Degenerative disc disease is a natural process of aging characterized by the compression and wearing away of the discs located between the vertebral bones of the spine, most commonly in the low back. The discs function to protect the vertebral bones from the effects of gravity on the spine and separate the bones enough to allow room for the spinal nerves to exit and innervate the muscular and tissues of the body. Disc disease can cause compression of the spinal nerves and inflict pain and weakness. To treat disc disease, physicians recommend more conservative measures before discussing surgical methods to reduce symptoms.
Rest
Degenerative disc disease can cause an acute bout of back pain by compressing the nerves that exit the spine. The University of Maryland Medical Center recommends rest to relax the back muscles and relieve nerve compression; however, it is not recommended to remain in bed beyond two to three days, as this can weaken the muscles and predispose you to further injury. A physical therapist may recommend certain exercises to perform at regular intervals during bed rest to reduce the likelihood of muscle atrophy, or weakness.
Medication
To help with pain control, medications to reduce inflammation are prescribed. Over-the-counter medications, such as aspirin or ibuprofen, reduce inflammation and pain; however, they are not recommended during pregnancy or if you suffer from kidney disease. Severe pain is treated with narcotics such as codeine or morphine, which can cause side effects such as nausea, sedation or constipation. UMMC does not recommend a prolonged course of narcotic drugs since they are addictive. Epidural steroid injections, or nerve blocks, are administered in extreme cases. A steroid such as cortisone is injected into the epidural space of the spinal cord to relieve pain.
Physical Therapy and Exercise
To relieve muscle spasm and to strengthen the back musculature, physical therapy and exercise are recommended. Physical therapy includes using massage, electrical stimulation and ultrasound modalities; strength and flexibility training; and pool therapy to strengthen the musculature and reduce the pressure of gravity on the spine. Posture training is also useful to maintain correct postural alignment, according to UMMC.
Surgery
If the conservative treatments for disc degeneration do not work and your condition progresses to severe chronic pain with neurological symptoms such as numbness, tingling and weakness of the legs, surgery can be discussed with your physician. The surgical procedure chosen will depend upon the clinical nature of your symptoms. Procedures include the following: spinal fusion, where the disc is removed and the vertebral fused together; disc replacement that is much like hip or knee replacement, where the disc is replaced with a plastic disc; laminectomy, a decompressive procedure to enlarge the space available for the spinal nerves by removing bone tissue and parts of the vertebral bone; laminotomy, which is similar to laminectomy except less bone is removed and it lessens the chance of spinal instability following surgery; and laminoplasty, which reshapes a portion of the vertebral bone at the back to relieve pressure on the spinal nerves, according to UMMC and the University of Connecticut Health Center.
