Disc regenerative therapy for lower back pain

Degenerative disc disease is one of the most prevalent causes of lower back pain. 

In short, this condition presents with pain and a general weakness or numbness in the area, which stems from a degenerated spinal disc – and although it may be related to the ageing process, it can affect anyone at any stage of life. We speak to a spinal expert on treatment options.

‘Between each bone (vertebra) in the spine is a cushion-like structure called an intervertebral disc,’ says Dr Russell Govender a specialist spine surgeon at Mediclinic Constantiaberg. ‘The disc is a shock-absorbing structure that also allows slight movement between the vertebrae, and acts as a ligament to hold the vertebrae together.’

‘Degenerative disc disease is due to wear and tear of the disc. The symptoms can range from low-level chronic back pain with acute episodes of more severe pain; or weakness and sensory change in a particular nerve distribution associated with the degenerate disc.’

The name given to degenerative disc disease can be misleading. Usually, the term degenerative would indicate a worsening of symptoms over time, but in this case it refers to the fact that this condition causes a spinal disc to worsen, and in most cases the symptoms actually improve. Degenerative disc disease is also technically not a disease, but a natural part of ageing that can lead to severe pain.

Degenerative disc disease can lead to the development of other serious conditions, such as spinal stenosis, or spinal cord pinching, and osteoarthritis in the spine. Symptoms of the condition vary from patient to patient, and can include everything from mild but consistent jarring to severe and disabling pain.

Treatment options

Usually, doctors prescribe various medications to help with pain control, and recommend a few lifestyle changes to help manage the condition and prevent it from worsening. These would typically include gentle exercise and rehabilitation to strengthen the area, as well as efforts to avoid stress on the spine.

Therefore, non-surgical options include:

• Pain control
• Oral medication
• Epidural steroid injection
• Exercise and Physical Therapy
• Manual treatment
• Mobilisation and facilitating range of movement
• Back and core muscle strengthening
• Lifestyle modification
• Stop smoking
• Weight loss
• Improve strength and fitness
• Workplace and activity modifications

‘For acute onset of back pain without neurological symptoms (such as referred pain or weakness in the arm or leg), a few days of rest and a short course of anti-inflammatories is usually effective in most cases,’ Dr Govender explains.

While these non-surgical measures may provide at least temporary relief for patients suffering from degenerative disc disease, those who do not benefit often resort to lumbar fusion surgery.

‘Disc regenerative therapy is treatment aimed at reversing the degenerative process in the disc by promoting healing and growth. The two main methods currently employed are the injection of growth factors and connective tissue into the disc or the injection of patient-derived stem cells into the disc. Some promising results have been shown in animal studies, however, it is currently an unproven treatment modality in humans,’ says Dr Govender.

When it’s time to see your doctor

Do you experience consistent pain in your back? And is it affecting your ability to move or walk? It may be time to see your doctor.

‘On-going pain or associated neurological symptoms usually warrant an assessment by your doctor. They will likely order radiological imaging (X-rays or MRI scan) to diagnose the problem, and certain cases may require specialist referral to a spinal surgeon,’ concludes Dr Govender.