From the Guidelines
Degenerative disc disease should be managed with a conservative approach, prioritizing lifestyle modifications and physical therapy, as these interventions have been shown to improve quality of life and reduce morbidity. Treatment typically begins with conservative approaches including over-the-counter pain medications like ibuprofen (400-800mg three times daily) or naproxen (220-500mg twice daily) for inflammation and pain relief 1. Physical therapy focusing on core strengthening exercises and proper body mechanics should be performed 2-3 times weekly for 6-8 weeks. Heat therapy for 15-20 minutes several times daily can relax muscles, while ice packs applied for 15-20 minutes can reduce inflammation during flare-ups. For persistent pain, prescription medications such as muscle relaxants (cyclobenzaprine 5-10mg) or gabapentin (starting at 300mg daily, increasing as needed) may be prescribed.
Some key points to consider in the management of degenerative disc disease include:
- Maintaining a healthy weight to reduce pressure on the spine
- Practicing good posture to reduce strain on the spinal discs
- Avoiding prolonged sitting and taking regular breaks to stretch and move
- Quitting smoking to improve overall health and reduce inflammation
- Considering alternative therapies such as acupuncture or acupressure for pain management 1
It is essential to note that surgery is typically reserved for severe cases with neurological symptoms or when conservative treatments fail after 6-12 months. This condition occurs because spinal discs lose water content and elasticity with age, becoming less effective as shock absorbers, which can lead to pain when the vertebrae have less cushioning between them. By prioritizing conservative management and lifestyle modifications, individuals with degenerative disc disease can improve their quality of life and reduce their risk of morbidity and mortality.
From the Research
Definition and Causes
- Degenerative disc disease is a condition that affects the spinal discs, causing pain and discomfort in the lower back 2.
- It can affect younger and middle-aged people with premature disc degeneration 2.
- The disease is often caused by wear and tear on the spinal discs, leading to disc space narrowing, end-plate sclerosis, or vacuum phenomenon in the disk 3.
Symptoms and Diagnosis
- Symptoms of degenerative disc disease include transverse low back pain that radiates into the sacroiliac joints 3.
- Radicular or claudicatory symptoms are generally absent unless there is concomitant nerve compression 3.
- Physical examination findings are often unremarkable, but radiographic examination and magnetic resonance imaging can help reveal the extent of the disease 3.
Treatment Options
- Conservative treatment options include physical therapy and nonsteroidal anti-inflammatory drugs 3.
- Exercise therapy is widely used and is the most conservative form of treatment for chronic low back pain 4.
- Stabilizing exercises have been shown to be more effective than mobilizing exercises in reducing pain and improving functional status 2.
- Pharmacotherapies such as acetaminophen, nonsteroidal anti-inflammatory drugs, and opioids may be used to manage pain, but their use should be carefully evaluated due to potential risks and side effects 4.
- Regenerative treatments, including stem cell and bone marrow concentrate therapies, are being explored as potential treatment options, but more research is needed to fully understand their effectiveness 5.
- Surgical options, such as laminarthrectomy and interspinous process distraction, may be considered in severe cases where conservative treatment has failed 6.