Health Matters: Matters of the Spine: Identifying and Treating Degenerative Disc Disease

Your spinal discs act like shock absorbers between the vertebrae of your spine. They help your back stay flexible, but as you get older, they can wear and tear—causing pain. When the pain becomes problematic, interrupting one’s ability to perform normal, daily activities, it’s referred to as degenerative disc disease.

“This is really common with aging but becomes more of a ‘disease’ when patients are symptomatic, the primary symptom typically being pain,” notes Dr. Patrick Hsieh, neurosurgeon at Keck Medical Center at USC, affiliated with Ridgecrest Regional Hospital. “In your typical mechanical strain or early degenerative disc tears, the pain may only last for a few days or a few weeks at most. The pain tends to get better, because your body does have a self-healing process.”

Patients who experience chronic disabling pain that becomes more of a disease process fall into the category of degenerative disc disease. “Not only is there pain, but some patients develop neurological manifestations that can include weakness, numbness, and loss of function as the result of the disturbances to the nerve roots or the spinal cord,” adds Dr. Hsieh.

Non-Surgical Treatment Options

Diagnosis of symptomatic degenerative disc disease generally starts with a physician’s evaluation—ideally one who has expertise in spine conditions. Per Dr. Hsieh, symptoms can be separated into two components: pain and the aforementioned neurological symptoms.

Conservative, non-surgical treatments are the first line of defense in most cases, including anti-inflammatory medications, anti-spasm medications, and physical therapy to strengthen the muscles surrounding the spine.

“Sometimes, an injection may be indicated. I don’t necessarily start with that right off the bat,” says Dr. John Lui, neurosurgeon at Keck. “We try medications and physical therapy first; also topical patches, heat treatment, soft tissue work. There are a lot of interventions we can try in the beginning stages.”

Is It Time for Surgery?

When conservative treatment options provide little or no relief, particularly after a period of three months, surgery may be considered. To confirm surgical intervention is a viable option, surgeons look for some type of pain generator or disturbance that can be altered with surgical treatments—typically identified with an MRI, CT, or CT myelogram.

“If we see mechanical compression, either from a disc herniation or overgrowth of bone spurs and ligaments, we do a laminectomy or a discectomy, which is removing the portions of the disc or bone spur overgrowth that relieves pressure off the spine,” explains Dr. Hsieh. “In cases where there is instability or mechanical disruption of the spine in terms of stability or alignment, then we may have to do something more complex like a spine fusion.”

Alternative & Innovative Treatment Options

Some treatment options don’t currently have extensive research or medical evidence to back them up, but patients have found them helpful; namely chiropractic adjustments and acupuncture. Clinical trials surrounding stem cell injections and nerve ablation show promise as additional non-surgical therapies.

“With stem cell injections, the hope is that these cells will help repair the environment of the disc and provide healing of the disc at an accelerated pace compared to the natural healing process,” informs Dr. Hsieh. “Nerve ablation involves applying thermal energy to a specific nerve that is sensing pain from the vertebrae. When you burn those nerves away, it can subside the pain. Those are just some examples of the clinical trials and investigative approaches besides surgical treatments.”

Preventative Measures

Most people will experience some form of disc degeneration—simply due to the aging process. However, you can reduce your risk of more severe degeneration by practicing a few preventative measures. Working on core strength, maintaining a healthy weight, being cognizant of your posture, and abstaining from smoking are all important for staving off degenerative disc disease.

“Everybody has bad posture, right? It’s critical to learn what good posture is, how to properly bend and twist. There’s a good way to bend, there’s a bad way to bend,” advises Dr. Liu. “If you keep those things in mind—smoking, your weight, your posture, and trying to maintain a good core—those are all good things to try to prevent this from getting out of control.”

For more information about the Neurosurgery Spine Clinic at Ridgecrest Regional Hospital in alliance with Keck Medicine of USC, visit www.rrh.org/treatment-care/neurosurgery.

**To listen to an interview with Dr. John Lui and Dr. Patrick Hsieh, neurosurgeons at Keck Medical Center at USC—affiliated with Ridgecrest Regional Hospital, follow this link: https://radiomd.com/ridgecrest/item/40121