Osteoarthritis &
Related Conditions

Degenerative Discs & Facet Joints

Degeneration of the discs and the small joints of the spine (facet joints) is generally a normal part of the aging process.

Symptoms & Diagnosis

Degeneration is detectable by x-ray, but may not cause any symptoms. However, in some individuals, it can cause significant back and/or leg pain. In patients with advanced degeneration, x-rays show marked narrowing of the discs as well as arthritic changes in the facet joints. The arthritic changes in the facet joints may cause narrowing of the space where spinal nerves are located, called stenosis. Stenosis can result in leg pain, or what many lay people refer to as "sciatica".

Treatment Options

Nonoperative treatment

Usually effective in managing the symptoms of degenerative discs or facet joints, and includes:

• Exercise to improve muscle support of the back
• Anti-inflammatory medications
• Braces
• Bed rest for a short time of one or two days for an acute episode of lower back pain for pain control (with gradual return of activities as soon as possible)

Operative treatment

May be required to alleviate pain associated with severe and progressive degenerative changes. Potential surgeries are:

• Spinal Fusion (the connection of two vertebra) with (hooks, rods, and/or screws) or without, and the use of bone grafts or bone graft substitutes to allow the two vertebra to weld together. The complete healing of a fusion can take 3-6 months and heals in a similar way as a broken bone.
• Posterior Lumbar Laminectomy/Decompression removes part of the vertebral layer and facet joints to reduce pressure on the nerves in the spine and the associated pain.