Tuesday, December 12, 2023

Chronic Pain Thoughts: Disc Degeneration Lumbar

 Disc Degeneration Lumbar



What causes lumbar disk disease?

Lumbar disk disease is caused by a change in the structure of the normal disk. Most of the time, disk disease happens as a result of aging and the normal break down that occurs within the disk. Sometimes, severe injury can cause a normal disk to herniate. Injury may also cause an already herniated disk to worsen.

What are the risks for lumbar disk disease?

Although age is the most common risk, physical inactivity can cause weak back and abdominal muscles, which may not support the spine properly. Back injuries also increase when people who are normally not physically active participate in overly strenuous activities. Jobs that require heavy lifting and twisting of the spine can also cause back injuries.

What are the symptoms of lumbar disk disease?

The symptoms of lumbar disk disease vary depending on where the disk has herniated, and what nerve root it is pushing on. These are the most common symptoms of lumbar disk disease:

  • Intermittent or continuous back pain. This may be made worse by movement, coughing, sneezing, or standing for long periods of time

  • Spasm of the back muscles

  • Sciatica – pain that starts near the back or buttock and travels down the leg to the calf or into the foot

  • Muscle weakness in the legs

  • Numbness in the leg or foot

  • Decreased reflexes at the knee or ankle

  • Changes in bladder or bowel function

The symptoms of lumbar disc disease may look like other conditions or medical problems. Always see your healthcare provider for a diagnosis.

How is lumbar disk disease diagnosed?

In addition to a complete medical history and physical exam, you may have one or more of the following tests:

  • X-ray. A test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.

  • Magnetic resonance imaging (MRI). A procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.

  • MyelogramA procedure that uses dye injected into the spinal canal to make the structure clearly visible on X-rays.

  • Computed tomography scan (also called a CT or CAT scan)An imaging procedure that uses X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.

  • Electromyography (EMG). A test that measures muscle response or electrical activity in response to a nerve’s stimulation of the muscle.

How is lumbar disk disease treated?

Typically, conservative therapy is the first line of treatment to manage lumbar disk disease. This may include a mix of the following:

  • Bed rest

  • Education on proper body mechanics (to help decrease the chance of worsening pain or damage to the disk)

  • Physical therapy, which may include ultrasound, massage, conditioning, and exercise programs

  • Weight control

  • Use of a lumbosacral back support

  • Medicine to control pain and relax muscles

If these measures fail, you may need surgery to remove the herniated disc. Surgery is done under general anesthesia. Your surgeon will make an incision in your lower back over the area where the disc is herniated. Some bone from the back of the spine may be removed to gain access to the disc. Your surgeon will remove the herniated part of the disc and any extra loose pieces from the disc space.

After surgery, you may be restricted from activity for several weeks while you heal to prevent another disc herniation. Your surgeon will discuss any restrictions with you.


Degenerative Disc Disease | Johns Hopkins Medicine


The information I couldn't find is how long do you try these treatments and live with extreme pain before other measures are taken?


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