I have chronic back pain and my doctor has told me I have disc disease. I do not wish to have surgery on my back. Is there anything else I can do?

Pain in the lower back can be secondary to different structures in the back and the spine and one of the structures which can cause pain is a disc disease. Sometimes the intervertebral disc which acts as a cushion between the vertebrae gets weaker after age 30 onwards and it starts getting degenerated. Occasionally this does not show up as a large diseased disc on the x-rays or MRI's, but it continues to give pain. Patients do differ with the deep-seated back pain especially in the sitting position. The pain can be identified as specifically coming from 1 or 2 discs from the lower back by doing special tests called Discogram and Provocation Discography. Once it is identified and a proper diagnosis is made, there are a selective number of patients who can be treated with disc Nucleoplasty or a Percutaneous Decompressive Nucleoplasty.

The Nucleoplasty is a great advancement in the medical field in the last four years. The new technologies have come to where a minimally invasive procedure, which is a fast treatment, can be performed under local anesthesia and mild sedation. It has a rapid recovery and there is no surgery or cutting of the skin. The procedure itself involves entering the disc with a needle and then through that, a special disc wand is inserted. It is connected with a machine and through this machine the tip of the spine wand is heated and the needle emits radio waves. This dissolves the excess tissue in the nucleus of the disc, which reduces the size of the bulge and relieves the pressure
inside the disc that is sometimes the cause of the pain. The disc also has the nerves and once the pressure is relieved, the pain is relieved.

In the last four years, studies have found an 85-90% rate of satisfaction with the disc Nucleoplasty. The patients usually go home within 1-2 hours after having the procedure done as an outpatient.

Ripu D. Arora, M.D., Q.M.E.
Diplomate, American Board of Pain Management and Anesthesiology
Member, South Bay Independent Physicians Medical Group, Inc.