What is a degenerative lumbar disc disease?
The spinal column is made up of a stack of vertebrae. The last 5 vertebrae make up the lumbar spine which rests on the sacrum. Between each vertebra, there is a disc that lives to cushion. It is made up of 2 parts, a central part which is the nucleus pulposus and a peripheral part which is the fibrous ring. The annulus is the envelope and surrounds the nucleus pulposus. When the annulus suffers an injury, most frequently associated with wear and tear, a part of the nucleus can come out of the annulus fibrosus, compressing the nerve inside the spine. We call this herniated disc or herniated disc; they can be lumbar or cervical. Normally, the disc is worn without rupturing and does not herniate or compress the nerves. Disc damage is called discopathy. An important discopathy can trigger in the same way the development of osteoarthritis at the local level or problems with the biomechanics of the spine, producing chronic pain. Discopathies can affect one or more lumbar discs. The natural history of low back pain due to discopathy is variable. The pains can remain stable or become more and more important and progressively limit both professional and personal activities.
What Causes Discopathy?
Discopathy can be normal or premature and are associated with specific problems such as being overweight, moving heavy objects, working with frequent vibrations or impacts, and prolonged postures. In discopathies, the intervertebral disc becomes dehydrated, and can more or less replace its function, mainly affecting cushioning. This creates local microtrauma that cause pain and muscle contractures, producing lumbago (lumbar pain).
Treatment for discopathy without surgery
These are relieved with rest and with medication (anti-inflammatories, analgesics and muscle relaxants, ozone therapy for the spine). If the seizures are sometimes painful, they never warrant surgical treatment. Until the pains are installed permanently during the crises, we say that the pains become chronic, the treatment of the spine without surgery is maintained in the first intention and physiotherapy and rehabilitation are also associated as well as advice to improve postural hygiene to limit the misuse of the spine. When low back pain persists in a way that limits activities of daily living even with optimal medical treatment (anti-inflammatory, analgesic, infiltrations) and well-directed physiotherapy, we could consider performing surgical treatment