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Spine Conditions

Degenerative Disc Disease Treatment Options

Degenerative disc disease is not a disease. It is a condition in which the vertebral discs wear down as a consequence of the normal aging process. The discs lose their ability molecularly to hold water or hydration and dry out, and they are prone to tearing or rupturing with even a minor strain or twist. In some cases, the discs may completely wear away over time, leading to direct contact between the bones. This bone-on-bone friction can result in the pain and stiffness associated with osteoarthritis.

Most disc degenerations cause no symptoms, but certain conditions associated with degenerative disc disease sometimes require surgery. These include cauda equina syndrome (Issues controlling bowel and bladder), infection, tumors, and trauma from a fall, assault, or collision. However, the majority of patients will improve without surgical treatment.

Most initial treatment efforts for degenerative disc disease are conservative. The aim is to manage symptoms to improve quality of life. Conservative treatments include:

  • Physical Therapy: Physical therapy can strengthen the core and muscles supporting the spine, improve flexibility, and increase the range of motion. These exercises can help relieve the pressure on the spinal discs.
  • Cognitive Behavior Therapy is a form of psychotherapy that can help you learn to cope with back pain.
  • Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen can help reduce inflammation and relieve pain. In some cases, stronger medications like muscle relaxants or oral corticosteroids may be prescribed.
  • Lifestyle modification: Avoiding activities that worsen pain, weight management, and smoking cessation.
  • Interventional Pain Management: This includes epidural steroid injections for short-term relief of pain.
  • Acupuncture: Acupuncture can help relieve pain in some patients.
  • Chiropractic Care: This can sometimes reduce pain and improve function.

Surgery may be an option when conservative measures do not provide relief and quality of life is significantly impaired.

  • Discectomy: Removal of a part of the disc that is pressing on a nerve root.
  • Laminectomy: This involves the removal of a part of the bone over the spinal column to relieve pressure on the nerves or spinal cord.
  • Anterior cervical discectomy and fusion: This surgery is commonly performed to treat cervical degenerative disc disease. During surgery, the damaged disc is removed (discectomy) to relieve pressure on nerve roots and/or spinal cord, and the space between the vertebrae is fused using a graft (from the patient’s bone or a synthetic material).
  • Lumbar spinal fusion: Spinal fusion is the sgold-standardsurgical treatment for lumbar disc degeneration. It involves fusing or joining two or more vertebrae with implants, plates and rods, and bone grafts to stabilize the spine. The goal is to eliminate pain by eliminating motions at the spinal joints. In select patients, this procedure can be performed as outpatient surgery.
  • Artificial disc replacement: This procedure is available for patients with one or two levels of disc disease up to age 65 who have chronic pain and do not have significant facet joint disease, spinal stenosis, or spinal instability. The damaged disc(s) is removed and replaced with an artificial disc. It can be used for cervical and lumbar degenerative disc disease. This option preserves spinal motion. This procedure is for carefully selected patients to reduce pain and disability.

Contact Dr. Hieu Ball to schedule a consultation at his San Ramon. He offers a full range of treatments for neck pain. Dr. Ball offers state-of-the-art patient-centered care for patients with neck, mid-back, and low-back problems. He received his orthopedic and spine surgery residency and fellowship training at Harvard Medical School and UCLA-affiliated institutions. Education included training at Massachusetts General Hospital, Brigham and Women’s Hospital, and Boston Children’s Hospital. Dr. Ball is a double fellowship-trained orthopedic spine surgeon. He received a pediatric spine fellowship at Boston Children’s Hospital and a second adult spine fellowship at UCLA. Dr. Ball offers minimally invasive spine care, and many procedures often may be performed on an outpatient basis in an ambulatory surgical center setting.

References

  • Donnally III CJ, Hanna A, Varacallo M. Lumbar Degenerative Disk Disease. [Updated 2023 Aug 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.¬†Available from:https://www.ncbi.nlm.nih.gov/books/NBK448134/
  • https://www.arthritis.org/diseases/degenerative-disc-disease
  • Shan Y, Zhang J, Ma Y, Zhang Y. The effects of acupuncture combined with Western medicine in treating neck, shoulder, lumbar, and leg pain. Am J Transl Res. 2023 Jun 15;15(6):4246-4254. PMID: 37434859; PMCID: PMC10331671.
At a Glance

Dr. Hieu Ball

  • Double fellowship-trained orthopedic
  • Orthopedic surgery residency at Harvard Medical School
  • Over 20 years of spine surgery experience
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