Degenerative Disc Disease/Discogenic Pain
Degenerative Disc Disease is a condition caused by wear and tear on the discs between the vertebrae causing them to lose their cushioning ability. This is a condition where the intervertebral disc, the gel-like material between the vertebrae, has begun to wear out due to aging, repetitive stress, smoking, genetics, etc. In most circumstances the cause is multi-factorial, and unless there is compression of the nerves or spinal cord, will not improve with surgery. It is a very common condition and may not even cause symptoms in many people.
Symptoms varies from person to person, some people may have no pain while others may experience severe pain. Depending upon the location of the affected disc the condition may cause;
- Neck or arm pain
- Back pain
- Numbness or tingling in the legs
- Pain in the thighs and buttocks
The pain is aggravated by movements such as bending, lifting, or twisting.
Degenerative disc disease is usually diagnosed based on medical history, physical examination and neurological examinations. Diagnostic imaging techniques such as X-rays, CT scan, or MRI scans, may be employed to confirm the diagnosis.
Nonsurgical treatment optionssuch as medication, rest, exercise and physical therapy may be recommended for people with no evidence ofnerve root compression or muscle weakness.
Interventional Pain procedures: Many Interventional pain procedures ranging from intradiscal injection of steroids & other drugs, IDET(intradiscal electrothermal therapy), intradiscal biaculoplasty, Percutaneous intradiscal RF thermocoagulation are done to block sensory nerve endings in the disc after discography proves concordant discogenic pain.
Ramus Communicans Radiofrequency at L2 level bilateral after a diagnostic block is done to obtund the sympathetic supply of the affected disc, thereby relieving discogenic pain
Surgery is considered when conservative treatment options fail to relieve the symptoms over a period of time. Spinal decompression along with a discectomy and fusion is usually done to remove the affected disc and fuse the adjoining vertebrae in order to stabilize the spine.