Lumbar Spine Degenerative Joint Disease Treatment

Symptoms

The symptoms of the degenerative joint disease vary depending on where the joint is located and which structures are affected. Symptoms range from mild to severe and may resemble those of a disc problem:

• Back pain or radicular symptoms to the trunk or rib cage;
• Localized pain and tenderness at the level of the involved facet joint;
• Muscle spasms and posture changes as a result of the injury;
• Limited range of motion, such as the inability to bend backward, move sideways to the affected side, or stand upright;
• Difficulty standing and walking due to severe irritation;
• Difficulty sitting;
• Joint stiffness after rest;
• Pain due to strenuous activity that relieves with rest;
• Swelling at the joint level.

If your pain worsens for no apparent reason and rest and over-the-counter medication are ineffective, consult your doctor. If the numbness and tingling persist or you are unable to move a part of your body, make an appointment. If you begin to lose control of your bowels or bladder, seek medical attention immediately.

Treating Degenerative Joint Disease

Treatment of degenerative joint disease or injury will depend on the severity of the condition. When treating acute back problems:

• Rest. Avoid the activities that produce the pain (bending, lifting, twisting, turning, bending backward, etc.);
• Anti-inflammatory drugs and other pain medication;
• Apply ice in acute cases to the thoracic spine to help reduce pain and associated muscle spasms. Apply it right away and then at intervals for about 20 minutes at a time. Do not apply directly to the skin;
• Moist heat may be helpful to reduce pain and improve any feelings of stiffness;
• An exercise regimen designed specifically to address the cause of the symptoms associated with the degenerative joint disease and improve joint mobility, spinal alignment, posture, and range of motion;
• The use of a brace or other supports may be necessary to reduce stress on the facet joints, muscles, and thoracic spine;
• Steroidal medication to reduce inflammation in moderate to severe conditions;
• Facet joint injections directly to the involved joint;
• Physical therapy to reduce inflammation, restore joint mobility, improve motion, and help the return of full function.

The main goal is to alleviate your pain and avoid further injury. These pain management techniques are usually intended to be used for a long time as long as your condition is manageable.

Medications to consider

Your physician may recommend several medication options individually or in combination to reduce the pain, inflammation, and muscle spasm that may be associated with facet joint injuries.

• Over-the-counter medications for mild to moderate pain;
• If over-the-counter medications are not effective, your physician may prescribe stronger pain medication;
• Anti-inflammatory drugs or prescription NSAIDS to reduce inflammation following acute injury;
• Muscle relaxers to reduce acute muscle spasms;
• Injections like facet injections, nerve blocks, or an epidural. These may involve the injection of corticosteroids to a specific structure to reduce local inflammation.

Severe or Non-responsive Conditions

In the case of conditions that do not respond to conservative care, surgery may be indicated. If you continue to experience some of the following symptoms:

• Increase in radiating or radicular pain;
• Pain or nerve irritation that gets worse;
• Associated disc involvement.

The majority of patients return to normal function within a few weeks of surgery, and the results are usually excellent.

Medical Procedures to Consider

Injections like facet injections, nerve blocks, or an epidural. These may involve the injection of corticosteroids to a specific structure to reduce local inflammation.

• Caudal Epidural Injections;
• Facet Joint Injections;
• Interlaminar Caudal Epidural Steroid Injections;
• Medial Branch Blocks;
• Selective Nerve Root Blocks.

The procedures mentioned above are used to isolate the source of pain, provide temporary pain relief, and improve the effectiveness of physical therapy in patients with severe pain.

Surgical Procedures

Procedures your doctor can perform to reduce the effects of degeneration on pain-producing structures of the spine include:

• Endoscopic Decompression;
• Endoscopic Foraminotomy;
• Laser Facet Rhizotomy;
• Facet Thermal Ablation;
• Radiofrequency Ablation.

Your doctor will use different surgical procedures depending on the condition and its severity. Sometimes, they can surgically repair a herniated disc to restore the normal anatomic structure. In other cases, the specialist must remove the painful disc or a bone pressing against the spinal cord. Only surgery to relieve pressure on the spinal cord can provide long-term relief in patients with spinal stenosis.