Degenerative Disc Disease And Facet Joint Disease

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[edit] Degenerative Disc Disease And 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, as seen on Fig. 1 of this link (blackened area with arrows pointing). To prevent this from happening prematurely, it is recommended to engage in fitness walking, stretching exercises and a mild to moderate weight training program is useful as well.

However, heavy weight training can accelerate the wearing out of the facet joints and discs thus leading to premature degenerative changes. Multiple sports injuries, car accidents or fights will also accelerate this degenerative arthritis, typically 5 to 10 years following the back injury delay.

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, back surgery with a bone graft taken from the pelvic bone may be the answer. In medical circles this is called "spinal fusion surgery". The orthopedic or neurosurgeon will be able to advise whether or not this is an option in a particular patient. The newest technology is disc transplantation instead of fusion surgery. Every patient has to be judged according to the individual circumstances to see what is best for the patient.

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