Disc Conditions

Eight out of 10 people experience back pain at some point in their lives. Back pain is often caused by disc conditions caused by natural aging processes, disease or injury.

Discs play an essential role in the supportive structure of your backbone, also called your vertebral column, which is made up of interconnected vertebrae separated by discs. These intervertebral discs have a cushioning effect that absorbs pressure on your spine as you move. The discs are somewhat flexible, but their flexibility diminishes as you age. Vertebrae are divided into three areas: cervical vertebrae in your neck, thoracic vertebrae in your mid back and lumbar vertebrae in your lower back.

Types of Disc Conditions

Weakened or damaged discs — known as degenerative discs — can cause pain and lead to conditions such as spinal stenosis (narrowed spinal column), spinal osteoarthritis or spondylolisthesis (slipped disk).

Disc conditions generally fall into three categories:

• Degenerative disc disease. Discs degenerate or break down over time due to aging, daily wear and tear, or injury. As you age, your discs lose fluid and dry out, which can lead to the deterioration and weakening of the tough outer edges of the disc.
• Herniated (slipped) discs. In weakened discs, the gel-like center (nucleus) can herniate or move out of place. With time and stress on the spine, this gel can become compressed and be pushed outward or broken, also called a ruptured disc. When a disc ruptures and the nucleus breaks through the outer ring, the gel can press against spinal nerves or the spinal cord, causing significant pain.
• Discitis. Autoimmune disease or a viral or bacterial infection can sometimes cause painful swelling and irritation of the space between spinal bones, called the intervertebral disc space. Discitis is fairly uncommon and usually occurs in children under 10.

Prevention

Disc conditions can have many causes and don't always have symptoms. That's why it's important to have regular checkups to treat back pain at the earliest stages, when noninvasive treatment options can be most effective.

Discitis and other types of spine infection are rare, but it's wise to know the risks and take steps to prevent spinal infections. This is especially important if you have a weakened immune system or other risk factors, such as having urology procedures or any type of surgery.

At El Camino Health, we offer a variety of classes and lectures that can help you stay healthy.Talk to your doctor about what you can do to prevent back injuries, such as practicing good posture, sitting properly, and using safe lifting techniques.

Symptoms

The level of pain and symptoms of disc conditions can vary widely, from no discomfort to severe pain. You may experience a dull aching sensation, with pressure across your lower back, which can even extend to your buttocks or thighs. Severe pain is less common, but disc pain can be sharp, stabbing or burning, occasionally accompanied by tingling and numbness.

Tell your doctor if you notice numbness or pain in your neck or back — even if it goes away. Symptoms that could indicate a disc condition include:

• Pain, numbness, tingling or weakness in your leg, lower back, neck, shoulders or arms.
• Stiff neck, or soreness and difficulty moving your neck, especially when turning your head. 
• Difficulty extending or lifting your wrist and altered sensation in your middle fingers or fingertips.
• Pain that intensifies while you’re active, but fades or stops completely during rest.
• Severe back or neck pain that lasts for days or months before returning to normal or to the previous level of pain.
• Pain that gets worse when you sit, bend, twist or lift, but gets better when you change positions.
• Symptoms of various types of spinal infections.

If you have degenerative disc disease, you’ll most likely experience chronic lower back or neck pain, with episodes of sharper pain. In most instances, pain isn’t severe continuously — when it is, your doctor will consider other diagnoses.

Lower back pain can be a warning sign of other medical conditions, such as a pinched nerve. See your doctor if your pain persists or is accompanied by fever, loss of bladder or bowel control, coughing or progressive leg weakness.

If you have diabetes, severe back pain or pain that extends down your leg, symptoms may be related to neuropathy. Contact your doctor immediately to help prevent permanent damage.

Diagnosis and Treatment

To diagnose disc disease, your doctor will evaluate your symptoms and medical history and perform a physical exam. Your doctor will decide whether you need to return for further testing, such as X-rays, MRI or CT scans. Imaging exams can confirm whether degeneration or other damage is present, and help your doctor determine other potential causes for your symptoms.

At El Camino Health, doctors begin treatment using nonsurgical or less invasive approaches whenever possible — surgery is only considered when other measures fail to relieve pain.

Initial treatments may include:

• Prescription medical devices, such as a cervical collar, pillows or traction to help stabilize and align bones and prevent further aggravation of compressed discs.
• Special stretches and exercises for your neck, shoulders, middle or lower back to relieve stiffness and improve flexibility. Your doctor may refer you to a physical therapist to develop a personalized exercise program or provide massage or other therapies.
• Chiropractic adjustment to temporarily expand the disc space in the affected vertebrae.
• Other therapies — such as oral and intravenous antibiotics — for spinal infections.

Advanced Spine Surgery

When nonsurgical treatment is unsuccessful, your doctor may recommend surgical options such as spinal fusion or other treatments to relieve pain, including:

• Discectomy – Removal of a herniated disc.
• Laminectomy – Removal of the lamina (part of the vertebra), sometimes done to remove bone spurs or relieve pressure on your spinal nerves or spinal cord.
• Foraminotomy – Widening the opening where nerve roots leave your spinal canal, sometimes done to treat spinal stenosis.

Spine specialists at El Camino Health are highly skilled in minimally invasive spine surgery, which requires smaller incisions and can offer less pain and faster recovery times.

Your doctor will discuss all available options and design a treatment plan that’s right for you.