The intervertebral disc is the fibrocartilage between the vertebral bodies, and its main function is to absorb the shock of the vertebrae colliding with one another. A normal disc has no sensation of pain, but when the disc degenerates, sensory nerves grow into the disc and cause pain. Research shows that roughly 30 to 40 percent of lower back pain is caused by the intervertebral disc, yet it is often overlooked.
Disc pain generally occurs in the cervical (neck) or lumbar (lower back) spine, and is typically seen in middle-aged to elderly people. Patients cannot sit or stand for long periods. If they sit for more than 30 minutes, they feel severe pain in the neck and shoulders or the lower back, yet they cannot clearly pinpoint the location of the pain. Stretching exercises provide no obvious relief, but if they have a chance to lie down, the pain immediately improves.
Patients often also find that the pain increases with actions such as coughing or straining to pass stool. Occasionally, some people also feel the pain radiating to the hands or feet, yet an MRI scan shows no obvious compression of the nerve roots.
Because the disc is located deep within the spine, it is not easily detected by a general physical examination. Diagnosis often requires an MRI. Early disc degeneration appears on an MRI as a loss of water content, while in later stages it may show disc deformity or tearing. Many patients require a provocative discography injection as a confirmatory diagnostic tool.
Treatment for disc pain can broadly be divided into three categories: regenerative (prolotherapy) treatment, disc ablation, and nerve ablation. Regenerative treatment mainly involves injecting bone marrow concentrate into the disc to improve the disc’s degeneration. Disc ablation uses heat to ablate the proliferated blood vessels and nerves inside the disc to achieve pain relief. Nerve ablation uses heat to ablate the nerves supplying the outside of the disc, in order to block the transmission of pain.
Dr. Lee Yuk-ming, Specialist in Pain Medicine
Original article: Health: Caring for the Elderly — Disc Degeneration Causing Lower Back Pain | Oriental Daily | Local News
Published in Oriental Daily on 23/12/2021
Source: https://orientaldaily.on.cc/content/news/odn-20211223-1223_00176_248/
