Heal Intervertebral Disc Injuries with Regenerative Medicine!
How Common Is Lumbar Disc Pain?
A common cause of lower back pain is degenerative disc disease (DDD). Approximately 30 million people per year are affected by this. DDD is the normal aging progression of lumbar intervertebral discs, but can be accelerated by injury or excessive chronic wear and tear. |
What Causes Disc Injuries?
Typically, acute injuries involving intervertebral discs occur with bending, lifting, or twisting injuries. The outer layer of the disc, the annulus fibrosus, is often damaged with these injuries. This outer layer can develop tears which are painful. If the tear is severe enough, the inner portion of the disc can herniate out of the disc and cause nerve irritation. |
What Are The Symptoms Of Disc Injuries?
People with painful discs often have pain whenever there is increased pressure on the disc. This includes sitting, bending, coughing, or flexion of the lumbar spine. The pain is often felt it the middle of the lower back, but can also refer and be felt in the buttock or to one side of the lower back. |
What Happens After Damage To The Lumbar Discs?
After an intervertebral disc injury, people often improve with time and no specific interventions. Unfortunately, some are not so lucky and develop longer lasting lower back pain. If the damage is severe enough it may take longer to heal or may go on to cause chronic pain.
DDD is often progressive and as the discs are further damaged a cascade of events can occur. These events include disc bulging, herniation, and narrowing, which then can lead to conditions such as lumbar radiculopathy (sciatica), spinal stenosis, and facet arthropathy (joint arthritis).
After an intervertebral disc injury, people often improve with time and no specific interventions. Unfortunately, some are not so lucky and develop longer lasting lower back pain. If the damage is severe enough it may take longer to heal or may go on to cause chronic pain.
DDD is often progressive and as the discs are further damaged a cascade of events can occur. These events include disc bulging, herniation, and narrowing, which then can lead to conditions such as lumbar radiculopathy (sciatica), spinal stenosis, and facet arthropathy (joint arthritis).
How Is Degenerative Disc Disease Treated?
Initially, DDD is treated with conservative management including rest, medications, avoiding painful activities, ice/heat, chiropractic, acupuncture, and physical therapy. There are times when all of these treatment options do not produce the expected improvement. The ultimate corrective action in some cases is surgery, although we prefer to avoid surgery until the absolute last resort. There have been a wide array of minimally invasive interventional procedures used to treat DDD. These include epidural steroid injections, intervertebral disc annuloplasty (IDET), and other injections into the disc. Unfortunately, these have not shown to be very effective in reducing symptoms. |
Can Regenerative Medicine Be Used To Treat DDD?
Regenerative medicine has been recently used to help with DDD. There are more and more studies being published on intradiscal injections of either platelet rich plasma (PRP) or stem cells. These studies, although small are demonstrating improvement in pain and function in patients with DDD. Unlike most medical treatments, these interventions actually enhance the body’s own healing ability. We would expect delay in secondary effects of DDD including radiculopathy, spinal stenosis, and facet arthropathy. These procedures have been shown to be safe and pose low risk to patients. Regenerative medicine may not be suitable for all patients with DDD. Setup a consultation with Black Stone Physical Medicine if you are interested in seeing if these treatments are right for you. |
Link to prospective, double-blind, placebo controlled trial using platelet rich plasma injection for lumbar degenerative disc disease:
https://www.pmrjournal.org/article/S1934-1482(15)00971-5/fulltext
https://www.pmrjournal.org/article/S1934-1482(15)00971-5/fulltext