As we get older, almost all people develop some measure of degenerative disc disease. In this condition, the discs between our spinal vertebrae decrease in height and bulge outwards due to a combination of the aging process, genetics and wear and tear.
When the discs wear out, we get shorter in height, possibly experience back deformities and back pain. But disc degeneration alone, without the complicating features of nerve irritation or spinal instability, is usually not a direct source of back pain.
The Trouble in Diagnosing Disc Degeneration
Since you may have disc degeneration, spinal stenosis, facet joint arthritis, muscle spasms or other spine problems all at once, diagnosis of pain from simple disc degeneration can be difficult. It can take several steps and many doctor visits to diagnose this condition. The right diagnosis is essential for effective treatment.
The diagnostic process may include a comprehensive history, physical exam and imaging tests like MRIs, differential injections and discograms. For instance, if injections of pain relieving medications are effective when directed to one specific part of the spine, that can help your doctor determine where the pain generator is.
Imperfect Treatment Options
After diagnosis, you should try non-invasive treatments first to see if they help. These may include pain medications, bracing and physical therapy. If all these treatment options fail, you may qualify for surgery like disc replacement or spinal fusions. These surgeries can be done minimally invasively. They are most effective in situations where only one disc is involved and little to no generalized arthritis is present in the spine.
While newer treatments are available, they sometimes aren’t covered by insurance. For instance, a new FDA-approved, ablation procedure burns away the central nerve that supplies pain sensation to the disc. The procedure is performed under X-Ray guidance usually done in an Ambulatory Surgery Center under light sedation. In the right patient, the procedure can offer pain relief without a large operation.
Other newer treatment options include injecting a specific protein, concentrated from the patient’s own blood, into the offending disk. However, this treatment only works for people whose disc degeneration has certain biomarkers or chemical characteristics.
While the diagnoses and the treatment of pain from disc degeneration is not a perfect process, a qualified and experienced spine surgeon will work with you to ensure you receive the least invasive and most effective treatment possible.