Personalized treatments for people with back pain and spine disorders
Published: Feb. 14, 2008
Updated: Nov. 17, 2010
Disks are a soft, rubbery pads located between the bones (vertebrae) of the spine. They allow the spine to be flexible and act as little shock absorbers.
Disks are made up of a tough outer edge called the annulus, and a soft, gel-like center called the nucleus. These disks degenerate naturally with age and do not always cause problems.
Degenerative disk disease (DDD) describes a condition in which a painful disk causes constant lower back pain.
DDD is caused by natural degeneration or a disk injury. Many times, DDD starts when a twisting injury weakens the disk and it is no longer able to hold its section of the spine together as it should.
Inflammation and excessive micro-motion at that specific spinal segment irritate and cause pain in that area.
This is a chronic pain in one localized area of the back, usually the lower back. The disk cannot heal itself, so once pain starts, it is usually chronic.
It is rare that pain from DDD will progressively worsen, but it can fluctuate, and may be severe at times.
X-rays can be used to look at the position of the vertebrae and disk space between these bones. Magnetic resonance imaging (MRI) can show the condition of the disk and disk space.
Conservative treatment is the first approach to treating degenerative disk disease. Anti-inflammatory medications such as ibuprofen can treat the pain and decrease inflammation. Physical therapy may also be used, including exercises to strengthen back and abdominal muscles, as well as stretching to increase flexibility.
Epidural steroid injections or oral steroids may be prescribed if the conservative treatment does not work or if the pain is severe.
Spinal fusion surgery may be an option for patients with extreme pain or excessive functional limitations. This surgery involves placing a piece of bone onto the back of the spine. As this bone graft heals, the vertebral bodies above and below the disk are fused together. Metal screws and rods or cages may be used to stabilize the bones as they heal. A fusion is helpful for DDD because it stops the motion at that level, minimizing irritation at that segment of the spine.