Degenerative Disc and Degenerative Facet
Joint Disease Treatment Suggestions

As we age, there is a drying up of the disc material and the lubrication of the joint fluid in the facet joints. The facet joints are the row of small joints on each side of the spinal canal, which together with the discs as a unit gives the spine its mobility.

With degenerative changes there are bone spurs, there is loss of joint space and a general stiffening and painful decrease of range of motion. These changes can eventually be seen on X-rays and the drying out of the discs called "dessication" can be visualized on an MRI scan. To prevent this from happening prematurely walking, stretching exercises and mild to moderate weight training is useful.

Anti-inflammatory medication such as the COX-2 inhibitors or regular nonsteroidal anti-inflammatories will help to control the inflammation and allow the patient to do the gentle reconditioning that is required. Heat treatment, acupuncture and massage treatments and swimming are all useful therapeutic modalities.

However, in more severe cases where the degeneration of the facet joints has progressed to the point that bone rubs on bone, or where the disc material has been thinned out to the point where one vertebral body almost rubs on the other, fusion surgery with a bone graft taken from the pelvic bone may be the answer. The orthopedic or neurosurgeon will be able to advise whether or not this is an option in a particular patient. Every patient has to be judged on his own merit.

Disclaimer:

This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.

References:

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8. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 56, p. 469.

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Last Modified: Aug. 31, 2004