Desiccation is defined as a drying out, but in terms of spinal discs, the definition of desiccation is a “degenerative change of intervertebral discs”. The meaning of desiccation can be benign and considered as a “normal part of disc aging”.1 For some people, though, disc desiccation is painful. Between the spinal bones, there is a disc that acts as a shock absorber or cushion. Discs are made of “a tough annulus fibrosis surrounding the jelly-like nucleus pulposus”. Desiccation is dehydration, or a fluid loss, in the discs. Aging is a typical cause of this condition, and most people who suffer from this are aged 60 or older. There are other causes of the discs drying out, such as repeated strain or back injuries, as well as trauma. These are the general causes of the condition in young people.2
Desiccation Symptoms and Diagnosis
Symptoms of disc dehydration may be gradual, or they could have a sudden onset as a result of an injury. Tenderness, pain due to movement, weakness, tingling, numbness, and reflex changes are all potential symptoms of desiccation.3 As the discs desiccate, they become less flexible, and their height is reduced. While some may not experience pain, others develop “spinal ‘instability’, the condition in which the spine is unable to bear the patient’s weight or perform its normal functions”. In the case of cervical degeneration, neck pain is the result, typically when the patient is moving the head or is in an upright position. Bone spurs may also be present, leading to less movement and the compression of the nerves. These nerves may impact the arms and hands, as well as the neck and head, and patients might experience numbness, pain, burning, tingling, or even headaches. For patients with lumbar disc degeneration, there is lower back pain, including “a weight-bearing type of back pain with severe pain on sitting”, but there may also be pain when walking or standing. The nerve pain associated with this situation could include symptoms of numbness, burning, pain, and tingling through the leg and buttock. Sometimes these disc disorders can show up on an X-ray, if they are “advanced enough”. While a CT scan could be useful, an MRI is considered a superior diagnostic tool. The MRI would show “the water content of the disc and best identifies the impingement on neurological structures”. If it is difficult to see which disc is involved, patients may need to undergo “discography/CT” or “facet joint blocks”. In a discography/CT, the discs are injected with dye while a CT scan is performed. With facet joint blocks, patients are injected with steroids and an anesthetic for the relief of pain.4
Treatment of Disc Desiccation
The general treatment options for desiccation are physiotherapy and chiropractic, massage therapy, medication, weight loss, or surgery. Physiotherapy may include “targeted exercises to stretch and strengthen” the spinal muscles. Heat and ice therapies might also be beneficial. Chiropractors align the back by “releasing muscles and evening pressure”, and they can assist patients with proper posture. Massage therapy aims to relax the muscles and alleviate pressure. Weight loss can help patients who are overweight to also reduce pressure on the discs. High-impact activities and exercises may strain the back, though. Some people could take medications to relax the muscles and relieve the pain, but there are side-effects, and these solutions are only temporary. Furthermore, some patients will undergo surgery, but that should be considered a last resort after all other treatments have been exhausted. Spinal fusion is the typical surgery offered. In this procedure, the “disc is removed (and sometimes an artificial one is inserted) and the adjacent vertebrae are joined with screws and rods”. Even though disc degeneration is considered “a normal part of aging”, patients can prevent problems by doing exercises and stretches to strengthen the back.5 Some people may benefit from the facet joint injections or even “facet rhizotomy…ablation of the sensory nerve through the facet joint”. Another non-surgical option is IDET: intradiscal electrothermal annuloplasty, which heats the discs with a copper coil to harden them. This can help the disc to “resist weight-bearing motion better than the degenerated disc in about 70% of patients”. Avoiding painful behaviors, sitting and lifting properly, perhaps using braces or a collar, and building up core muscles may all be beneficial. Exercise options might include Pilates, swimming, and yoga.6 The pain of disc degeneration could be debilitating, and losing that disc height can lead to inflammation and nerve impingement. With surgery carrying risks and pain medications having side-effects or addiction potential, conservative treatments such as cold and heat therapy, physical therapy, and massage, chiropractic or acupuncture may be good alternatives for many patients. Learning exercises and stretches, receiving traction as part of therapy, and practicing good posture are all beneficial tools for patients.7
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