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Back Problems Message Board


Back Problems Board Index


[COLOR=Magenta][CENTER][B]Hello :wave: Monica,[/B][/CENTER]

[INDENT]I am very sorry to hear of your pain. I do wish you the best of luck with your facet joint injections. I also suffer with DDD and Stenosis. I had a discogram before my fusion and my disc that had the ddd was not the cause of my pain. But I had two other bad disc's and had a two level fusion. I had some information that might help you to understand your diagnosis. Here it is:[/INDENT]
[INDENT][B]DDD[/B]
Degenerative disc disease refers to a syndrome in which a painful disc causes chronic low back pain. The condition generally starts with a torsional (twisting) injury to the disc space. The injury weakens the disc and creates excessive micro-motion at the corresponding vertebral level because the disc cannot hold the vertebral segment together as well as it used to. The excessive micro-motion, combined with the inflammatory proteins inside the disc that become exposed and irritate the local area, produces low back pain.
Unlike the muscles in the back, the disc does not have a blood supply and therefore cannot heal itself and the painful symptoms of degenerative disc disease can become chronic. While it is rare that low back pain from degenerative disc disease will progress or increase, the pain will tend to fluctuate and at times may become significantly worse.
A fully degenerated disc no longer has any inflammatory proteins (that can cause pain) and usually collapses into a stable position [/INDENT]

[CENTER][B]Treatment options[/B][/CENTER]
[INDENT]For most people, degenerative disc disease can be successfully treated with conservative care. Most patients will experience low-grade continuous but tolerable pain that will occasionally flare (intensify). The frequency and intensity of the flares can be managed with an exercise program that consists of:
hamstring stretching
dynamic lumbar stabilization exercises
low-impact aerobic conditioning Non-prescription medications, such as NSAID's and acetaminophen, may be helpful in alleviating low back pain, and stronger therapies, such as oral steroids or epidurals, may be prescribed to treat severe flares.

For patients who are unable to function because of the pain, or who are frustrated with their activity limitations, lumbar spinal fusion surgery is an option. Fusion surgery works because it stops the motion at a painful motion segment.[/INDENT]


[CENTER][B]Understanding Medical Terms[/B][/CENTER]
[INDENT][B]Disc bulge[/B] is due to radial tears in the annulus allowing disc material to increase the disc volume either centrally or laterally, depending on the area that has accumulated the most radial tears.

[B]Disc herniation[/B], also called subligamentous, is a situation in which the nuclear material has protruded into the radial tears in one area and has displaced surrounding anatomic structures, i.e., proximal spinal nerve, but has not passed the annulus.

Another term commonly used to describe this finding is [B]disc protrusion[/B]. A herniated disc is still considered a contained disc as long as the protruding nuclear material is contained by the posterior longitudinal ligament-disc capsule complex.

Radiological reports often use the terms disc protrusion and disc herniation indiscriminately to describe an abnormal bulging of the disc. These terms are confusing as they may be defined in different ways by clinicians. Disc protrusion generally signifies anatomically a focal or diffuse protrusion of the disc with an intact annulus fibrosus. The diffusely bulging disc is broad-based or slightly asymmetric and reflects disc degeneration. The term protrusion is used to define this radiological aspect of the a diffuse disc bulging.[/INDENT]

[INDENT][B]Spinal stenosis[/B] is a narrowing of the spinal canal, which places pressure on the spinal cord. If the stenosis is located on the lower part of the spinal cord it is called lumbar spinal stenosis. Stenosis in the upper part of the spinal cord is called cervical spinal stenosis. While spinal stenosis can be found in any part of the spine, the lumbar and cervical areas are the most commonly affected.

[B]What Causes Spinal Stenosis?[/B]
Some patients are born with this narrowing, but most often spinal stenosis is seen in patients over the age of 50. In these patients, stenosis is the gradual result of aging and “wear and tear” on the spine during everyday activities. There most likely is a genetic predisposition to this since only a minority of individuals develops advanced symptomatic changes. As people age, the ligaments of the spine can thicken and harden (called calcification). Bones and joints may also enlarge, and bone spurs (called osteophytes) may form. Bulging or herniated discs are also common. Spondylolisthesis (the slipping of one vertebra onto another) also occurs and leads to compression. When these conditions occur in the spinal area, they can cause the spinal canal to narrow, creating pressure on the spinal nerve.

[B][CENTER]Symptoms of Stenosis[/CENTER][/B]
The narrowing of the spinal canal itself does not usually cause any symptoms. It is when inflammation of the nerves occurs at the level of increased pressure that patients begin to experience problems. Patients with lumbar spinal stenosis may feel pain, weakness, or numbness in the legs, calves or buttocks. In the lumbar spine, symptoms often increase when walking short distances and decrease when the patient sits, bends forward or lies down. Cervical spinal stenosis may cause similar symptoms in the shoulders, arms, and legs; hand clumsiness and gait and balance disturbances can also occur. In some patients the pain starts in the legs and moves upward to the buttocks; in other patients the pain begins higher in the body and moves downward. This is referred to as a “sensory march”. The pain may radiate like sciatica or may be a cramping pain. In severe cases, the pain can be constant. Severe cases of stenosis can also cause bladder and bowel problems, but this rarely occurs. Also paraplegia or significant loss of function also rarely, if ever, occurs. [/INDENT]

[CENTER]Again, I wish you the best of luck.[/CENTER]

[B][CENTER] :angel: Have a good night. :angel: [/CENTER][/B][/COLOR]





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