Lumbar Degenerative Disc Disease Treatment in and around Atlanta
What is Degenerative Disc Disease?
Degenerative disc disease is a misunderstood condition, despite being one of the leading sources of back pain and neck pain. This condition is not actually a disease -- it is part of the normal aging of the spine. In this condition, the discs in the spine (the pillow-like pads between the bones) lose their cushioning. When this happens, it can cause persistent pain in the lower back, legs, neck or arms.
Lumbar degenerative disc disease treatment can include
medications and physical therapy. Sometimes neck or back surgery is needed if the pain is severe and causes a person the inability to participate in everyday activities.
Pain and Symptoms
Most patients with lumbar degenerative disc disease will experience low-grade continuous but tolerable pain that will occasionally flare (intensify) for a few days or more. Pain symptoms can vary, but generally are:
Centered on the lower back, although it can radiate to the hips and legs
Frequently worse when sitting, when the discs experience a heavier load than when patients are standing, walking or even laying down
Exacerbated by certain movements, particularly bending, twisting or lifting
The low back pain associated with lumbar degenerative disc disease is usually generated from one or both of two sources:
Inflammation, as the proteins in the disc space irritate the surrounding nerves, and/or
Abnormal micro-motion instability, when the outer rings of the disc - the annulus fibrous – are worn down and cannot absorb stress on the spine effectively, resulting in movement along the vertebral segment
For most people, degenerative disc disease can be successfully treated with conservative (meaning non-surgical) care consisting of medication to control inflammation and pain (either oral or injection), and physical therapy and exercise. Surgery is only considered when patients have not achieved relief over six months of conservative care and/or are significantly constrained in performing everyday activities.
Patients unable to function because of the pain or who are frustrated with their activity limitations may consider spinal Lumbar Fusion surgery. Fusion surgery works because it stops the motion at a painful motion segment. A one-level fusion at the L5-S1 segment does not significantly change the mechanics in the back and is the most common form of fusion, as this is the most likely level to break down for degenerative disc disease.
Fusion of the L4-L5 level does remove some of the normal motion of the spine as this is a major motion segment (as opposed to L5-S1 which has really limited motion) Multi-level fusions are more problematic. A two-level fusion may be considered for patients with severe, disabling pain, but three-level fusions are not recommended because back movement is too diminished and altering the muscle composition can in and of itself cause pain (this has been termed fusion disease).
While it is a major surgery, fusion surgery can be an effective option for patients to enhance their activity level and overall quality of life. This is particularly true now that minimally invasive techniques are available to decrease post-operative discomfort, preserve more of the normal anatomy of the low back, and result in higher rates of fusion than previous techniques. Dr. Bendiks’ pioneering percutaneous Lumbar Fusion done through a few small poke holes in the skin may be an option for your painful back if other treatment options have failed. Please Contact Dr. Bendiks to find out if you are a candidate for his surgery. To learn more about this technique, please click on Lumbar Fusion.