Degenerative disc disease (DDD) is a common cause of ongoing neck or back pain. When spinal discs dry out and wear down over time, they may no longer cushion the spine the way they should. For some people, this causes little or no discomfort. For others, it leads to significant pain, stiffness, numbness or weakness that gets in the way of everyday life.
At the University of Miami Health System, orthopedic spine specialists focus on degenerative disc disease treatment that helps you stay active and independent. Our orthopedic specialists start with conservative, non-surgical treatment options and recommend surgery only if your symptoms persist and keep you from doing daily activities.
UHealth orthopedic surgeons prioritize preserving your mobility and function to give you the quickest recovery and best possible long-term outcomes. We offer motion-preserving surgical options, such as minimally invasive procedures and disc replacement. Fusion surgery is recommended only when less invasive approaches are unable to provide symptom relief.
What is degenerative disc disease?
Degenerative disc disease is a condition where the soft cushions (intervertebral discs) between the bones of your spine gradually break down. As discs lose height and flexibility, nearby joints and nerves can become irritated, which may cause back or neck pain. Degenerative disc disease can affect the cervical spine (neck) and/or the lumbar spine (lower back).
Symptoms of degenerative disc disease
Symptoms vary based on where the disc changes are happening and whether a nerve is involved. You may notice only mild, occasional discomfort or develop more persistent symptoms that can radiate into your arm or leg.
Common symptoms include:
- ongoing neck or lower back pain
- pain that worsens when you sit, bend, twist or lift
- pain that improves when you change positions, stand or walk
- stiffness or reduced flexibility in your spine
- pain, numbness, tingling or weakness that travels into your arm or leg
Complications of degenerative disc disease
Seek immediate emergency care right away if you experience:
- sudden, severe pain with new weakness in your legs
- sudden loss of bladder or bowel control
- numbness in the area around the groin
When should I see an orthopedic doctor for degenerative disc disease?
Make an appointment with a UHealth orthopedic spine specialist if you have:
- neck or back pain that lasts more than a few weeks
- pain that interferes with sleep, work or daily activities
- pain, numbness, tingling or weakness that travels into an arm or leg
- spine pain after a fall, accident or other injury
Your UHealth orthopedic specialist can confirm whether degenerative disc disease is the source of your pain and help you understand your treatment choices.
How do our orthopedic specialists diagnose degenerative disc disease?
UHealth’s orthopedic spine doctors can diagnose degenerative disc disease after considering your:
- Medical history – when your symptoms started, what makes them better or worse, any prior injuries or surgeries
- Physical and neurologic exam – checking your posture, range of motion, reflexes, strength, and sensation
- Imaging tests – X-rays to look at your bones and disc spaces, and MRI scans to evaluate your discs, nerves, and soft tissues more closely
- Additional tests (when needed) – can include nerve studies to evaluate whether a nerve is irritated or damaged
Non-surgical treatment options
Your UHealth orthopedic team will always prioritize the following non-surgical treatment options for degenerative disc disease, whenever appropriate.
Pain management
Depending on your health history and level of pain, your doctor may recommend:
- over-the-counter medicines such as anti-inflammatory drugs like ibuprofen and/or pain killers like acetaminophen
- anti-inflammatory creams/ointments
- prescription medications to reduce pain and inflammation, used for a limited time when needed
Physical therapy and exercise
A UHealth physical therapist can design a program to support your spine and improve how you move. The primary goal of physical therapy is to strengthen your core (back and abdominal) muscles to reduce the demand on your spinal discs to support your body in an upright position. The stronger your core muscles are, the less stress is placed on your spinal discs, which often relieves pain caused by degenerative disc disease.
Your physical therapy plan may include:
- core strengthening to support the spine
- gentle stretching to improve flexibility in your neck, back and hamstrings
- exercises to improve posture, balance and body mechanics
- low-impact aerobic activity, such as walking or stationary cycling
If your treatment plan includes surgery, physical therapy remains essential to your return to daily activities and long-term recovery.
Your UHealth physical therapist can help you:
- regain strength and flexibility after a pain flare, minimally invasive procedure, or surgery
- improve posture and movement patterns that protect your spine
- safely return to work, sports, and daily activities
- build a home exercise program to support your long-term spine health
Click here to learn more about UHealth’s physical therapy services.
Interventional treatments
If your symptoms of degenerative disc disease persist following medications and physical therapy, your UHealth orthopedic specialist may recommend one or more of the following interventional treatments prior to considering surgery. Your orthopedist will review the benefits and risks of each option and monitor how well interventional treatment is working for you.
- Spinal injections place medication near the painful area of your spine to reduce inflammation and help you participate in therapy. When needed, UHealth administers epidural injections and facet injections.
- Nerve ablations are a minimally invasive procedure that use heat (radiofrequency), cold (cryoablation), or chemicals to destroy or block specific nerves to stop them from sending pain signals to your brain.
Surgical treatment options
Surgery is not the first step for most patients with degenerative disc disease. Your UHealth orthopedic specialist will consider surgery only if:
- your symptoms of degenerative disc disease do not improve with non-surgical care
- pain or weakness significantly limits your daily activities
- your imaging tests show a clear problem that surgery can address
This conservative approach ensures that we move forward with surgery with a high level of confidence that it will improve your symptoms.
If needed, your UHealth orthopedic spine surgeon will discuss the potential benefits of the following surgical options:
- Extreme lateral interbody fusion
- Cervical disc replacement
- Lumbar disc replacement
- Laminectomy or discectomy
UHealth’s orthopedic team specializes in:
- minimally invasive and extreme lateral spine surgery
- motion-preserving laminoplasty
- disc replacement surgery (lumbar and cervical spine)
- endoscopic spine surgery
UHealth’s orthopedic department focuses on minimally invasive surgical techniques that involve minimal muscle and tissue dissection. Our approach helps preserve your tissue and promote your postoperative recovery. If you are not a candidate for motion-preserving surgery, your UHealth doctor may consider a fusion or decompression procedure to relieve your symptoms.
Recovery and rehabilitation after treatment
We place a strong emphasis on optimizing your postoperative outcomes. UHealth’s orthopedic specialists routinely collect patient-reported outcome data, allowing us to objectively measure the success of spine surgeries, refine our approaches, and contribute to research through published studies.
Pain management during recovery
Pain control often includes a combination of strategies, such as:
- short-term use of medications recommended by your doctor
- physical therapy
- ice or heat to manage soreness
- gentle stretching and gradual activity
- relaxation and breathing techniques to ease muscle tension
Long-term management and returning to activities
By following our pre- and post-operative recommendations and care plan, UHealth patients are typically able to return to their regular activities over time. Your long-term management plan may include:
- staying active with low-impact exercises
- keeping up with your home exercise routine
- maintaining a healthy weight
- avoiding tobacco use
- using good posture and safe lifting techniques at work and at home
Multidisciplinary, research-backed care for better outcomes
UHealth is part of a robust academic health system, which places us at the forefront of research on conditions including degenerative disc disease. Our doctors and surgeons conduct extensive, multidisciplinary research focused on improving spinal surgery techniques and patient outcomes.
When UHealth patients with degenerative disc disease are referred to physical therapy, our orthopedic specialists coordinate care with our physical therapists to ensure patients receive personalized and targeted therapies for optimal results.
When spinal injections are recommended for UHealth patients with degenerative disc disease, our orthopedic specialists communicate closely with our interventional treatment providers in a coordinated effort to relieve symptoms without surgery.
Questions to ask your UHealth orthopedic specialist
Bringing a list of questions to your visit can help you make decisions with confidence. You may want to ask:
- What is causing my back or neck pain?
- Which non-surgical treatments do you recommend first?
- How long should I try non-surgical treatment before considering surgery?
- What are the potential benefits and risks of surgery in my case?
- What exercises are safe for me to do at home?
- How will we track my progress over time?
Why choose UHealth for orthopedic degenerative disc disease treatment?
At UHealth, you receive care from a team that understands both spine mechanics and the impact of chronic back and neck pain on daily life. Our program offers coordinated care with:
- board-certified orthopedic surgeons with expertise in spine conditions
- physical therapists experienced in back and neck rehabilitation
- pain management and rehabilitation specialists
We emphasize:
- Conservative care first. Non-surgical treatment for degenerative disc disease is the starting point for most patients.
- Shared decision-making. Your doctor explains all appropriate options and helps you weigh pros and cons based on your goals.
- Collaboration across disciplines. When you need advanced or minimally invasive spine surgery, UHealth’s orthopedic specialists coordinate closely with our neurosurgeons.
- Coordinated care. We connect you with UHealth’s related services, such as physical therapy and interventional therapies, in one integrated health system.
FAQs: Orthopedic treatment for degenerative disc disease
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