Degenerative Disc (cont.)
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Catherine Burt Driver, MD
Catherine Burt Driver, MD, is board certified in internal medicine and rheumatology by the American Board of Internal Medicine. Dr. Driver is a member of the American College of Rheumatology. She currently is in active practice in the field of rheumatology in Mission Viejo, Calif., where she is a partner in Mission Internal Medical Group.
In this Article
- Degenerative disc disease and sciatica facts
- How is the spine designed?
- What is the purpose of the spine and its discs?
- What causes degenerative disc disease?
- What are the symptoms of degenerative disc disease?
- What are radiculopathy and sciatica? What are the symptoms?
- How are degenerative disc disease, radiculopathy, and sciatica diagnosed?
- How is radiculopathy treated?
- What is bony encroachment and spinal stenosis?
- What is the outlook (prognosis) of degenerative disc disease, radiculopathy, and sciatica?
- Can degenerative disc disease, radiculopathy, and sciatica be prevented?
- Find a local Orthopedic Surgeon in your town
How are degenerative disc disease, radiculopathy, and sciatica diagnosed?
Degenerative disc disease, radiculopathy, and sciatica are suspected when the symptoms described above are noted. The doctor can sometimes detect signs of irritated nerves during the examination. For example, increased radiating pain when the lower extremity is lifted supports the diagnosis of lumbar radiculopathy. Nerve testing (EMG/electromyogram and NCV/nerve conduction velocity) of the lower extremities can be used to detect the nerve irritation. The actual disc herniation can be detected with radiology testing, such as CAT or MRI scanning.
How is radiculopathy treated?
The treatment of degenerative disc disease, radiculopathy, and sciatica ranges from nonsurgical (medical) management to surgery. Medical management of radiculopathy includes patient education of the condition, medications to relieve pain and muscles spasm, cortisone injection around the spinal cord (epidural injection), physical therapy (heat, exercises, massage, ultrasound, electrical stimulation), and rest (not strict bed rest, but avoiding reinjury). With unrelenting pain, severe impairment of function, or incontinence (which can indicate spinal cord irritation), surgery may be necessary. The operation performed depends on the overall status of the spine and the age and health of the patient. Procedures include removal of the herniated disc with laminotomy (producing a small hole in the bone of the spine surrounding the spinal cord), laminectomy (removal of the bony wall adjacent to the nerve tissues), by needle technique through the skin (percutaneous discectomy), disc-dissolving procedures (chemonucleolysis), and others.
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