When it comes to degenerative disc disease, millions of Americans deal with chronic pain from the problem. While most who have degenerative discs experience no pain, there Are a substantial amount of people who have daily, chronic back pain that may be disabling.
The short answer is no a degenerative disc will not heal itself. Here’s the explanation of why. As individuals reach adulthood, the blood supply to spinal discs goes away. A spinal disc receives its nutrition from the bone above or below, called the vertebrae.
The nutrition comes in by way of diffusion, therefore, it is an extremely poor method of receiving nutrients and therefore has a very low capacity to heal any damage. The human body overall is amazing, so why would it set up the disc for failure with no blood supply?
When degeneration of the disc occurs or injury, or surgery is performed, the disc really doesn’t fix itself to any significant amount. The hope is that regenerative medicine will continue to advance so that biologic substances may be injected into the disk and help the regenerative process be able to reconstitute degenerative discs.
All hope is not lost when an individual has pain from degenerative disc disease. It is possible that the pain being experienced can burnout over time and that is why most individuals will not end up needing surgery for the problem. Physical therapy, chiropractic treatment and injections of pain medicine into the disc can help reduce pain along with waiting for the pain to burnout on its own.
So that’s the long answer is that spinal discs do not have the capacity in any meaningful way to repair themselves. Pain management doctors in Florida have numerous methods of treatment for degenerative disc disease. These include Port St Lucie pain management clinics, Tampa pain management clinics, Miami, Ocala, Fort Myers and more.
Click HERE and put in your zip code to find those closest to you!
Over the last couple months, we have seen the effects of contaminated steroid medication distributed to a large number of clinics around the country. The New England Compounding Center produced contaminated methylprednisolone that was delivered to 75 pain clinics in approximately 14 states.
Three lots of the medication was found to be contaminated and was injected into over 14,000 individuals. This included epidural injections, facet joint injections, extremity joint injections, and soft tissue injections for pain relief.
So far, due to the contamination there have been almost 80 deaths and over 700 infections as a result of the fungal contamination.
Only a few infections occurred in Florida, as only a small amount of medication from the New England Compounding Center was delivered to the state. What can we learn from this horrible tragedy?
Modern pain management has advanced tremendously over the last decade. However, even a clinic who has a first rate surgical center with Board Certified pain doctors and a stellar reputation can receive medication that is tainted. This is a long way of saying that there are certain things a pain clinic can control, and there are some that are unknown risks. Those risks have nothing at all to do with physician competence.
Another thing that most people following this tragedy have learned is that there is a significant difference between manufacturers who are controlled by the FDA and under those regulations, and compounding pharmacies which are not under the direct purview of the FDA.
In this case, the New England Compounding Center is a compounding pharmacy and not a large manufacturer. Compounding centers do not fall under the FDA’s direct line regulation. Over last few years, the FDA has come under fire for hitting manufacturers with an increasing amount of regulatory warnings that have led to drug shortages from time to time. When a tragedy like this occurs, most reasonable people would look at that and say “I wish the FDA would have the right to oversee all manufacturers and compounding pharmacies of medications such as this.”
In addition to learning about the regulatory limitations of the FDA with compounding pharmacies, this tragedy has also brought up discussions about the effectiveness of epidural steroid injections. The question of risk versus benefit has been placed at the forefront of these discussions.
There’s a reason why epidural steroid injections have been in use for over 60 years. There are significant benefits to these procedures, and they can often allow individuals to avoid surgery and achieve substantial pain relief in a very difficult time. Normally, the risks with steroid medications are under 1%. It is a tragedy like this one that pushes the medical community to take a hard look at the effectiveness of these injections. The vast majority of pain management doctors immediately elucidated the benefits of the procedures and quieted down the naysayers.
One last thing this tragedy has shown us is that fungal infections are very different from bacterial infections. They have a longer incubation period and the medications needed to treat fungal infections can do a lot more harm to the human body than a simple antibiotic typically.
All in all, the fungal meningitis outbreak is something that should have been avoided. It has taught us some interesting facts about how the manufacturing process works and who has the oversight on safety of medications. That may help significantly in the future as the FDA takes a more direct approach with compounding pharmacies, but it will do little at this point to help those who were infected and those unfortunate patients who passed away from fungal meningitis.
The Florida Pain Network connects those in pain with pain clinics in Florida. There are pain management Orlando clinics, pain management Port St Lucie clinics, Tampa, Palm Beach County, Miami, Fort Myers, Ocala and more.
Go to THIS PAGE and put in your zip code to see those closest to you, or call (877) 877-8556 for assistance.
The leading pain management clinic in Orlando, National Pain Institute, is now offering over five effective spinal arthritis treatments. As a cutting-edge Orlando pain management practice, National Pain offers Board Certified pain doctors who specialize in comprehensive nonsurgical pain management options.
Spinal arthritis affects millions of Americans, and surgery is often not a great idea due to the number of spinal levels involved. There is no effective joint replacement for the arthritis of the spine as there is for knees and hips yet. Therefore, nonoperative pain relief is the best approach and the Orlando pain doctors incorporate multiple options that are customized to the individual patients needs.
These options include such treatments as medication management, which may include anti-inflammatories, neurologic modifying agents, or short-term opiate medications. In addition, the Orlando pain management doctors are experts in interventional procedures for spinal arthritis including facet blocks, medial branch blocks, multiple types of epidural injections, and radiofrequency ablation.
As mentioned, spinal arthritis typically affects multiple levels at the same time. In order to achieve longer term pain relief, radiofrequency ablation is an excellent option and has been a revolutionary pain management treatment over the last few years as it continues to improve. The treatment may provide over a year of consistent pain relief and national pain offers the treatment at each of its three Orlando area pain clinics.
National Pain accepts most major medical insurance including Medicare, Florida Worker’s Compensation, and personal injury. They have three clinic locations in the Orlando area. National Pain also offers multiple additional pain clinics in Florida, including pain management Boca Raton, Tampa pain management, Ocala pain management and more.
Call (407) 487-2539 for more information and scheduling.
One of the most common problems seen by pain management clinics is a person experiencing pain from an intervertebral disc herniation. Here are some commonly asked questions regarding disc herniations.
What are other names for a disc herniation?
How common are disc herniations?
It’s a very common problem. At any one point in time, one percent of the population is experiencing sciatica from a disc herniation. Sciatica occurs when a disc herniation actually pushes on a nearby nerve root, creating inflammation and pain in that nerve root that goes down a person’s leg.
So one percent of the American population is over 3 million individals. There are an additional amount of people who have a disc herniation but are not experiencing sciatica. If the disc herniates and does not push on a nearby nerve root, sciatica may not result.
An individual may have back pain but not leg pain, so essentially there may be another 1% of people experiencing issues with a disc herniation and not sciatica, so the overall amount is between one and 2%.
How does a disc herniation occur?
The healthy intervertebral disc is composed of 80% water and the remaining 20% is a combination of collagen and proteins known as proteoglycans. The disc acts as a great shock absorber and allows significant range of motion when it is healthy. Due to advancing age, trauma or for genetics, the person may experience degeneration of the disc and loss of water content.
The disc itself is best analogous to a jelly donut. The inner jelly is called the nucleus pulposus and the covering to the donut is called the annulus fibrosis. The annulus is the only part of the disc that experiences pain because it does have some nerve endings there. Due to disc degeneration, the annulus can experience a tear which can lead to back pain along with some of the inner jelly squeezing out.
This is known as a disc herniation. If the jelly that squeezes out then compresses on an adjacent nerve root, that is called in layman’s terms a pinched nerve. This can then spark up inflammation and sciatica consisting of a burning, electrical type pain down the leg, numbness and possibly muscle weakness.
What are the symptoms of a disc herniation?
It is possible to have a disc herniation and have no pain whatsoever. A significant amount of the American population has disc degeneration and no back pain whatsoever. If a person has a tear in a disk and some of the disc squeezes out, the pain that is experienced is due to an inflammatory reaction. So if that inflammatory reaction does not occur, pain will not typically ensue.
If it does, symptoms may consist of just back pain, or a person may have no back pain at all but simply sciatica. Back pain usually spreads out to one or both sides of the low back, an individual may also have substantial muscle spasms as a protective effect. The pain may also radiate into the buttock area or around to the hip or groin.
Sciatica pain usually feels like a burning or electrical type sensation along with some numbness or pins and needles. The area of the pain typically correlates with whichever nerve root is being pinched.
It may go down the back of the thigh into the foot, or on the front of the thigh, or on the front of the shin. The pain is not usually constant, it will vary with positioning and then come and go depending on the time of the day.
How is a herniated disc diagnosed?
In most cases, there is an established method for making the diagnosis. Usually a person’s history will raise suspicion for a herniated disc. If the person walks right out of a textbook, he or she will describe pain that goes down the leg in a pattern that correlates with a nerve root.
There are some specific physical examination signs that can tip off the doctor including a straight leg raise test if it is positive for tension signs.
X-rays are not helpful in the diagnosis of a herniated disc, it is an MRI that typically will show the disk herniation nicely and how large it is. There’s not a great correlation between the size of the disk herniation and the amount of symptoms experienced. It may be a very small disc herniation, yet produce very big symptoms.
What are my treatment options with a herniated disc?
Most of the time, treatment options for a herniated disc to come a quality of life elective decision. Only if it leads to significant neurologic symptoms should surgery be considered either emergently or as a relative indication.
Without motor weakness or bowel or bladder symptoms it truly is a quality-of-life decision. If the person is experiencing mild to moderate pain, then anti-inflammatory medications, Tylenol and maybe some ice and heat might suffice.
For more significant symptoms, the person may need physical therapy, chiropractic treatment, or maybe spinal decompression therapy as well.
A TENS unit may help, which is a device about the size of an iPod that can be placed on the belt and be very mobile. You can help tire out the muscles around the back and relieve muscle spasms and also help change the way the brain perceives pain signals.
Treatment with a pain management doctor may consist of medication management along with interventional treatment. This may consist of short-term narcotics along with some muscle relaxers. With regards to interventional treatments, the gold standard is there are multiple different ways of performing the injections, and a series of 1 to 3 procedures may be necessary depending on how well they work. Injections usually work over 75 to 80% of the time for significant pain relief.
If substantial conservative treatment for over six weeks is ineffective, then surgery should be considered. If neurological deterioration occurs before then, then surgery should be considered sooner but it is best to make that decision in conjunction with your doctor.
What are my chances of needing surgery?
The vast majority of those experiencing sciatica symptoms will not end up needing surgery Over 95% of those with sciatica symptoms are able to achieve adequate pain relief with the above mentioned treatments. This is really good news considering there are some small but real risks associated with herniated disc surgery.
The Florida Pain Network connects those in pain with pain relievers around the state. This includes pain clinics in south Florida, pain management Orlando clinics, Tampa pain management and more. The pain doctors are Board Certified and offer comprehensive treatments including medication management and injections. Chiropractors offer manipulations, physical rehabilitation and spinal decompression therapy.
Visit THIS page to find the pain clinics closest to you, or just call (877) 877-8556 for assistance.
The term degenerative disc disease is actually a misnomer. It does not represent a true disease as you cannot catch it from a virus and it does not typically get worse like a lot of diseases do. Nevertheless, the term has stuck and represents a medical condition causing low back pain and pain is sometimes radiates into the legs but I am throughout the back.
What exactly is degenerative disc disease?
Humans have an intervertebral disc between every vertebrae of the spine. It acts as a shock absorber and allows an incredible range of motion of the spine in multiple directions. The disc consists of 80% water in normal anatomy along with 20% being a combination of proteins and collagen.
When a person is in their 20s to 40s, it is common for the disc along with many other parts of the body to start dehydrating and losing water.
The disc has two parts to it and the best analogy is that of a jelly doughnut. The outer part is called the annulus fibrosis and the inner part is the nucleus pulposis. The inner part has no sensation, meaning that the person cannot experience any pain from a problem in the nucleus.
Pain can however, come from the outer part which is called the annulus. There are nerve endings in this region and if there is a tear in the disc those nerve endings can’t be irritated.
Over 35% of individuals have evidence of disc degeneration on either MRI or x-ray and don’t even know it. No back pain whatsoever. This age range is between 20 and 40 and was shown in the study back in 1990.
For an unfortunate few, degenerative disc disease leads to substantial back pain that flares up every few weeks to months. Usually it is not constant and comes and goes, but when it is present can be disabling.
Does degenerative disc disease get worse over time?
This is actually a mess and typically not true. Over time, degenerate this disease can typically be managed without surgery just fine and allow a person to maintain a normal lifestyle with nonsurgical treatment. Eventually, the disc and surrounding tissues will stiffen up considerably and pain often that will decrease.
Should I avoid certain activities or sporting activities?
The answer to this question is to let symptoms be your guide. Degenerative disc disease is a quality of life condition and if the person is able to do those activities desired, then they should go ahead and do them. If however, a person is a runner for instance and has resulting low back pain that is significant after jogging, then possibly they should switch to swimming or something less impactful for exercise. but the general rule with degenerative disc disease is that if it does not hurt, then it is okay to do it.
What are effective treatment options for degenerative disc disease?
There are numerous treatments for degenerative disc disease that can help a person avoid surgery and achieve a satisfactory baseline. The first is physical therapy. This can help strengthen up a person’s core muscles and achieve better range of motion. Treatments including electrical stimulation, ice and heat, TENS
units, and ultrasound can help as well. This can be especially useful during acute flareups to alleviate spasms and other symptoms.
Chiropractic and acupuncture can also be helpful. These are termed alternative therapy and may help considerably with maintaining baseline pain and helping decrease exacerbations.
Spinal decompression therapy is a non-surgical treatment that involves 4 to 7 weeks of regular visits. These treatments are noninvasive and very low risk and can help alleviate back pain from degenerative disc disease for quite a few months.
Treatment with a pain management doctor can consist of medication management or interventional pain treatments. Initial medications should consist of over-the-counter Tylenol or acetaminophen. These may be enough for mild to moderate pain. For those times with acute exacerbations, short-term narcotic medication may be necessary or muscle relaxers as well.
Pain management treatments that may be useful include trigger point injections, intradiscal injections, facet blocks, or epidural steroid injections. All of these will depend on an individual’s particular presentation on physical exam and imaging. A pain management doctor will tailor the treatments to what he or she sees.
What are my chances of needing surgery?
The vast majority of those with low back pain due to degenerative disc disease are able to avoid an operation. In certain instances if considerable conservative treatment for over six months does not help, then surgery can be considered. Results can be anywhere from 50 to 80% good to excellent in certain studies, but patient selection is very important.
If you live in Florida and are suffering from chronic low back pain, let the Florida Pain Network help you.
The Network connects those in pain with pain relievers throughout the state. This includes Palm Beach County pain clinics, Orlando pain clinics, Port St. Lucie pain management clinics, Central Florida pain clinics, and there’s also a pain clinic north of Tampa.There are many more Florida pain clinics as well.
Visit this page for options and simply put in your ZIP Code to see those closest to you or you may call 877-877-8556 for assistance.