The fluid-filled discs that serve as shock absorbers between the vertebrae of the spine gradually dry out over time, causing inflammation and instability. This condition, called lumbar degenerative disc disease when it involves the discs of the lower back, causes periodic flare-ups of pain that can usually be treated with a combination of medication, physical therapy, exercise and other conservative treatment, according to a report by Dr. Peter Ullrich, Jr.'s report in the May 3, 2006 issue of "Spine-Health." If conservative therapy is unsuccessful, surgical intervention may be needed.
Medications
Over-the-counter pain medications such as acetaminophen or non-steroidal anti-inflammatory drugs can relieve mild to moderate back pain. Some patients experience temporary relief with topical agents applied to the skin. For more severe pain, prescription medications such as steroids, narcotics or muscle relaxants may be needed. Injecting steroids into the spine, called an epidural injection or nerve block, can relieve pain by reducing inflammation and swelling. These injections are tried only when conservative treatment has failed and are not always successful.
Physical Therapy
Physical therapy can help to relieve acute back pain and prevent future episodes. Heat therapy, ice massage, ultrasound and trans-cutaneous electrical nerve stimulation or TENS units can help to stimulate blood flow, reduce pain and promote healing.
Most patients with lumbar degenerative disc diseases benefit from a combination of strength training, stretching and low-impact aerobic exercise. Pool therapy in warm water is especially therapeutic.
Passive Treatment
Chiropractic manipulation relieves pain in the lower back by restoring blood flow, reducing pressure on sensitive areas, relieving muscle tension and increasing range of motion. Therapeutic massage reduces muscle stiffness, raises endorphin levels and improves range of motion.
Lifestyle Changes
Lifestyle changes, in combination with pain relief measures, can provide long-term benefits to the patient with lumbar degenerative disc disease, according to Dr. Ullrich. Quitting smoking can improve blood circulation to the back and promote healing, and weight loss reduces the strain on the lower back. Using ergonomically sound techniques for lifting and office work, as well as wearing supportive shoes and avoiding standing for long periods, can assist with preventing further damage and pain.
Surgery
If the patient does not improve significantly after trying conservative treatment, surgery may be recommended. Spinal fusion locks two or more vertebrae together, alleviating pain in that segment of the spine, but this procedure permanently alters the patient's ability to move and may also hasten the development of degenerative disc disease above and below the fusion, according to Cedars-Sinai Spine Center. A newer procedure, artificial disc replacement, relieves pain while preserving the motion of the spine. The FDA only approved the artificial disc in 2007, so long-term effects are not known.
References
- Spine-Health: Degenerative Disc Disease Treatments
- Cedars-Sinai Spine Center: Degenerative Disc Disease
- University of Maryland Spine Center: Patient's Guide to Degenerative Disc Disease
- Cedars-Sinai Spine Center: Artificial Disc Replacement
- University of Maryland Medical Center: Artificial Disc Replacement
