Discs

Discs separate two adjacent vertebral bodies. They are semi-solid which allows mobility of the spine. Since they are not a rigid structure and because of regular and repetitive movement, they are more prone to injury (bulging or herniation of the disc) and degeneration (thinning of the discs).

Disc degeneration cannot be “fixed.” There is ongoing research into different medications or materials that can be injected into these discs to help them regenerate. None of these, however, have been proven effective yet, and therefore they are not FDA approved. Degeneration of discs leads to inflammation which itself is a significant source of pain. Therefore, the best way to address pain caused by degenerated discs is to control the inflammation that they cause. One of the most effective ways to accomplish this is with the injection of steroid (a potent anti-inflammatory) into the epidural space. This can be done using the interlaminar approach or the transforaminal approach.

Beyond just degeneration, discs can also bulge or herniate. This itself can cause pain in the neck or back. Futhermore, these herniated discs can put pressure on nearby nerve roots which can lead to radiating pain into the arms or legs (sciatica). As with degenerated discs, herniated discs cause a great deal of inflammation. Therefore, steroid injections are an effective treatment option for this problem as well. Often times, this alone is enough to alleviate most (or all) of the symptoms, and therefore surgery can be avoided. If such conservative care fails to provide adequate relief, herniated discs can be repaired surgically.