What is the difference between disc degeneration and disc herniation?

What is intervertebral disc degeneration?

There is a certain area between the lumbar vertebrae (of the spine) that are called "intervertebral discs". The intervertebral discs have a two-layer structure consisting of an annulus fibrosus and a nucleus pulposus. The annulus fibrosus is made of alternatingly oriented fibers designed to absorb impact from movements in any direction. The nucleus pulposus contains mainly water and its movements help to cushion the disc.
What is called intervertebral disc degeneration is a condition in which, due to damage or some other cause, the original shape of an intervertebral disc can no longer be maintained, initiating deformation of the intervertebral disc, and ends up in the deterioration of the intervertebral disc function and symptoms such as low back pain.

Causes of disc degeneration

The aging process, excessive physical exercise, work environment, and genetics have all been linked to this condition.
Discs are mainly composed of water. As the amount of water in the body decreases with age, it also decreases accordingly in the intervertebral discs. The reduced water content causes the disc to become less flexible and more rigid. When this happens, even the smallest amount of external stimulus can cause the disc to crack. This is one of the causes of disc damage. Also, the disc itself has a limited regenerative ability and has difficulty recovering once damaged. Any physical exercise or work that puts pressure on the disc can cause it to wear out faster and hasten its decline.

Symptoms of disc degeneration

The predominant symptom for an intervertebral disc is lower back pain. A crack in the disc can cause the nucleus pulposus to leak out, resulting in a herniated disc and damage to the nerve. The injury causes nerve inflammation, resulting in symptoms such as pain and numbness in the legs.

*Inflammation is a reaction that occurs when the body is repairing a wound, resulting in pain, swelling and fever.

The deterioration of the discs also reduces their height, shrinking the distance between the bones, so that the discs are more likely to collide into each other. Repeated friction can lead to the formation of bone spurs called osteophytes, or deformity of the vertebral body itself, resulting in degenerative lumbar spondylosis. Due to this deformity, inflammation occurs on the surface of the bone and the surrounding tissues, and in addition to nerve-induced symptoms, new pain occurs in the lower back and around the buttocks.
If the inflammation becomes chronic, the body will become hypersensitive because of the pain that has been building up and may not subside even after surgery because it has accumulated for so long.

How to Treat Disc Degeneration

Conservative treatments

Our clinic offers physical therapy and medication.
Physical therapy is designed to treat the back conditions caused by lifestyle habits, such as standing, walking, and sitting, that have accumulated in the past, remove stress on the body and correct imbalances in muscles and joints to nurse them back to a stress-free state. These corrections are implemented to promote the elimination of inflammation caused by lifestyle-related stress.
The lumbar spine also concentrates a large amount of blood vessels, so by improving blood flow, inflammation may be alleviated, and pain reduced.

Surgery

Surgery may be considered if the nerve is being compressed by the development of bone spurs or caused by a hernia. However, note there are currently no actual surgical procedures that are effective for disc degeneration.
This is because the purpose of surgical procedures is to shave bones and ligaments to remove pressure on nerves, and therefore this method offers no actual treatment of the intervertebral disc itself.

What treatments at our clinic are effective for disc degeneration?

We offer the DST procedure at our clinic.
DST treatment is the injection of medication into the damaged area of the disc to promote disc repair and regeneration. Intervertebral disc treatment is designed to improve pain by restoring disc function and maintaining cushioning.
Unlike conventional surgical procedures, this treatment does not involve a scalpel at all, instead a needle is used to directly pierce through the intervertebral disc under local anesthesia, and from there the drug is injected into the disc.
This helps restore the original function of the deformed disc and prevents the nucleus pulposus from leaking out by sealing the damaged area of the wound.

Treatment flow

  • 01 Consultation with one of our doctors

    An MRI and x-ray will be taken, and the doctor will then make a diagnosis.
    If the diagnosis indicates that DST is suitable, you can start the procedure on the afternoon of the same day.

  • 02 Before the procedure

    A local anesthetic is administered to the lower back in the operating room and a needle is inserted into the lumbar disc(s) identified during the examination.
    An examination using a contrast agent is performed to pinpoint the location of the damaged disc.

  • 03 The procedure

    Fluoroscope guidance is then used to locate the disc and administer the drug to the damaged area. Once the drug has penetrated the zone, the needle is removed, and the bleeding is controlled.

  • 04 Going home

    The patient can go home upon completion of the treatment, after resting in a private room for about an hour and a final routine examination by the doctor.
    *The time of release depends on the patient's symptoms and condition.

Prevention of disc degeneration after surgery

After receiving treatment for your disc degeneration at our clinic, you can start doing light work, such as desk work, starting on the next day.
Nevertheless, you should avoid sports and heavy work for about a month and rest accordingly.
In addition, if the results of the MRI/X-rays show that the cause lies not just in the disc, but also in the muscles and ligaments, we will recommend that you incorporate therapeutic exercise in your program.
If there are other causes to your condition besides the intervertebral disc, even if the disc has been repaired or its condition improved, it may continue to be painful due to muscle and ligament inflammation. Especially if the pain has become chronic, the causes may be multiple, such as blood circulation for instance, and improvement at the root level may become necessary.
At ILM International Lumbago Medical Fitness, our clinic’s facility specialized in low back pain rehabilitation, we are dedicated to providing postural corrections for the muscles and ligaments and offer detoxification and medical nutrition therapy while also providing flexibility exercises to counter muscle stiffness.

Questions and Answers about Disc Degeneration

  • question

    What are some precautions to take if I am diagnosed with disc degeneration?

    answer

    First, if the symptoms, such as current pain, are quite severe, try resting and observe your condition for about a week. If the symptoms have improved during the week, conservative treatments, such as exercise, are recommended. If your symptoms do not improve, we recommend a visit to your local orthopedic clinic or hospital.

  • question

    Can a deformed disc ever return to its original state without surgery?

    answer

    If the damage to the disc is minor, it may heal on its own. When the wound closes naturally, the water content inside will increase, and the intervertebral disc will resume fulfilling its original role.
    However, if the wound is deep and the annulus fibrosus has been torn, it will usually be difficult for it to heal by itself, and if the condition worsens even further, it may lead to a herniated disc or degenerative lumbar spondylosis. In that case, treatment with the DST procedure may be considered as an option.

  • question

    What is the difference between disc degeneration and a herniated disc?

    answer

    Disc degeneration is a condition where discs crack and become damaged, water escapes from them and the discs start to stiffen, lose their cushioning function and become deformed, leading to lower back pain. At this point, disc herniation occurs when the nucleus pulposus has leaked outside the damaged area and compresses the nerve.
    The worse disc degeneration gets, the more likely it is that disc herniation will occur.

  • question

    What is some useful advice to bear in mind to prevent disc damage?

    answer

    Disc damage is thought to be caused by aging and other factors, but stress put on the back by postures and movements on a daily basis also plays a great role. Especially, the posture assumed during prolonged sitting puts a lot of strain on the lower back. Therefore, we recommend that you give careful thought to your chair and sitting posture and perform daily training at home.

  • question

    Can I have another surgery if my intervertebral disc becomes deformed again after a first procedure?

    answer

    Yes, a second treatment is possible with the DST method because it promotes disc repair and regeneration. However, disc deformity following a DST treatment may happen when fairly strong pressure is sustained, in sports of intense exertion for instance, or for strenuous work that keeps you in an uncomfortable posture for a long time. Also, following the surgery, ILM Back Pain Medical Fitness will provide exercise guidance and home training or one-on-one rehabilitation to prevent future problems.

5 Types of Outpatient Treatment for Low Back Pain

  • The DST Method (Discseel™)

    An intervertebral disc treatment that began in the United States in the 2010s. Can be suitable for a wide range of conditions, including problems in patients after surgery. It is the only (※2)treatment that can repair and regenerate intervertebral discs.
    ※2 According to research by Operation Japan (Ltd.)

    Click here for details.
  • The PIDD Method (Implant)

    An implant intervertebral disc treatment that has been conducted since the 2000s. As with PLDD, results without injury to intervertebral discs can be anticipated. This treatment is suitable for herniated discs only.

    Click here for details.
  • Hybrid Laser Treatment

    A treatment that combines the benefits of PLDD and PODD. This treatment is suitable for herniated discs only.

    Click here for details.
  • The PODD Method (Ozone)

    An ozone intervertebral disc treatment that has been conducted mainly in Europe since the 1990s. It can be suitable for a wide range of conditions.

    Click here for details.
  • The PLDD Method (Laser)

    An outpatient, laser intervertebral disc treatment that has been well known worldwide since the 1980s. This treatment is suitable for herniated discs only.

    Click here for details.