Treating discogenic pain
Introduction
Discogenic pain is described as pain that originates from the intervertebral discs. These discs are the cushions or shock absorbers that are found between each of the vertebrae. Along with the facet joints, these discs work to not only protect the bones, but also provide flexibility, allowing the back to bend in any direction. They are made up of tough, fibrous connective tissue which protects a soft gel-like centre. These discs can become damaged from the strain of lifting something too heavy, an injury caused from an accident, or simply become weak over time. The discs can bulge out of place or the centre can bulge through the fibrous outer core – this is what we called a ‘sipped disc.’
Treatment
In many cases, discogenic pain will sort itself out with a week or so. Patients can use a combination of rest and over the counter pain medications such as ibuprofen or paracetemol to help fight the pain and reduce the swelling of the disc. It is important to keep the resting down to a minimum after an injury, and keep it confined to only the first day or two. After that, moving around can actually help the back begin to heal. Patients are encouraged to try to go about their normal activities as much as possible but avoiding anything that causes intense pain.
If the pain is still intense or gets worse after a week, it is recommended to seek out medical advice. Stronger pain or anti-inflammatory medications may be prescribed as well as additional physiotherapy. It may be suggested to perform some light exercises or manipulation with the assistance of a physical therapist to help rehabilitate the back. Improving the muscle mass in the area of the damaged disc can help better support the back and put less strain on the disc. Also, getting fit can also help take extra pressure off the intervertebral discs if the patient is overweight.
Once these treatments have been tried without success, the doctor may suggest an epidural in order to inject medication directly to the disc in order to help treat it. These injections usually consist of a local anaesthetic and sometimes an anti-inflammatory steroid, which works to stop the pain signals from being sent and help decrease the swelling of the disc and allow it to heal. In many cases, one injection will be enough to heal the disc, but some patients may need to have several injections over the course of a year before the disc is healed.
Finally, in cases where the disc is putting significant pressure on nearby nerve roots or other elements of the spine, surgery may be necessary. A discectomy involves removing a part of the disc that is damaging nerves, muscles or other parts of the back. The latest technology allows for this to be performed with minimal invasive procedures with shorter recovery time. In the worst cases, a disc can be completely removed with an artificial disc inserted in its place.
