How Is Degenerative Disc Disease Treated?

Degenerative disc disease is initially managed with targeted exercise, medications, cold therapy, and lifestyle modification to reduce pain and inflammation. However, if conservative treatment fails, doctors perform artificial disc replacement to restore disc height, preserve spinal motion, and address the affected disc causing symptoms.

At Total Orthopedics and Sports Medicine, our ADR surgeon, Dr. Georgiy Brusovanik, MD, assesses your spine using advanced imaging and clinical findings to identify the exact source of disc damage. Based on these findings, he recommends a targeted treatment plan, such as conservative care or artificial disc replacement, depending on your condition. Contact us to book your appointment with our disc replacement doctors in Syosset.

How Do Our ADR Surgeons Treat Degenerative Disc Disease?

To treat degenerative disc disease, our ADR surgeon, Dr. Georgiy Brusovanik, MD, at Total Orthopedics & Sports Medicine, first reviews your diagnostic imaging and symptoms to identify the exact source of pain and nerve compression. Then he uses conservative treatments such as targeted exercises, medications, injections, massage therapy, and lifestyle changes to reduce inflammation, support the spine, and improve movement.

However, if these nonsurgical treatments do not provide sufficient relief or disc damage continues to affect your spinal stability and movement, Dr. Georgiy Brusovanik may recommend surgery such as Artificial Disc Replacement (ADR) to directly address the structural cause of your symptoms. During this procedure, he removes your damaged disc and replaces it with an artificial implant. This surgery preserves motion at the treated level of your spine and limits abnormal load transfer to adjacent discs, which often occurs when movement is restricted.

Once the damaged disc is removed, pressure on your spinal cord and nearby nerves decreases. The artificial disc is then placed between the bones of your spine to keep them properly spaced apart. This restored spacing increases the space around the nerves, which improves nerve function. As a result, artificial disc surgery helps relieve symptoms such as radiating pain, numbness, and weakness.

In fact, a study published in PubMed involving 130 patients found significant pain relief nearly 14 years after lumbar disc replacement surgery. Average back pain scores decreased from 8.6 to 1.6, while leg pain scores improved from 7.3 to 1.1 on a standard pain scale (p < .001). Beyond pain reduction, patients experienced significant improvements in daily function, high satisfaction rates, and successful return-to-work rates.

What Are the Early Signs of Lumbar Disc Degeneration?

You may notice persistent lower back pain that increases with sitting, bending, or prolonged activity. You may also experience stiffness or reduced flexibility in the lower spine, especially after rest or in the morning. These early symptoms result from disc dehydration and reduced function of spinal shock absorbers within the affected segment.

In addition, the following signs may also point to early lumbar disc degeneration:

• Localized pain without radiating symptoms in the early stages
• Muscle tightness around the lumbar spine
• Discomfort after prolonged standing or walking
• Pain that improves with position changes or lying down
• Occasional flare-ups of severe pain after lifting or twisting
• Localized tenderness along the lower spine

How Does Degenerative Disc Disease Progress Over Time?

Degenerative disc disease progresses in stages, beginning with early disc changes and progressing to structural breakdown and possible nerve involvement. As spinal discs lose function, mechanical stress on the spine increases, especially with excess body weight, leading to increased pain and reduced mobility.

Degenerative disc disease typically develops through the following stages:

Stage 1: Early Dysfunction

In this early stage, your spinal discs begin to lose water content, reducing shock absorption and flexibility as a natural part of aging. Small tears may develop in the outer disc layer, weakening structural support. These changes can cause mild stiffness or intermittent pain, especially during movement or prolonged activity.

Stage 2: Progressive Degeneration

At this stage, disc height decreases, narrowing the space between vertebrae and increasing mechanical stress across the spine. This added load places greater strain on surrounding joints and reduces segmental stability. As a result, pain becomes more persistent, and movement is often restricted. Early disc bulging may also develop, potentially affecting adjacent structures and contributing to functional limitations during daily activities.

Stage 3: Advanced Degeneration

In advanced degeneration, the disc becomes thinner and less stable, increasing mechanical strain within the affected segment. The body may form bone spurs to stabilize the area. These changes can narrow the spinal canal and place pressure on nearby nerves. This results in persistent pain, stiffness, and neurological symptoms that limit movement and functional capacity.

Stage 4: Structural Collapse

In the final stage, severe disc space narrowing leads to loss of disc structure and reduced motion in the affected segment. Herniated discs may also develop and contribute to chronic pain and limited movement. Therefore, this stage often requires targeted treatment based on the extent of disc damage.

When Should You Visit a Degenerative Disc Disease Doctor?

You should consult our spine surgeon, Dr. Georgiy Brusovanik, MD, if your pain persists despite conservative treatment or worsens with activity. You should also seek medical care if you develop weakness or experience loss of bladder or bowel control. These symptoms may indicate nerve involvement and require prompt medical attention. Besides that, you should visit our disc replacement doctor if you experience any of the following symptoms:

• Sharp, radiating pain traveling into the buttocks or legs
• Tingling or burning sensations that worsen with sitting or bending
• Sudden flare-ups after minor movements, such as twisting or lifting
• Significant imbalance or difficulty coordinating leg movement

In these cases, Dr. Georgiy Brusovanik determines the exact disc level causing nerve compression. He uses MRI, X-rays, and a focused physical exam to confirm the source. This accurate diagnosis helps guide timely treatment, which can reduce inflammation, prevent long-term damage, and support faster healing.

What Are the Risks of Untreated Disc Degeneration?

You may experience severe pain, reduced mobility, and ongoing nerve irritation if your degenerative disc disease is left untreated. You may also develop a herniated disc or spinal stenosis, which can lead to more persistent symptoms and reduced function over time. Here are some other common risks linked with untreated disc degeneration:

• Progressive Disc Degeneration: The affected disc continues to lose height and hydration over time. As this happens, the spine becomes less stable, and everyday movements may place more strain on surrounding structures.
• Nerve Damage: Ongoing pressure on nearby nerves can lead to numbness, tingling, or weakness in the legs. If this compression continues, nerve function may not fully recover.
• Spondylolisthesis: As disc support weakens, one vertebra may begin to slip forward over another. This shift can increase pain and place additional pressure on spinal nerves.
• Adult Scoliosis: Uneven disc wear can gradually change spinal alignment. This may lead to a sideways curvature of the spine, affecting posture and balance.
• Bone Spurs (Spondylosis): As the spine tries to stabilize itself, extra bone may form along the edges of the vertebrae. These growths can narrow the space around nerves, contributing to ongoing discomfort.

Which Diagnostic Tests Are Needed for DDD Treatment?

At our clinic, Dr. Georgiy Brusovanik, MD, uses imaging tests such as MRI and X-rays to diagnose degenerative disc disease and identify the exact source of pain. MRI assesses spinal discs, nerve compression, and soft tissues, while X-rays show disc space narrowing, alignment, and structural changes in the vertebrae.

In addition, Dr. Georgiy Brusovanik uses the following tests to assess degenerative disc disease:

• Provocative discography: In this procedure, a doctor injects contrast dye into a damaged disc to reproduce the patient’s typical pain. This helps confirm whether a specific disc is the actual source of symptoms, especially when MRI findings are unclear, or multiple levels show degeneration.
• Electromyography (EMG): EMG measures electrical activity in muscles to detect abnormal nerve signaling. It helps determine whether nerve damage from disc disease is affecting muscle function. It is especially useful when patients report weakness or unexplained movement limitations.
• Nerve Conduction Studies (NCS): NCS assess how quickly electrical signals travel through nerves. Slowed conduction points to compression or irritation caused by spinal discs, helping identify the extent of nerve involvement and differentiate it from other neurological conditions.
• Selective Nerve Root Block (SNRB): This diagnostic injection targets a specific nerve root to confirm the exact source of pain in a minimally invasive procedure. Relief after this injection indicates that the selected nerve is responsible for pain, which is useful in severe cases with multi-level disc degeneration or overlapping symptoms.

What MRI Findings Suggest Lumbar Disc Degeneration?

MRI findings of lumbar disc degeneration include disc desiccation and decreased disc height. Disc desiccation appears as reduced signal intensity due to loss of hydration. However, decreased disc height shows disc space narrowing and early collapse. MRI results may also show disc bulging or herniation. These changes can compress nearby nerves, leading to side effects associated with a disc bulge, a common spine condition.

Here are some other MRI findings that signal progressive disc degeneration:

Annular Tears

Annular tears are structural damage to the outer layer of the disc, known as the annulus fibrosus. They often appear as high-intensity zones and indicate weakening of the disc wall. As the tear progresses, disc material from the inner part may shift outward and increase pressure on nearby nerves. Over time, this can result in localized pain or radiating symptoms, especially during movement or mechanical stress.

Modic Changes

Modic changes are alterations in the vertebral bone marrow adjacent to degenerative disc disease. They are classified into three types based on MRI findings, such as:

• Type I: Shows inflammation and fluid changes, often linked to active pain and altered blood flow
• Type II: Indicates fatty replacement of bone marrow, suggesting chronic degeneration
• Type III: Shows bone hardening (sclerosis), linked with advanced structural changes

Schmorl’s Nodes

Schmorl’s nodes occur when disc material pushes vertically into the adjacent vertebrae through weakened endplates. This indicates structural change within the spinal segment and altered load transfer across the spinal discs. Although Schmorl’s nodes are often asymptomatic (without symptoms), they can indicate underlying disc weakness. In symptomatic cases, they may cause localized pain due to increased stress within the vertebral body.

Spinal Stenosis

Spinal stenosis is the narrowing of the spinal canal, which reduces space for nerves. In degenerative disc disease, spinal stenosis results from disc height loss, ligament thickening, and bony overgrowth. As narrowing progresses, nerves get compressed, causing pain, numbness, or weakness. Moreover, symptoms often worsen with standing or walking as nerve compression increases in the lower spine.

Facet Joint Changes

Facet joint changes involve degeneration of the stabilizing joints located at the back of the spine. With disc degeneration, load shifts toward these joints, leading to cartilage wear and joint enlargement. This alters segmental motion, leading to stiffness and localized pain. In advanced stages, joint enlargement can also narrow adjacent neural pathways.

Can Neuropathic Drugs Relieve Degenerative Disc Symptoms?

Yes, neuropathic drugs relieve degenerative disc disease symptoms by controlling nerve-related pain. These medications are used when disc degeneration compresses an affected nerve or narrows the spinal canal to relieve pain. Neuropathic drugs also reduce burning, tingling, and radiating pain from the lower spine into the legs.

In addition, a randomized clinical trial published on PubMed shows that neuropathic drugs, including gabapentin and pregabalin, are used in patients with chronic sciatica. This condition results from nerve root compression caused by disc problems. In such cases, neuropathic medications improve tolerance to movement and reduce discomfort during sitting and daily activity.

Here are the most common neuropathic medications that doctors use to manage pain:

• Gabapentin and pregabalin control nerve signaling linked to chronic pain
• Amitriptyline and duloxetine reduce nerve-related pain and improve sleep quality
• Lidocaine patches act on the affected area to reduce localized pain

However, these medications do not restore a damaged disc or reverse disc degeneration. Instead, they reduce pain while other treatment options target the underlying disc issues. Therefore, doctors often combine these neuropathic drugs with conservative treatments such as targeted core exercises, physical medicine, and anti-inflammatory medications to improve spinal stability and symptom control.

When is ADR Recommended for Disc Degeneration?

Our disc replacement surgeon, Dr. Georgiy Brusovanik, MD, recommends ADR surgery when degenerative disc disease causes persistent lower back pain that does not respond to conservative treatment. He also advises this procedure when the affected disc limits movement or causes mechanical pain during daily activity. Besides that, patients with stable spinal alignment and preserved motion are the ideal candidates for the ADR.

Dr. Georgiy Brusovanik also recommends ADR for the following clinical conditions:

• Disc degeneration is limited to a single lumbar level without multi-segment involvement
• Herniated disc producing confirmed nerve root compression with correlating symptoms
• No evidence of severe spinal stenosis that would restrict neural space
• Absence of advanced or irreversible nerve damage affecting function
• No structural collapse across multiple vertebral levels

However, before proceeding with surgery, Dr. Georgiy Brusovanik assesses factors that may affect surgical outcomes and long-term stability. These factors include spinal instability, advanced stenosis, significant facet joint degeneration, and reduced bone quality. In these cases, he uses detailed imaging and motion analysis to assess disc condition, vertebral strength, and segmental stability. This assessment helps determine whether surgery is appropriate for your condition. Contact us to book your consultation.

How Effective Is ADR for Degenerative Disc Disease?

Artificial Disc Replacement (ADR) is about 75.5% to 93.3% effective for treating degenerative disc disease, according to J Orthop Surg Res. It reduces pain caused by a damaged disc and maintains motion between two or more vertebrae, unlike spinal fusion, which involves permanently connecting the bones. This helps the spine absorb shock and handle daily mechanical load more efficiently.

Besides that, ADR also provides the following benefits:

• Improves movement by preserving motion between vertebrae and keeping the segment stable
• Helps you return to daily physical activities faster by reducing pain and restoring movement
• Reduces the need for long-term medication by treating the source of disc-related pain
• Maintains spinal alignment, which helps distribute load evenly across the spine
• Improves physical function by reducing stiffness and supporting regular movement

In fact, a study in the Journal of Spine Surgery on lumbar total disc replacement reported significant long-term improvements in leg pain. The results also showed that patients had better functional ability and improved quality of life. Moreover, revision surgery rates were also low (4.6%) at a 7-year follow-up.

Consult Dr. Georgiy Brusovanik for Advanced Disc Degeneration Treatment in Syosset!

Degenerative disc disease can cause persistent pain, spinal stiffness, and reduced mobility that disrupt your daily activities. As the condition progresses, disc damage may lead to nerve compression and instability. This can result in radiating pain, numbness, or weakness in your legs.

At Total Orthopedics and Sports Medicine, our minimally invasive orthopedic spine surgeon, Dr. Georgiy Brusovanik, starts with structured non-surgical care, including neuropathic medications, targeted injections, and guided lifestyle changes to control pain and support spinal function. However, if symptoms persist or worsen, he performs advanced procedures such as artificial disc replacement to relieve pressure and restore movement. Call 855-321-6784 or visit our clinics in Syosset and Manhattan for your consultation.

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