When discopathy, also known as degenerative disc disease (DDD), is diagnosed, one of the first things many patients ask is, “Will I need surgery to solve the problem?” For most people, the answer is no. In fact, you must have quite serious symptoms for your doctor to recommend surgery.
Degenerative disc disease is an age-related condition that occurs when one or more discs between the vertebrae of the spine deteriorate or break down, leading to pain.
Your doctor may suggest an injection or medication to help deal with your pain. The severity of your symptoms determines what medications you may need, and it also matters whether your pain is acute or chronic.
Acute pain is sometimes described as feeling a sudden flame.
Chronic pain is long-term, and as the disease progresses, you are more likely to have chronic pain than acute pain.
As with any medication or injection, you should not take anything without first consulting your doctor to see if this is really the best option for you. You will most likely go through a progression of medications starting with over-the-counter drugs.
If they do not work, your doctor may prescribe stronger ones. But even if they don’t help, then you can resort to injections that send the stronger drug right into the source of the pain.
Causes of this condition
Intervertebral discs, also known as intervertebral fibrocartilage or spinal discs, provide padding between the vertebrae of the spine. They have an elastic structure composed of fibrocartilage tissue.
The outer part of the disc is known as the annulus fibus. It is tough and fibrous and consists of several overlapping layers. The inner core of the disc is the nucleus pulposus. It is soft and gelatinous. Intervertebral discs reduce stress when your spine moves or carries your weight. They also help the spine to bend.
With age, repetitive daily loads on the spine and accidental injuries, including minor and unnoticed ones, can damage the discs.
The changes include:
- Fluid loss: The intervertebral discs of a healthy and young person is 90 percent fluid. With age, the fluid content decreases, which makes the disc thinner. The area between the vertebrae becomes less effective in its role as a cushion or shock absorber.
- Disc structure: Very small tears or cracks appear in the outer layer of the disc. The soft and gelatinous material on the inside can penetrate cracks or tears, causing the disc to swell or tear.
The disc may break into fragments. When the vertebrae have fewer pads between them, the spine is more unstable
To compensate for this, the body builds up osteophytes or bone spurs, small bony protrusions that develop along the edge of the bones.
These projections can be pressed against the spinal cord or spinal nerve roots. They can undermine nerve function and cause pain.
Other problems include:
- Destruction of cartilage
- A swollen disc known as a herniated disc
- Narrowing of the spinal canal or spinal stenosis
These changes can affect the nerves, leading to pain, weakness, and numbness.
Age is the biggest risk factor, but some other factors can accelerate the process of degeneration.
- Intensive physical work
- Acute or sudden injury, such as from a fall.
Degenerative disc pain can begin when an injury leads to sudden and unexpected back pain. Or it may present as a mild pain that worsens over time.
Types of spinal injections for degenerative disc diseases
Epidural steroid injection
This is one of the most common injections. In many people, an epidural steroid injection (ESI) is effective in reducing back pain caused by a herniated disc.
An epidural steroid injection is aimed at the space around the membrane that covers the spine and nerve roots. This injection sends steroids – very strong, anti-inflammatory drugs – right to the nerve root which is inflamed. This is a pain management therapy, so it can be performed under fluoroscopy (real-time X-ray).
You may need two or three injections, but generally you should not receive more than that because of the potential unpleasant side effects of steroids.
Injection for the facet joint
This injection is only useful if one (or more) of your facet joints are causing pain. A steroid drug (a strong anti-inflammatory) is injected into the protective capsule of the joint. The drug acts to relieve inflammation and reduce joint pain.
Disc injections are mainly used to reduce the pain in the lower back experienced by patients suffering from discopathy. These injections are given using a hypodermic needle that is inserted into the patient’s discs that have been torn due to the disease. Disc injections contain steroids that reduce inflammation and thus provide the patient with immediate relief from back pain.
Although most patients with degenerative disc disease respond well to non-surgical treatment, some require surgery. Surgery should be considered only after you have tried several months of non-surgical treatment.
Patients who do not respond to conservative therapies within about 3 months may consider surgery.
This may be an option if you have:
- Back or leg pain that stops you from doing regular, normal, daily activities
- Numbness or weakness in the legs
- Difficulty standing or walking
The following surgical options are available:
This is the fusion of two vertebrae into one to ensure the stability of the spine. The operation can be done anywhere in the spine, but is done more often in the lower back and neck area. These are the parts of your spine that move the most.
This surgery can relieve extreme pain in patients whose spine can no longer bear their weight, but it can also accelerate disc degeneration in the fused vertebrae.
In this case, part of the joint of the disc is removed so that the pressure on the nerves can be relieved. A patient who develops osteoarthritis, disc herniation, or spinal stenosis may need other treatments.
Stem cell surgery
The purpose of this surgery is to promote regeneration of functional cartilage using an injectable hydrogel system. The researchers conclude that this operation may be useful for the regeneration of intervertebral discs.
Additionally, you can try some other methods to alleviate the discomfort associated with your condition:
- Healthy diet. It is advisable to include healthy foods such as fruits, vegetables, whole grains, beans and healthy fats, such as olive oil and / or coconut oil, which will help you maintain a normal body weight. This is because being overweight can put extra pressure on your spine, which in turn can lead to increased back pain.
- Exercise: Regular, gentle training, including light aerobic and strengthening exercises, can help you deal with the symptoms of degenerative disc disease. Work with a personal trainer who has experience in helping people with spinal conditions. He or she will show you specific exercises that can help relieve pain and other symptoms
Your trainer can also develop a detailed, personalized physical therapy program. Regular physical therapy sessions will teach you proper body mechanics, good posture and how to avoid positions that cause pain.