Most of us take our backs for granted. It’s the only one we have, but we use it indiscriminately for hard labor, excessive sports, and long hours of sitting or standing, usually with incorrect posture and expect it to keep on being our main system of support. Our backs are subject to injuries and strains on a daily basis, yet we only notice them when they actually hurt.
As children and young adults, our backs normally hurt after an injury; these injuries run the gamut from slight sprains or strains all the way up to broken vertebrae. The extent of the injury determines the length of recovery and the likelihood of chronic back pain.
Degenerative Disc Disease
Degenerative disc disease is normally an age-related condition; after long years of use and misuse, the discs separating the vertebrae begin to degenerate.
Degenerative disc disease results when the disc space narrows, causing compression of the spinal vertebrae. There is currently no cure or explanation of its cause.
Degenerated discs cause severe, chronic back pain. The condition, if untreated, causes limited mobility and may result in disability.
Chronic low back pain may radiate to the hips, or the pain may be located in the buttocks and thighs. Pain may radiate when the patient bends, twists, sits or lifts. Chronic neck pain, radiating into the head, shoulders, arms, and hands, may come from degeneration of the cervical vertebrae in the spine.
Treatments for Degenerative Disc Disease
Surgical treatment of degenerative disc disease is not always required; the same treatments used for sciatica pain – bed rest, exercise or physical therapy, pain medication, acupuncture, acupressure, yoga or gentle stretching should always be tried first. If, after three months, these therapies are ineffective, a surgical option is a next option in allopathic medicine to be considered. The main surgical therapy for degenerative disc disease is spinal fusion, but many options exist depending on the area of the spine affected:
Anterior cervical discectomy and fusion
A procedure to remove the intervertebral disc and replace it with a plug or graft, which in time will fuse the vertebrae. This procedure accesses the cervical spine from the front of the neck, instead of through the spinal area.
In this procedure, a portion of the vertebrae and disc are removed to decompress the spinal cord and spinal nerves. The spine is stabilized with a bone graft, and in some cases, a metal plate and screws.
After a discectomy, a stabilization device is implanted in the affected vertebrae to offload pressure and to allow the spinal column to flex still and extend.
This procedure increases space in the spinal column by removing part of a facet.
Procedure to increase the size of the nerve pathway by enlarging the vertebral foramen. This procedure may be performed as part of a laminotomy, or performed alone.
Intervertebral disc annuloplasty (IDET)
This procedure is done to seal the affected disc with heat. The affected disc is heated to 90° C for a period of fifteen minutes. The procedure may also deaden the nerves irritated by the degeneration of the disc.
Intervertebral disc arthroplasty
Also known as artificial disc replacement or total disc replacement. In this procedure, a degenerated disc is completely removed and replaced with an artificial one. Used cautiously in the United States, it is widely practiced in Europe.
This procedure is used to reconstruct the spinal canal, making more room for the spinal cord. The spinal column in accessed from the back of the neck.
This procedure relieves pressure on the nerve roots by removing a small portion of the lamina.
Uses a laser or surgical instrument to remove part of a herniated disc while the area is magnified by a loupe or an operating microscope. This is classified as a minimally invasive procedure.
Percutaneous disc decompression
Reduces a bulging or herniated disc via aspiration through a needle inserted into the affected area. Also classified as a minimally invasive procedure.
A non-invasive procedure; it utilizes rehydration of the spinal discs to temporarily enlarge the intervertebral foramen.
Relieves pressure on the spinal cord by removing or trimming the lamina. The removal of the lamina creates space in the spinal column.
New therapies are under investigation, such as adult stem cell disc regeneration, but this therapy is a long way away from becoming accepted practice. Other therapies are also under investigation at this time.
It is possible to treat degenerative disc disease without resorting to surgery, and all available non-surgical options should be given as long a trial as is feasible before resorting to surgery. Surgical procedures involve tremendous back pain and long rehabilitation periods, so avoid them if at all possible.