Most people suffering from lumbar degenerative disc disease can be successfully treated through a course of conservative, non-surgical care.
Heat and Ice Treatments
Localized applications of heat helps to increase blood flow, which aids in the healing process. Many patients use heat on stiff muscles and joints to increase flexibility and range of motion.
Applications of ice are used to decrease localized swelling, inflammation and pain associated with many different types of injuries.
Medications for DDD Pain Relief
A variety of medications may be prescribed to manage pain associated with degenerative disc disease. Mild pain can be relieved through the use of drugs such as acetaminophen (Tylenol).
Non-steroidal anti-inflammatory medications such as ibuprofen, naproxen and COX-2 inhibitors are used not only to manage pain, but to reduce swelling in the body as well.
Intense episodes of pain are typically managed with oral steroids, muscle relaxants or narcotics. Patients must be careful when using these medications due to their sedative effects, and in the case of narcotics, the potential for addiction.
Each situation is unique and some medications are not appropriate for all patients. Therefore, patients should always discuss medications, side effects and other factors with a physician prior to accepting any prescription.
Epidural Steroid Injections
Epidural steroid injections (ESI) are a common treatment option for low back and leg pain. The primary goal of ESIs is to relieve pain by delivering medication directly to the source. A secondary goal is to decrease inflammation around the damaged disc, providing healthy discs with an opportunity to repair themselves.
ESIs are given by using fluoroscopy to place a needle close to irritated nerve roots or directly into the foraminal space and bathing the area in a steroidal solution.
Chiropractic Manipulation to Relieve Pain
During the first month of therapy, acute and chronic low back pain and degenerative disc disease not associated with nerve compression may respond to chiropractic manipulation. Chiropractic care has the ability to relieve low back pain by taking pressure off sensitive nerves and tissue, reducing muscle tension, increasing range of motion and restoring blood flow to affected areas. These manipulations also may promote the release of natural endorphins within the body to act as natural painkillers.
Exercise Programs for Lumbar DDD
Exercise programs have proven to be successful in relieving pain from lumbar DDD. Elements of a good exercise program include:
- Low-impact aerobic workouts such as walking, swimming and biking relieve pressure on the discs and provide better flow of blood and nutrients to spinal structures. Aerobics also improve muscular endurance, coordination and strength.
- Hamstring stretches to reduce tightness, which increases stress on the back and pain caused by a damaged disc.
- Other stretches to improve flexibility of the back and abdominal muscles. Flexion exercises may also help widen the foramen, which are small canals where nerve roots exit the spinal cord.
- Strengthening exercises to increase support of the lower back and help patients find and maintain comfortable spine positions.
Patients should discuss exercise options with their doctor before starting any program. It is extremely important to stop participating in any exercise that increases pain levels until consulting with a physician.
Other Conservative Treatment Options
In addition to the above options, with the approval of a doctor, patients can try other treatments including:
- Massage – Helpful for increasing blood flow and reducing muscle spasms.
- Acupuncture – Helps control pain, but for best results, should be combined with an approved exercise program.
- Pilates and yoga – Alternative forms of low-impact exercise that help increase both strength and flexibility.
Surgery is usually considered only for patients whose pain has not been relieved after six or more months of conservative therapy or those who have trouble performing everyday activities.
