Back pain with history of Degenerative Disc Disease

Patient

Q: I've been diagnosed with degenerative disc disease including a herniated disc, torn and leaking. The initial injury occurred 20 years ago and at the time it was debilitating. I underwent extensive physical therapy and things improved tremendously. However, in the past year I've experienced an enormous set-back and have been seen by a pain center to no avail (nerve block injections), taking a steady stream of Oxycodone, yoga and PT. The drugs help me function, but in an effort to be narco free, I visited a Neurologist about any surgical options. His response was baffling. Apparently, my pain is not congruous by the looks of the MRI. According to him, I should not feel any pain and that it must have another cause. I'm totally baffled and left with no further instruction. What else could it be and why would it be anything else when there is clearly a diagnosed anomaly?

Doctor

A:   Degenerative disc disease produces changes in the vertebrae that along with the bulging disc are causing a nerve compression which is the cause of the pain. The treatment options depend on the age, severity of the pain, neurologic symptoms present and if you have some other associated health issue. The first approach is conservative as a Physical Therapy program aimed to control pain and inflammation along with anti-inflammatory medication, if there is no improvement and with time the pain is worse and intractable you should get a reevaluation by an orthopedic surgeon to decide if Surgery might be consider as a treatment option for you.
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