FAQ’s on Degenerative Disc Disease Treatment in Las Vegas

 

Degenerative Disc Disease (DDD)

A common age-related disease of the spine is degenerative disc disease (DDD). Intervertebral discs lie between each vertebra, and pain related to these discs is called discogenic pain. With daily stress and loss of inner water content, the disc degenerate over time.

How common is degenerative disc disease?

The average age of DDD onset was reported at 66 years, according to a recent study involving 1,000 people. According to statistics, 77% of women and 71% of men under the age of 50 years have degenerative disc disease. For people older than age 50 years, the prevalence rate can be as high as 90%.

What are intervertebral discs?

Discs serve as padding for the spine bones (vertebrae). The outer layer is composed of a fibrocartilage padding (annulus fibrosus), and the inner layer is filled with a gel-like material (nucleus pulposus). In healthy adults, the nucleus has 90% water content.

What causes degenerative disc disease?

The intervertebral discs lose water content from wear-and-tear and aging. With damage, the outer layer becomes thinner, and the loss of water content causes the distance between the vertebra to lessen. With cracks and tears, the disc’s outer later splits, and the inner gel-like material will leak out. Any injury or trauma to the disc can increase the degeneration process.

What symptoms and signs are associated with DDD?

The most common symptom of degenerative disc disease is neck or back pain. However, some patients with DDD do not have any symptoms. When the discs cause bone shifting, and nerves are impinged, the patient may experience leg pain, numbness, and tinging.

How does the doctor diagnose degenerative disc disease?

The pain management specialist suspects DDD when the patient has back pain. To make a diagnosis, the doctor will take a medical history and conduct a physical examination. Diagnostic tests can confirm a diagnosis of degenerative disc disease, including x-rays and magnetic resonance imaging scans. To determine if the outer layer of the disc is severely damaged, the doctor may perform a discogram, which involves injecting the disc with dye.

What are the treatment options for degenerative disc disease?

DDD treatment is different for every patient. Therapy depends on the extent of the disc damage, the severity of the spine disease, and the patient’s other conditions. Combination of treatments often are used. These include:

  • Physical therapy – Designed to improve muscle strength and spine range of motion, a short course of physical therapy often improves the pain associated with DDD. For pain relief, the therapist can use ultrasound, heat/cold therapy, and electrical stimulation.

 

  • Medications – The drugs of choice for DDD are nonsteroidal anti-inflammatory drugs (NSAIDs), such as ketoprofen and naproxen. For severe pain, the doctor may prescribe narcotic analgesics and a short course of steroids.

 

  • Intradiscal injection – The pain specialist can inject the disc with a corticosteroid agent or other substance. In a recent study, corticosteroid injection was proven effective and safe for relief of back pain associated with DDD.

 

  • Disc regenerative therapy – The doctor can inject the disc with a solution composed of dextrose and glucosamine. This substance stimulates new collagen growth and improves the strength of the disc. According to a recent research study, this therapy proved to greatly reduce discogenic pain.

 

  • Epidural steroid injection (ESI) – When nerve compression is involved, the doctor can inject a corticosteroid, with or without a long-acting anesthetic, into the space outside the spinal cord. ESI alleviates irritation of the nerve root near the damaged or injured disc. In clinical studies, ESI has shown a 90% efficacy rate.

Resources

Abdi, S, Datta, S, Trescot, AM et al. (2007). Epidural steroids in the management of chronic spinal pain: a systematic review. Pain Physician, 10(1), 185-212.

Muzin S, Issac Z, & Walker J (2008).The role of intradiscal steroids in the treatment of discogenic low back pain. Curr Rev Musculoskelet Med, 1(2), 103-107. doi:  10.1007/s12178-007-9015-y

Teraguchi, M., Yoshimura, N., Hashizume, H. et al. (2014). Prevalence and distribution of intervertebral disc degeneration over the entire spine in a population-based cohort: the Wakayama Spine Study. Osteoarthritis and Cartilage, 22(1), 104-110.