are certain factors that increase a person’s chance of experiencing degenerative disc disease. These include: 

• Injuries, such as falling or a car accident
• Smoking
• obesity/overweight, which puts more stress on the spine and discs
• Working a physically demanding job or having a rigorous exercise regimen 
• Being female, as women most often experience symptoms

The degeneration of the discs can either be because the discs dry out due to losing water over time, or from tearing or cracking, most often from minor injuries. 

What are the Symptoms of Degenerative Disc Disease?

In addition to pain, the most common symptoms of degenerative disc disease include numbness in the arms or legs, tingling or radiating pain that increases when sitting, bending or lifting. If the symptoms aren’t treated, or the condition worsens, a person might experience other conditions, such as:

• Disc herniation, which can put pressure on nearby nerves
• Adult scoliosis, where the spine curves
• Spinal stenosis, when there is narrowing of the spine
• Spondylolisthesis, when the vertebrae move in and out of their normal alignment

How is Degenerative Disc Disease Treated?

The first step for beginning treatment is to partner with a pain management specialist who can recognize degenerative disc disease. Due to the fact that many people might have degeneration but no symptoms, diagnosis generally includes ruling out other health conditions. It’s necessary that a provider perform a physical exam, review the patient’s medical history, as well as utilize an MRI machine to best diagnose (or rule out) degenerative disc disease. 

The most common treatment methods for degenerative disc disease, which are most often utilized together, include: 

• At-home methods: rest, ice/heat and stretching can help alleviate pain symptoms associated with the beginning stages of the disease
• Exercise: strengthening both the core and back muscles can help to support the spine and alleviate some of the pressure on the discs
• Over-the-counter medications: pain relievers and Non-steroidal anti-inflammatory drugs (NSAIDs) can help to relieve mild acute pain symptoms. It’s important to note that opioid-based medications are no longer recommended. 

Physical therapy: partnering with a trained healthcare provider who can recommend specific strengthening and stretching exercises can help to alleviate symptoms as well as strengthen muscles

• Surgical options: when all conservative methods have failed to provide needed pain relief, surgery might be the best course of action. Spinal fusion of the vertebrae where the degenerated disc is located helps to restrict motion and ease pain. Another similar surgery is dynamic stabilization that helps to support the vertebrae but with more flexible materials that allow for more movement. Artificial disc replacement, or disc arthroplasty, replaced the damaged disc with a new artificial disc. Nucleoplasty, which is the removal of disc material, helps to restore function and relieve pain. It’s important to note that surgery has a greater chance of complications and risks, and patients still may not experience a complete pre-condition range of motion. 

Most people can successfully manage pain symptoms by utilizing at-home and conservative methods. If back pain is mild to moderate, a person can expect to have to actively manage symptoms to experience long-term pain relief. 

Treatment is not only important to relieve pain symptoms, but also to mitigate a person’s chances of degenerative disc disease leading to other conditions such as osteoarthritis, scoliosis, spinal stenosis and more. 

The best way to determine if you have degenerative disc disease and to find pain relief is to partner with a pain management specialist. While many adults will experience some form of degenerative disc disease, there is no reason to live with neck and back pain and stiffness. Treatment options aim to provide patients with increased function and mobility, as well as a reduction of pain. Moreover, The Nevada Advanced Pain Specialists in the Reno, Sparks and Carson City areas are well equipped to properly diagnose and treat all stages of degenerative disc disease with the goal to help their patients achieve their ideal quality of life. If you are suffering from neck and back pain, please schedule an appointment today.

Degenerative disc disease is not really a disease but a term used to describe the normal age-related changes in your spinal discs as you age. The discs act as “shock absorbers” for the spine, allowing it to flex, bend, and twist. Degenerative disc disease can take place throughout the spine, but it most often occurs in the discs in the lower back (lumbar region) and the neck (cervical region). 

What causes degenerative disc disease? As we age, our spinal discs break down, or degenerate, which may result in degenerative disc disease in some people. These age-related changes include loss of fluid in the disc and tiny tears or cracks in the outer layer (annulus or capsule) of the the disc. These changes alone do not result in pain. If pain results it is do to inflammation or abnormal micromotion instability. Click on this link for more information about degenerative disc disease, About Degenerative Disc Disease

If degenerative disc disease is part of the normal aging process and may not result in pain, how is it determined that the disc is the source of the pain? This is done by a procedure called a discogram. A discogram is a procedure where normal and abnormal discs are “pressurized” independently in hopes that the pain is only reproduced when the abnormal disc is “pressurized.” Click on this link for more information about lumbar discograms, Discography.

Treatment options include medications, physical therapy and injections. The injection that is used typically to treat this condition is an epidural. For more information on epidurals, Click on the appropriate spinal segment for more information.

Caudal Steroid Injection
Cervical Epidural Steroid Injection
Lumbar Epidural Steroid Injection
Thoracic Epidural Steroid Injection

If an epidural is not beneficial, the same medication can then be injected using a more direct approach to get the medication right next to the painful disc. This is called a transformational injection. This is done only in the lumbar region because doing this type of injection is dangerous to do in the thoracic or cervical spine region. Click on this link for more information about transformational injections, Lumbar Transforaminal Epidural Steroid Injection.

Another procedure that can be considered but is rarely approved by insurance is intradiscal electrothermal therapy (IDET). In this treatment a catheter is inserted through a needle into the herniated disc. The catheter is heated to a high temperature for up to 20 minutes. The heat thickens and seals the disc wall, reducing the disc herniation and the related spinal nerve compression. Click on this link for more information about IDET, Intradiscal Electrothermal Therapy (IDET).

Nevada Advanced Pain Specialists is recognized as an industry leader in pain management. We have a state-of-the-art facility in Reno, Nevada, that allows for us to offer the highest possible level of quality care of our patients.

We are committed to providing a comprehensive and multi-disciplinary approach for each individual’s pain complaints to provide the most appropriate care. Our approach includes analysis of biomechanics, joint motion, as well as skeletal, nerve and muscle tissues. Every individual is evaluated for the root cause of their pain – not just a “quick fix” approach to only provide symptomatic relief.

Your pain will be evaluated with latest diagnostic tools and technologies used by the professionals at Nevada Advanced Pain Specialists to make accurate assessments including: EMG/Nerve testing, MRIs, x-rays, bone scans, and diagnostic pain injections.