Column: I’ve been diagnosed with Degenerative Disc Disease
I’ve been diagnosed with Degenerative Disc Disease… Now What?
By Christian Whitney
It is very common to be upset and feel overwhelmed after you’ve been told that you have degenerative disc disease. Not only does it sound awful, it also sounds like there’s not much you can do about it.
My patients frequently tell me that they believe this is a progressive condition that will ultimately lead to more pain and even disability. Sometimes even patients tell me that they’ve been told by their healthcare providers that there isn’t any long term solution and that the pain will only get worse. These beliefs, however, are challenged by numerous studies.
Firstly, what is degenerative disc disease? Degenerative disc disease is a catchall phrase for a variety of conditions of the spine. These conditions are seen on imaging, including CT Scans and MRIs. They include a loss of dis height, disc bulges and herniations, osteophytes, stenosis, etc.
Next, let’s look at the data and ask ourselves the following…Do degenerative changes always inevitably worsen?
One study used MRIs to track disc herniations over time (Matsubara, et al 1995). They found that the majority of disc herniations spontaneously reduced in size and the remaining did not get any worse. The disc herniations tended to improve over time and surprisingly, the larger the disc herniation, the more it reduced.
Another study looked at patients with neck pain and a condition called cervical spondylolisthesis (Park, et al 2013). In this study of 27 patients, only three had a progressive worsening of their condition over a 2-7 year period.
In 2013, a study by Berg, et al looked at whether degenerative disc disease correlates with pain and disability. They looked at low back pain patients who were recommended to have surgery. They found no significant correlation at all between the degenerative disc changes and either pain or disability.
What does this data tell us? By reviewing the literature published on this topic, we can conclude that while degenerative changes sometimes get worse, they often either remain the same or get better. In fact, the worse the degenerative condition is, the more it tends to even stay the same or get better.
Now that we’ve been reassured about the progressive nature of degenerative disc disease, what can you do to treat the symptoms?
The first step is to be evaluated by a physician with experience in treating spinal conditions. The physician will corroborate the imaging results with your clinical symptoms and develop an appropriate treatment plan.
There are a multitude of treatment options depending upon the severity of the condition and your other co-existing medical condition.
Pain is best treated with a multi-modal approach. While over the counter (OTC) and prescription medications are often used to manage pain, a combination of treatments and approaches is most helpful.
Some of the other treatment options other than medications include:
Physical Modalities such as Physical Therapy, Exercise, Massage Therapy, Yoga, Tai Chi, Chiropractor, Osteopathic Manipulation
Alternative Treatments- Acupuncture and Acupressure, Biofeedback, Cognitive
Behavioral Therapy, Meditation, Relaxation Techniques, Aromatherapy, Breathing Exercises, Imagery, healing touch
Injections such as epidural steroid injections, facet injections, medial branch blocks, and radio frequency ablation.
Devices such as TENS Unit and hot/cold packs
Surgery is usually a last resort if the condition is not life threatening or urgent.
When pain becomes chronic or difficult to treat, consultation with a pain management specialist can be of benefit. A Board-certified, Fellowship trained Pain Management Specialist can evaluate the painful condition, order additional diagnostic tests, and offer a variety of treatment options, including interventional treatments, for the painful condition.
Note: The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
Christian Whitney is a Yale and Dartmouth trained Board-Certified Anesthesiologist and has received numerous awards for his work, including Castle Connolly’s Top Doctor Award and Greenwich Hospital Quality Award. He recently opened “Restorative Pain Solutions,” a serene and sleekly designed pain and wellness center, located at 4 Dearfield Drive. Call (203) 992-1845 or visit rpsgreenwich.com for more information or to schedule an appointment.