What Are the Treatments for Lumbar Degenerative Disc Disease?

Lumbar degenerative disc disease is seen often in older people. As people get older, the discs in their spine dry out and become weaker. Most people are not even aware they have this problem because the change is so gradual. Eventually though, it can lead to low back pain, though not always. Sometimes the discs simply get older and weaker, but still function well enough as shock absorbers that a person may not feel discomfort.

What is a Disc?

• A disc is connective tissue that sits between the 24 vertebrae in a person's spine.The lower part of the spine in what is commonly referred to as the lower back is considered the lumbar region. The discs act as shock absorbers when someone puts stress on the spine from activity like jumping. They also protect the vertebrae from gravity.

Reasons for Disc Degeneration

• The discs degenerate gradually over time on their own. The center of the disc, or the nucleus, begins to lose the ability to absorb water and gets dehydrated. This makes the nucleus less able to absorb shock. Tears form and the disc begins to collapse.
  A back injury can exacerbate the issue and cause the discs to degenerate faster, as can smoking.

Symptoms

• Recurring back pain is the most common symptom a person will experience. He will typically have pain for a few days at time, though over time the pain may last longer. The collapsing of the discs can cause inflammation of the nerves and impingement of the vertebrae.

Diagnosis

• To diagnosis lumbar DDD, a doctor will typically do a physical exam which may include an X-ray, testing of reflexes and muscle strength, and a questionnaire.
  If the X-ray does not provide enough information, an MRI may be used. X-rays will show problems with the bones, but an MRI will reveal issues with soft tissues. Often dye may be injected into the affected area to get clearer X-ray results. This test is called a discography.

Non-operative Treaments

• Usually, 97 percent or more of people with lumbar DDD do not need surgery. Prescription pain relief like acetaminophen, anti-inflammatories and/or muscle relaxants may be given for pain management. Massage therapy can help reduce pain as well. Bed rest may also be prescribed. Other helpful treatments may include physical therapy and exercise to strengthen the spine.

Surgical Treaments

• Effective kinds of surgery for lumbar DDD include: lumbar laminectomy, fusion and discectomy. Discectomy involves removing the degenerated disc. Fusion involves fusing the vertebrae above and below the removed disc together. A lumbar laminectomy involves reducing pressure on the spinal nerves by taking out most of the lamina. The lamina is a structure that covers the back of the spinal column.

Surgery Rehabilitation

• After surgery, doctors typically suggest a back brace to be worn for a few weeks. Physical therapy for four to six months afterward is also normal