Degenerative Disc Disease
Degenerative disc disease refers to the changes that occur to the spinal discs as part of the body's natural aging process. Spinal discs separate the vertebrae, the interconnected bones of which the spine is composed. While degenerative disc disease can occur anywhere within the spine, it most commonly affects the neck (cervical) and the lower back (lumbar) areas.
In addition to age, degenerative disc disease can occur as a result of small tears in a disc. These small tears lead to the release of nucleus, a jelly-like material found in the disc, which can cause the disc to bulge or rupture. Degenerative disc disease can also stem from a herniated disc. As with many conditions, those who smoke or are obese are at a higher risk of developing degenerative disc disease.
The symptoms of degenerative disc disease vary. Depending on the location of the degenerating disc, individuals may experience pain in the neck, back, arm, leg, or buttocks. In some cases, no pain is experienced, causing the condition to remain unnoticed. It is important to see a doctor if you experience persistent pain in any of the aforementioned areas.
To diagnose degenerative disc disease, your doctor will perform a physical evaluation and review your medical history. The physical examination typically entails inspecting the affected area for tenderness, changes in range of motion, as well as other potential conditions, such as infection or fractures. In some cases, x-rays may also be used to obtain a better view of the discs.
Degenerative disc disease can often be managed with over-the-counter pain medications, such as acetaminophen or ibuprofen, and applying ice or heat to the affected area. More aggressive treatments may not be necessary unless additional conditions, such as osteoarthritis, have developed as a result of the degenerating disc. Such cases may require physical therapy or surgery to remove the degenerated disc. Your doctor will develop a customized treatment plan for your individual condition.
Facet Joint Syndrome
Facet joint syndrome is a condition that occurs when the facet joints of the spine become damaged or worn out. The facet joints are the small joints located between the bones of the spine; they are lined with cartilage and synovial fluid that allows them to glide easily over each other. They are also intertwined with nerves that run from the spinal cord to the arms, legs and other parts of the body. The facet joints are in constant motion and provide the spine with flexibility that allows movement, and stability that keeps the back from moving too far forward or twisting too far.
Due to constant motion, the facet joints may wear out or degenerate, and the cartilage within the joints may thin or tear over time. This causes increased friction in between the individual vertebra. This may occur from arthritis, overuse or injury. As a result, the facet joints may become swollen or painful.
The symptoms of facet joint syndrome vary depending on where the affected joint is located, and what nerve roots it affects. If the affected joints are in the neck, they may cause headaches and difficulty in moving the head and neck. If the degenerated joints are in the back, they may cause pain or stiffness in the lower back, buttocks or thighs. Inflamed facet joints may also cause painful muscle spasms.
Facet joint syndrome is diagnosed after a physical examination and review of symptoms. An MRI scan may be performed to provide internal images of the back and spine. A diagnostic facet injection is also used to confirm a diagnosis of facet joint syndrome. Diagnostic facet injections contain a corticosteroid, and an anesthetic to temporarily relieve discomfort. If the patient experiences relief, the facet joint is likely the cause of the pain.
Initial treatment for facet joint syndrome is often conservative and may include rest, and ice or heat therapy. Other conservative approaches may include:
- Anti-inflammatory drugs
- Physical therapy
- Use of a back or neck brace
If symptoms are troubling, pain medication may be prescribed. Steroids injections directly into the facet joints may also help to relieve pain for an extended period of time. In severe cases, surgery may be required to clean out the facet joints and deaden symptomatic local nerves.