Lumbar Degenerative Disc Disease
Intervertebral discs are made of connective tissue. An intervertebral disc is present in between each pair of vertebrae of the spinal column and act as a shock absorber. As ageing occurs the wear and tear exaggerates and the repair process of the body slows down resulting in degeneration of the disc. Improper posture, excessive use, overweight, trauma and injury may further accelerate the process of degeneration. This may lead to dysfunctioning of the degenerated disc which may tear at different places. The disc may reduce in height and then finally collapse. The movement at these weakened discs causes pain and results in a condition known as lumbar degenerative disc disease. Lumbar degenerative disc disease is not a disease but a part of the ageing process. It is more common in people older than 50 years of age. The degenerated disc may lead to bony outgrowths (osteophytes), osteoarthritis of the spine and low back instability.
Lumbar Disc Degeneration is a progressive disease. Symptoms vary depending on the stage of the disease but some people may be asymptomatic. The symptoms include recurring back pain which may be mild initially but worsens with time and is more severe after an activity or being in one posture for a long time. It thus affects the normal daily activities by making it difficult to stand, walk or bend. The pain may also spread to the legs or buttocks (sciatica). In rare cases it may cause bowel or bladder dysfunction.
Diagnosis includes medical history, physical and neurological examination. Neurological examination is done to indicate any neurological injury and involves evaluation of reflexes and muscle weakness by various tests. To confirm the diagnosis the doctor may order a spinal X-ray to see the reduction in the disc height and the number of discs affected. CT scan or MRI are performed to detect changes in the disc and spinal nerves. A specialized test called discography may be used to obtain more information on the condition of the involved disc, in case surgery is considered. This involves injecting a dye into one or more discs and observing them under real time fluoroscopy.
Non-surgical treatment is preferred over surgery and includes pain medication, muscle relaxants and spinal injections. Back braces are recommended for a few days to keep the lower back still and reduce mechanical pain due to movement. Physical therapy, chiropractic or acupuncture may be helpful in some cases.
Surgery is considered only if pain and symptoms do not improve over a few months and neurologic dysfunction and spinal instability is evident in diagnosis. Spinal stabilization and fusion are performed through surgery to alleviate symptoms and stop the progression of the disease. The surgery can be done using the minimally invasive approach which results in less post operative pain, smaller scar and quicker recovery.
In case you have any doubts or unanswered questions about lumbar degenerative disc disease, consult your doctor.