The field of pain management uses a wide variety of techniques to address pain and painful disorders. Low back pain caused by degenerative disc disease is often difficult to treat, and many patients find that they have to try more than one treatment, or combination of treatments, before finding sufficient pain relief to be able to complete their daily routines and maintain an exercise and fitness routine. While this is by no means a comprehensive list, here are some treatments that are often prescribed for patients with low back pain:
This degenerative disc disease treatment involves use of behavioral methods to help patient self-manage their low back pain. For example, cognitive therapy involves teaching the patient to alleviate low back pain by means of relaxation techniques, coping techniques (such as visualization), and other methods. Biofeedback involves the gradual alteration of neuromuscular signals that helps reduce symptoms of low back pain.
Restorative Sleep and Rest
Patients with chronic low back pain often report both difficulties falling asleep and staying asleep during the night, leading to less restorative deep sleep. This non-restorative sleep pattern can then cause diminished energy, depressed mood, fatigue, and worse pain during the day. For patients with sleep problems, it is often important to treat both the pain from degenerative disc disease and sleep problems. The problem may often be addressed by sleep medication and individual behavioral changes, such as going to sleep and waking up on a consistent schedule, avoiding naps during the day, developing a relaxing pre-sleep routine of a warm bath, reading a book in bed, and more.
Manual manipulation by a chiropractor or other qualified health professional is thought to help relieve low back pain by taking pressure off sensitive neurological tissue, increasing range of motion, restoring blood flow, reducing muscle tension, and creating a series of chemical reactions in the body (such as endorphin release) that act as natural painkillers.
Epidural Steroid Injections
Direct delivery of steroids and/or anesthetic to into the epidural space in the spine can help provide relief of low back pain. While the pain relief is usually temporary, it can be useful to help the patient feel comfortable enough to start an exercise and rehabilitation program. Epidural injections are effective in providing significant pain relief about 50% of the time, and are generally limited to not more than three per year.
The use of electrical stimulation can sometimes be helpful to relieve back pain from degenerative disc disease, although there is little hard evidence in the literature to support its efficacy. It does, however, seem to reduce pain for some patients and helps them function better with less pain medication. An example of electrical stimulation is Transcutaneous Electrical Nerve Stimulation units, or TENS units. Pads are applied to the skin overlying the most painful areas and a low current electrical charge is transmitted to the skin. The theory is that the electrical signals help override the pain signals.
Low back braces can sometimes help reduce episodic low back pain from degenerative disc disease by limiting motion of the spine. Some physicians caution against use of a back brace, especially on a long term basis, as it may lead to weakening of the muscles. Short term bracing, or bracing with certain activities, may be a reasonable option for some patients.
The use of traction can help relieve low back pain be allowing muscles to relax. Traction may be a reasonable to try with a trained professional if it is done in a cost effective manner. However, patients should be aware that there is no scientific evidence that traction will reverse a degenerative process. Although traction is not harmful, it can be expensive and patients should be wary of using traction due to the lack of scientific evidence of its efficacy in treating low back pain.