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| What Is The Best Pain Relief For Degenerative Disc Disease |
Understanding Degenerative Disc Disease
DDD, also known as degenerative disc disease, is a disease where the discs in the spine begin to break down. These discs act as cushions between the vertebrae, or bones, in the spine. When they degenerate or break down, they can no longer buffer and support the spine effectively.
What Causes DDD?
DDD is typically caused by general “wear and tear” on the discs as a person ages. In addition to age, other factors that can contribute to DDD include:
- Genetics: Some people are genetically inclined to develop DDD sooner than others.
- Injury: A severe back injury that places excessive strain on the discs, like a herniated disc, can lead to early degeneration.
- Occupation: Jobs requiring heavy lifting, bending, or other repetitive motions that stress the back can raise the risk of DDD.
Symptoms of DDD
The most common symptom of DDD is low back pain. As the discs break down, they lose their ability to cushion the spine. It leads to pain, stiffness, and limited mobility in the lower back. Radiating leg pain that travels down one or both legs is also common. Other signs and symptoms include:
- Pain that declines with activity and improves with rest
- Numbness or tingling in the legs
- Pain at night or when waking up
- pain that increases over time
- Restricted scope of motion in the lower back
- Tenderness or pain when pressing on the back
Nonsurgical Treatment Options
For mild to moderate cases of DDD, nonsurgical treatments are usually attempted first before considering more invasive options. The goals of nonsurgical care include reducing pain and inflammation, improving mobility, and strengthening supporting muscles.
Medications for Pain Relief
pain relievers are often used as the initial approach to managing back pain from DDD. These include over-the-counter and prescription options.
Over-the-Counter Pain Relievers
Typical over-the-counter (OTC) pain relievers used for DDD include:
- Acetaminophen (Tylenol) – Considered safe for short-term use but doesn’t directly reduce inflammation.
- Ibuprofen (Advil) is an NSAID medication that helps reduce pain and inflammation.
Prescription Pain Medications
For more severe pain, a doctor may prescribe stronger NSAIDs or other prescription medications like:
- Naproxen (Aleve) is another NSAID requiring a higher dose prescription.
- Topical pain creams: Creams containing capsaicin or lidocaine can help relieve pain when rubbed onto the skin over painful areas.
- Tramadol: A narcotic-like pain reliever that binds to opioid receptors in the brain.
- Muscle relaxants – Medications like cyclobenzaprine help relax tight back muscles.
Physical Therapy for DDD
Physical therapy is very effective for DDD when used alone or with other treatments. During sessions, a physical therapist will:
- Assess mobility and strength issues to design an appropriate treatment plan.
- Instruct stretches and exercises to improve flexibility and strengthen core/back muscles.
- Heat or ice therapy, massage, and spinal manipulation relieve pain and increase motion.
- Provide tips on proper body positioning and lifting techniques to prevent re-injury.
- Fit patients for assistive walking devices like canes or braces if needed.
Most insurance plans cover several visits with a physical therapist for back pain without requiring a physician referral. Committing to home exercises between visits leads to better long-term outcomes.
Lifestyle Changes and Alternative Therapies
Beyond medical treatments, making healthy lifestyle tweaks can help manage DDD:
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| Lifestyle Changes and Alternative Therapies |
- Weight loss: Extra pounds stress discs, and weight loss relieves pain.
- Proper lifting: Bend the knees, keep the back straight, and lift with leg muscles to avoid strains.
- Stress relief: Relaxation techniques counter inflammation through reduced cortisol levels.
- Heat/ice therapy: Applying heat or cold compresses for 15-20 minutes relieves spasms.
- Yoga or Tai Chi: Gentle movement eases pain while strengthening the core and back muscles.
Acupuncture and chiropractic care have also helped some patients. However, talk to your doctor before adding alternative therapies to prevent harmful interactions.
These nonsurgical changes usually provide adequate pain relief and function improvement for mild to moderate DDD cases. Surgery is considered if the pain becomes severe or limitations impact the quality of life.
In summary, the best options often involve pain medication, physical therapy, and lifestyle adjustments. Staying as active as comfortably possible through exercise also helps manage long-term degeneration in many cases. Consulting with your doctor is vital to finding the right nonsurgical approach for your symptoms and lifestyle.
Minimally Invasive Procedures
For those whose back pain isn’t improving with nonsurgical options, minimally invasive procedures may be an excellent intermediate step before considering surgery:
Epidural Steroid Injections
During an epidural steroid injection, a long, thin needle is threaded into the epidural space surrounding the spinal nerves. Corticosteroid medications are injected into this area to reduce inflammation around irritated nerves and relieve radiating leg pain. Multiple injections spaced a few months apart are usually required for long-term effects.
Radiofrequency Ablation
This procedure uses heat from radiofrequency energy to “ablate” or destroy problematic nerve fibers carrying pain signals from the spinal region. It aims to provide six months or longer of relief for leg-dominant pain. RFA targets precise nerves and risks fewer side effects than traditional back surgery.
Spinal Surgery
For those with DDD causing significant mobility loss, weakness, or intolerable pain not helped by other options, spinal surgery may become necessary. Surgical options depend on the location and severity of degeneration, but two standard procedures are:
Microdiscectomy
During a microdiscectomy, a small portion of a herniated disc pressing on a spinal nerve is removed through a tiny incision. It relieves pressure and leg pain from damaged discs, most often affecting the lumbar spine. Recovery takes 4-6 weeks with good long-term outcomes.
Spinal Fusion
Fusion surgery with severe instability between vertebrae from multiple collapsed discs may be recommended. It involves removing discs and inserting bone grafts and hardware like screws and plates to join vertebrae in a stabilized position permanently. Fusion eliminates motion but prevents pain from abnormal segment movement. Recovery takes several months.
While more invasive than other options, spinal surgery aims to get a disabled person back to work and normal activities if other treatments have not provided sufficient relief over months of effort. However, it should only be considered after weighing potential risks versus quality of life benefits.
Conclusion
In summary, degenerative disc disease is prevalent but diverse in experience from person to person. Effectively managing pain involves matching nonsurgical options to the stage and severity of a patient’s DDD. The best pain relief usually involves a multidisciplinary approach emphasizing pain medication, physical therapy, lifestyle changes, and potentially minimally invasive pain treatments before considering surgery. With proper care and self-management, people can often maintain mobility and function even into advanced stages of degenerative changes in the spine.
Final Thoughts
While DDD presents ongoing challenges, staying positive and proactively engaged in your healthcare empowers better outcomes. Consult regularly with your healthcare team to discuss new symptoms or changes in your nonsurgical plan as degeneration progresses. Committing to practices like avoidance of high-impact activities, muscle-strengthening exercises, and weight control supports long-term back health. With a multifaceted approach and patience throughout rehabilitation, you can lead an active, fulfilling life despite degenerative disc disease.
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FAQs About What Is The Best Pain Relief For Degenerative Disc Disease
High-impact activities like running, competitive sports, heavy lifting, frequent bouncing/jerking motions, and prolonged sitting/standing without breaks should typically be limited or avoided to prevent exacerbating DDD pain and symptoms.
Surgery is usually only considered if significant pain and functional limitations persist for at least six months despite consistent nonsurgical treatments. Factors like leg weakness, inability to walk or sit comfortably, and radiating pain below the knee increase the likelihood of surgery providing better relief than other options.
While degeneration is progressive and irreversible, periods of relative remission are possible depending on the individual. Staying active as comfortably allowed through low-impact exercise and keeping a healthy weight can help manage long-term symptoms without needing medical interventions at all stages. Complete resolution of symptoms is rare once established DDD occurs, though.
With proper self-management, including medication, physical therapy, lifestyle changes, and potentially minimally invasive treatments as needed, most people can maintain good mobility and functional independence even into older adulthood despite degenerative changes seen on imaging tests. Ongoing flares will likely continue but can often be managed nonsurgically.