Did you know the term “degenerative disc disease” is actually a misnomer? What was once believed to be a disease by physicians has been revealed to be a natural, and sometimes painful, part of aging. Fortunately, the majority of individuals with degenerative disc disease are treated with pain management techniques without undergoing traditional surgery.
What is Degenerative Disc Disease?
“Bones in the spine – called vertebral bodies – stack on top of each to form the spinal column. Between these bones sit “discs” which act as cushions or shock absorbing pads as you move,” says Matthew R. Willey, M.D., the newest pain management specialist to join the Orlando Orthopaedic Center team. “As one ages, these discs sustain wear-and-tear injuries and may start to breakdown, become compressed or even bulge out to one side of the spinal column. This is what is often referred to as degenerative disc disease.”
As the cushions become less capable of performing their daily duties, the vertebral bodies in the spine may impact each other when walking, running or performing various other activities. This results in intense, sometimes prolonged, pain for sufferers.
“Although it can occur in any region of the spine, it most often appears in the lumbar spine,” Dr. Willey assures. “Aging, arthritis and trauma all play a contributing role in the onset of degenerative disc disease.”
He says the only real symptom a sufferer will feel is pain; and the discomfort can be felt either suddenly after an injury or gradually increase over time.
According to Dr. Willey, pain associated with degenerative disc disease for most individuals may include weakness, tingling, burning, numbness and pressure in the spinal region. Typically, degenerative disc disease is seen in middle-aged, active lifestyle individuals.
Treating Degenerative Disc Disease
Once the appropriate testing has been done and a patient has been diagnosed with degenerative disc disease, it’s time to discuss non-surgical treatment methods. Oftentimes, a pain management specialist, like Dr. Willey, is brought in to create a treatment plan for the patient.
Medication. Over-the-counter and/or prescription medication may be used to treat a patient’s pain as an initial step by the pain management doctor. These medications may include acetaminophen (Tylenol) to control pain or NSAIDs (ibuprofen or naproxen) to reduce inflammation.
“Typically, once we’re brought in to treat a patient, they’re willing to try anything short of surgery to help decrease or eliminate the pain. Medication is a good starting point in many cases,” says Dr. Willey. “If symptoms continue to present themselves, or we can’t find the level of relief we’re looking for, we will continue working with the patient to find other treatment options that might work better.”
“It is important to remember that degenerative disc disease and the resulting pain is just as much a part of life as gray hair. If you put enough miles on your car, eventually your tires are going to wear out.” – Dr. Willey
Activity Modification/Bracing. Many times, a certain motion or activity may cause the pain to present itself or increase to substantially. If that’s the case, a plan to modify said activity through behavioral changes is created with the help of a physical therapist. In addition, doctors may also recommend that the patient wear a back or neck brace to help provide pain relief. Again, an occupational or physical therapist may be brought in to help teach exercises to strengthen the back and/or neck muscles.
“Helping a patient find a pattern that can help them get through the day and get a helpful night’s sleep can really do wonders for pain relief,” says Dr. Willey. “It’s a team effort between myself, the therapist and the patient. We all have to be on the same page for this treatment method to be successful.”
Epidural Steroid Injections. If pain has not improved significantly with medication and activity modification/bracing, a pain management specialist may choose to inject a patient’s spine with corticosteroid medication to relieve pain.
“Patients often report pain relief when using this method to deliver steroids directly into the epidural space in the spine,” says Dr. Willey. “Typically, epidural steroid injections are considered safe and very effective in providing significant pain relief; but we must try to limit patients to no more than three or four injections per year.”
The Purpose of Pain Management
It’s important to note that the purpose of non-surgical pain management treatment for degenerative disc disease is meant to relieve pain and restore daily function to patients. The methods listed will not correct structural issues in a disc or vertebral body.
“It is important to remember that degenerative disc disease and the resulting pain is just as much a part of life as gray hair. If you put enough miles on your car, eventually your tires are going to wear out. While you can replace your tires, medicine has not yet developed the back replacement,” explains Dr. Willey. “We are working on ways to help regenerate the shock absorbers, or discs, but we are not quite there yet. Fortunately, we do have a lot of other methods that can dramatically improve pain and function.”
“Helping patients achieve their highest functional goals with little to no pain is why I went into this specialty,” says Dr. Willey. “It’s a great feeling to see someone go from barely being able to move to returning to walking, sitting, gardening and exercising with a big smile on their face.”
Originally Published in the October 2013 issue of FloridaMD Magazine.