How do you treat DDD (degenerative disc disease) with a slipped disc?

Doctor's Answers 1

Photo of Dr Shee Yan Fong
Dr Shee Yan Fong

Orthopaedic Surgeon

Degenerative spine disease includes both degenerated disc (known as "slipped" disc by lay person) and facet joint arthritis. It is actually not a "disease" (unlike cancer or diabetes) but a natural aging process of our spine as we age, similar to wear and tear in our joints and dementia.

As such degenerated spine including "slipped" disc is not a disease that can be "treated". Rather, "treatment" for patients actually means management (or "reduction") of his neck/back pain and subsequent disability.

More than 90% of pain and disability can be successfully managed with neck/back rest and care, bending/falling precaution, pain medications, physical therapy, TCM, or combination of the above. Like all degenerative joint pain, it frequently takes 2-3 weeks of treatment to notice any sustainable improvement but majority usually resolves within a month, so please don't rush the recovery process!

Rarely spinal injection is needed for persistent pain lasting more than a month of conservative management. However patients will often experience relapse of pain again later if they are not careful with their neck or back, confirming this natural "disease" cannot be "treated" permanently.

Occasionally 10% of patients may suffer more serious spinal nerve/cord encroachment by the "slipped" disc will experience nerve pain, numbness and weakness besides neck/back pain.

This can only be confirmed by MRI scan only and unfortunately may require surgical treatment to release spinal nerve/cord before neurological deficits worsen further to paralysis. Despite surgery to alleviate "pinched" nerve and enable patients to resume normal work and life, neck/back pain still remains on-and-off for life, confirming the fact of no permanent cure for degenerative spine.

Similar Questions

How can I get rid of persistent back pain that is not responding to physiotherapy?

Thank you for your email and I am sorry to hear about your ongoing pain symptoms. This can be an issue after surgery even if it does resolve the disc issue/symptoms that you were experiencing. The only way to resolve pain is to assess you and consider the pain generators in the back - unfortunately there can be many. It could be residual pain from degenerative discs, facet joints, nerve irritation, muscular tightness, scar tissue formation and so on.

Photo of Dr Dinesh Sirisena

Answered By

Dr Dinesh Sirisena

Sport Medicine

What should I do next for lower back pain that occured on running?

Thank you for your questions. I agreed with both Dr. Sean and Dr. Dinesh that your pain is likely "discogenic", meaning that it is coming from the disc, which is the cushion in between the bones. There are also a spectrum of a "slipped disc", only when the slipped disc is very severe and compressing onto the nerve then you will develop tingling sensation or sciatica. Of course we don't want to wait until then before we do a thorough checkup on you, I'd recommend a MRI scan for you to investigate the actual cause of the pain and the severity of the condition.

Photo of Dr Henry Chan

Answered By

Dr Henry Chan

Orthopaedic Surgeon

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