DEAR DR. GOTT: I have recently been diagnosed with degenerative disc disease. I am 69 and also have osteoarthritis. My symptoms are groin, knee, hip and thigh pain — all on the left side. What treatment would you recommend? I take 12 prescription medications and 13 supplements. I’m allergic to penicillin, Demerol, codeine and Vancomycin.
DEAR READER: The spine is made up of bones called vertebrae. A disc that contains a soft, jelly-like inner layer cushions each vertebra. The discs in our backs can be compared with shock absorbers on a car. During activity, they absorb jarring and movements while allowing you to bend and flex in a variety of positions.
As we age, the normal wear and tear on these “shock absorbers” is known as disc degeneration. The discs may lose some of their water content, making them less capable of performing as effectively as they did before. The result is pain, numbness, weakness and the inability to function effectively. Risk factors other than age include height, excess body weight, a history of smoking and physical activity. Men taller than 5 feet 11 inches and women taller than 5 feet 7 inches have an increased risk for developing disc disease. The additional weight some people carry puts more stress on discs. A history of smoking decreases oxygen levels in the blood and deprives the body of necessary nutrients. Finally, activity such as frequent heavy lifting, sitting for hours at a time at work, or playing high-impact sports can cause problems.
Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) or topical creams might relieve some symptoms. If you are a runner or enjoy high-impact activity, consider making a change to something less strenuous. Cold compresses should work to reduce inflammation initially. Following that, consider using heat. Conservative treatment can include water aerobics, gentle yoga, tai chi, acupuncture, massage and physical therapy. Exercise in moderation is endorsed. Bed rest may be necessary for a day or two; however, inactivity isn’t always a good thing. Too much rest will result in a loss of muscle strength, which will make symptoms worse and delay recovery.
Osteoarthritis affects almost everyone as we age. It is a joint disease caused by the breakdown of cartilage, commonly occurring in the hips, knees, feet and spine. Healthy cartilage is smooth, flexible and elastic, allowing for easy movement. With osteoarthritis, the surface of the cartilage softens, frays and cracks. With continued breakdown, the ends of bones thicken and form spurs at points where ligaments attach to bone.
Again, normal wear and tear of the joints over time is to blame. Treatment is aimed at controlling pain, preventing joint deformity and, most importantly, maintaining movement. NSAIDs might be taken for relief of symptoms. Rest, protection of the affected joint(s), yoga, water aerobics and physical therapy might be endorsed. Exercise is vital to maintain movement. Beyond that, your physician or orthopedic specialist should be consulted to determine the next step.
I don’t know what your other medical conditions are, but I suggest you speak with the prescriber(s) regarding discontinuing some of your prescription drugs. Then ask about replacing some of your supplements with a good daily vitamin supplement.
To provide related information, I am sending you a copy of my Health Report “Understanding Osteoarthritis.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.
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