Duke spine specialists help you find relief from severe back and nerve pain, weakness, and loss of function, and even inflammation associated with degenerative disc disease. Expert treatment is especially important if your pain or symptoms are not getting better and you’re experiencing numbness, tingling, or weakness. We offer a wide range of conservative and surgical approaches to improve your quality of life.
About Degenerative Disc Disease
This common condition is a natural result of aging, but at an accelerated rate. Spinal discs pad vertebrae in your spine and absorb shock. Wear and tear may cause the discs to lose their shape and become weak -- sometimes putting pressure on nerves. Eventually your discs can bulge or even rupture, causing severe pain and potential nerve compression. As it progresses, disc disease can lead to spine arthritis conditions like spondylosis, radiculopathy (pinched nerve), spondylolisthesis (a slipping vertebra), and other spinal deformities.
Duke Health offers locations throughout the Triangle. Find one near you.
A conservative degenerative disc disease treatment approach is the first step and controls pain for most people. In addition to rest and heat or ice, your back doctor may suggest:
Besides over-the-counter pain relievers, nerve medications may help relieve nerve symptoms, and short-term steroids can help reduce inflammation. Medication is typically combined with physical therapy as your first step.
A trained physical therapist guides you in exercises and stretches designed to strengthen your back, improve your balance and flexibility, and improve range of motion -- all benefits that can alleviate your pain.
Epidural steroid injections treat inflammation and pain right at the source -- your pinched nerve roots or arthritic joints. Using X-ray imaging as a guide, a doctor numbs your skin and places a needle into the pain source in your spine. You’ll feel pressure during this. The medicine usually begins working within a few days to a week. You’ll be able to return to normal activities the following day. We give these injections in a special, sterile suite.
In some cases, a rigid or semi-rigid back brace may provide comfort by stabilizing your spine.
Some people find relief from acupuncture, chiropractic care, or aquatic therapy. Nutritionists and weight loss specialists can help manage disc problems caused by obesity. We offer these treatments as a complement to your regular treatment plan, not as a substitute.
If you require spine surgery for disc problems, we use minimally invasive approaches whenever appropriate.
For this minimally invasive procedure, surgeons work through a small incision to remove a portion of disc and bone to relieve pressure on a nerve. You will need general anesthesia, and you will probably be able to go home within 24 hours. You’ll need to limit activities for 6 to 12 weeks after surgery.
Surgeons remove the back part (the lamina) of one or more vertebrae to create more space in the spinal canal and relieve pressure on nerves or the spinal cord. This procedure requires general anesthesia and a short hospital stay.
We offer complex spinal reconstruction (or spinal fusion) surgery to correct spinal problems. These procedures stabilize your spine with rods and screws and fuse together the vertebrae. Whenever possible, we use the least-invasive technique available so that you can recover faster and experience less pain and fewer complications.
Disc Replacement (Total Disc Arthroplasty)
This newer option replaces your damaged disc with an artificial disc. This procedure requires general anesthesia. Generally, you are able to go home the same day as surgery or the following day. You’ll need to limit activities for several weeks to months.
Your doctor may order one or more of the following tests to find the cause of your pain and determine next steps.
By taking pictures of bones and joints in your back, X-rays can help identify fractures, tumors, dislocations, bone spurs, instability, or other potential causes of pain. X-rays take about 15 minutes and are virtually painless. Because X-rays only show bones, and not discs or nerves, an additional imaging test may be needed.
MRI (Magnetic Resonance Imaging)
Magnets and radio waves create detailed pictures of your spine, including your discs and nerves. Images can help identify disc damage or pinched nerves. This test takes about 30 to 60 minutes and is virtually painless.
CT (Computed Tomography)
A series of cross-sectional pictures produce detailed, 3-D images of your spine. This test takes about 30 to 60 minutes and is virtually painless.
A dye is injected into the sac around the nerve roots in your spinal cord to make them more visible on a CT scan. This test is often used for people who are unable to get an MRI. You will probably feel some discomfort during the injection. This test takes about 1 or 2 hours.
Where you receive your care matters. Duke University Hospital’s nationally ranked orthopaedics, neurology, and neurosurgery programs were named best in North Carolina by U.S. News & World Report for 2019–2020.
Why Choose Duke
A Team of Specialists
In addition to neurosurgeons and orthopaedic surgeons, your team may include physiatrists (physical medicine and rehabilitation doctors who specialize in conservative spine care), physical therapists, psychologists, pain management experts, an acupuncturist, a chiropractor and others -- all of whom work with you to alleviate the pain and inflammation caused by your disc condition.
Personalized Treatment Plans
We aim to help you avoid surgery, if possible. That’s why our approach involves a combination of treatments to target the cause of your pain and improve symptoms. If you are a candidate for surgery, we use the least-invasive surgical techniques whenever possible, so you recover quickly and experience less pain and fewer complications.
High-Volume Spine Center
Research shows that hospitals and surgeons who perform more surgeries tend to have better outcomes. Our surgical team performs more than 3,000 spine surgeries every year and sees over 40,000 patients.
Operating Room Technology
Our ORs are equipped with real-time imaging options that give spine surgeons detailed, 3-D pictures and video of your spine. These systems help avoid the need for extra imaging after surgery, exposing you to less post-operative radiation. Our surgeons may also use a sophisticated navigation system -- similar to GPS for your body -- that helps them avoid vital nerves and other structures. This allows for more surgical accuracy than ever before.