Spondylosis (Degenerative Disc Disease)

Sherri O’Connor, PA-C

Aging is a normal part of life and begins in our younger days, and is not necessarily a condition of the elderly. The aging process often begins silently, but can suddenly become symptomatic. The sudden onset of symptoms is reasonably common, and somewhat unsatisfying for patients to accept. The wear and tear process can arise between the bones in the disc or in the small joints of the spine called the facets. It can present as stiffness, pain or nerve irritation.

The spine is divided into three regions, the cervical spine (7 neck bones), thoracic spine (12 midback bones) and the lumbar spine (5 lower back bones and pelvis). An injury may begin in the disc between the bones, or in small facet joints of the spine. Initially this injury may begin as pain or stiffness. The injury to a portion of the anatomy can lead to a loss of normal mechanical relationships. This loss of alignment can result in a reduction in the space for a nerve. The nerves travel within the bones of the spine in the spinal canal and leave the spine through the neural foramen, a whole on the left and right side of each bone. As the space for the nerves narrows, a patient can experience pain, stiffness, and loss of range of motion. Pain can evolve if the nerve is physically pinched, possibly leading to loss of function.

Not everyone will experience nerve irritation along with arthritic change, and some experience only neck or back pain. Depending on the severity of your symptoms, treatments can range from physical therapy, anti-inflammatories, heat, or ice. In some instances, medications are used for a short period of time to decrease inflammation. There are different types of anti-inflammatories, such as non steroidal anti-inflammatories like ibuprofen or naproxen or their prescription cousins. In addition, steroids are a category of anti-inflammatory medication that can be useful like prednisone. Prednisone can delivered orally for a short period of time or as an injection. In many cases, an X-ray can offer the insight needed to implement a treatment plan. A MRI can be obtained when more invasive treatments are necessary such as in an epidural steroid injection or possibly surgery. However, surgery is usually the last resort as is infrequently used.

© 2014 O’Connor “Back Pain: Common Diagnosis and Treatment”