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Lumbar Degenerative Disc Disease

Understanding the condition, and two of medicine's newest treatments.

Key points

  • Lumbar degenerative disc disease affects millions of people worldwide, and there are new treatments to help treat the condition.
  • Lifestyle changes such as strengthening your core, eating well, and staying hydrated can help prevent disc degeneration.
  • New treatments for degenerated discs include stopping the surrounding nerves from sending pain signals and supplementing the degenerated discs.
BigBlueStudio/ Shutterstock
Source: BigBlueStudio/ Shutterstock

Did you know that chronic lower back pain is the single greatest cause of years lived with disability worldwide?

One of the main causes of lower back pain is lumbar degenerative disc disease. This is a common age-related condition in which the vertebral discs “wear down over time." Vertebral discs serve as a “cushion” between spinal vertebrae. The discs function to absorb “stress” between each vertebra, preventing friction as you run, jump and bend. Younger people will have discs that are “thick and spongey” with a “gel-like” center. Older discs “stiffen” and “dry up” over time because as we age the blood supply to the discs diminishes.

With reduced blood flow to the discs, the body has very little ability to regenerate or repair the discs. Eventually, these age-related changes can lead to spinal pain. Disc degeneration is so common that the Spine Center of Baton Rouge has stated that up to 40% of 40-year-olds and 80% of 80-year-olds have at least one painful degenerated disc.

People with lumbar degenerative disc disease will experience constant low back pain that is moderate to severe in intensity. They will describe having focal lower back tenderness that can radiate into the buttocks and legs. They may also experience “sharp” pain with movement (typically bending and twisting), increased pain with sitting or standing, and/or weak legs.

Preventing disc degeneration

Keeping vertebral discs young and healthy can be a great way to prevent disc degeneration. Here are some tips on preventing disc degeneration:

  • Core strength — Make sure that your back and abdominal muscles are strong. These muscles can support and protect your vertebra from compressing on each other.
  • Eat well and get sufficient nutrients — A healthy diet consisting of proteins and fats with micronutrients like K2, calcium, magnesium, and Vitamin D will properly nourish the discs. Another great way to get vitamin D is to go for a short daily walk outside.
  • Stay hydrated — Drink plenty of water. Not only will it help your discs but it benefits all of your bodily systems.

Treatments for lumbar degenerative disc disease

For those suffering from lumbar degenerative disc disease, there have been recent medical advancements that have become available to treat the condition. Below is an introduction and description of these novel treatments. We are proud to be offering these new treatment options at Nevada Advanced Pain Specialists.

The Via Disc Procedure

The VIA Disc procedure is a non-surgical intervention intended to supplement degenerated intervertebral discs. It is an injection treatment comprised of intervertebral disc tissue particulate, spine-derived cells, and saline. Prior to injection, the three components are mixed together by the physician in a sterile environment. The patient is then brought back to the procedure room where they are placed in a comfortable position on the procedure table. An intravenous antibiotic is administered to reduce the risk of infection. A local anesthetic combined with conscious sedation is then utilized for patient comfort. The physician then places a spinal needle into the center of the desired disc to be treated under fluoroscopic guidance. Once the perfect placement of the needle is confirmed, the injection is done. The procedure takes no more than 30 minutes to perform.

What to expect after the VIA Disc Procedure

After the VIA Disc procedure, patients may experience increased pain and soreness. Specific instructions for care will be given after the procedure, which will include how to care for the procedure site and limiting strenuous physical activity for 72 hours following the procedure. Your physician may also recommend applying ice over the injection site and may prescribe post-operative pain medication if needed. A follow-up appointment is usually scheduled for 2-4 weeks after the procedure to monitor healing, recovery, and overall progress.

Relievant Medsystems, used with permission
The Intracept Procedure uses radiofrequency energy to heat the nerve, stopping it from transmitting pain signals.
Source: Relievant Medsystems, used with permission

The Intracept Procedure

This procedure helps disc pain by using radiofrequency to ablate the basivertebral nerve (BVN) which innervates the vertebral endplates of the painful disc. The patient is brought back to the procedure room where they are placed in a comfortable position on the procedure table. An intravenous antibiotic is administered to reduce the risk of infection. A local anesthetic combined with conscious sedation is then utilized for patient comfort (alternatively, general anesthesia can be done). The physician will then make a small incision over the patient's lower back and surgical instruments are placed using fluoroscopic guidance to access the painful vertebral body. A channel inside the vertebral body is created to reach the basivertebral nerve (or BVN). The physician will then use radiofrequency energy to heat the nerve — stopping it from transmitting pain signals. Once the ablation is completed, the incision(s) is then closed and nothing is left behind.

What to Expect After the Intracept Procedure

After the Intracept procedure, patients may experience increased pain and soreness. Specific instructions for care will be given after the procedure which will include how to care for the procedure site and limiting strenuous physical activity for 72 hours following the procedure. Your physician may also recommend applying ice over the procedure site and may prescribe post-operative pain medication if needed. A follow-up appointment is usually scheduled for 2-4 weeks after the procedure to monitor healing, recovery, and overall progress.

The basivertebral nerve (BVN) is different from other nerves in your body. Typically nerves have the ability to grow back (regenerate). Fortunately, the BVN has not shown the ability to regenerate following the Intracept procedure. Because of this, patients who benefit from the procedure will have sustained pain relief. A recent study showed the patient who underwent the procedure showed improvements in function and pain five years after having the procedure done. A third of the patients in the study indicated that they were totally pain-free five years later after having the procedure done.

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