Degenerative Disc Disease Treatment in Castle Rock

What is Degenerative Disc Disease?

Degenerative disc disease (DDD) is not actually a disease - it is the term used to describe the normal wear-and-tear changes that happen to spinal discs over time. The discs are the cushions between each vertebra in your spine. As we age, these discs lose water content, become thinner, and develop small tears in their outer layer. These changes can cause chronic pain in the neck or back.

DDD is extremely common. Most people over 40 have some degree of disc degeneration on imaging, though not everyone with disc changes has symptoms. When DDD does cause pain, it tends to be a deep, aching pain in the lower back (or neck) that is often worse with sitting, bending forward, and prolonged positions. Unlike sciatica, which shoots down the leg from a pinched nerve, DDD pain is typically centered in the back itself and does not radiate below the knee.

How is DDD Different from a Disc Herniation?

These two conditions are related but distinct. A disc herniation is a specific event - part of the disc's soft center pushes through a tear in the outer layer and presses on a nearby nerve, causing arm or leg pain (radiculopathy). Degenerative disc disease is a gradual process of disc breakdown that causes pain from the disc itself, not from nerve compression.

The treatments are different too. Disc herniations that compress nerves are typically treated with epidural steroid injections. DDD-related pain is treated with a different set of tools, including Intracept, PRP, facet treatments, and physical therapy. Dr. Carrera's team uses your history, exam, and imaging to determine which type of pain you have.

What Causes DDD?

  • Aging - disc degeneration is a normal part of getting older

  • Genetics - some people are more prone to disc breakdown

  • Repetitive loading - years of heavy lifting, bending, or high-impact activities

  • Smoking - reduces blood supply to the discs and accelerates degeneration

  • Previous disc injuries - a torn or injured disc may degenerate faster

  • Obesity - increased mechanical load on the spine

What are the Symptoms of DDD?

  • Chronic aching pain in the lower back or neck

  • Pain that is worse with sitting, bending forward, or lifting

  • Pain that improves with movement, walking, or changing positions

  • Stiffness in the morning or after prolonged inactivity

  • Occasional flares of more severe pain lasting days to weeks

  • In some cases, pain that radiates into the buttock or upper thigh (but typically not below the knee)

How is DDD Diagnosed?

Dr. Carrera's team evaluates DDD through a combination of your history, physical examination, and imaging. An MRI is the most useful study because it shows the condition of the discs, including loss of hydration (appearing as dark discs on MRI), disc height loss, annular tears, and Modic changes - specific signal changes in the vertebral bone adjacent to a degenerated disc that are associated with vertebrogenic pain.

It is important to understand that many people have DDD on imaging without significant symptoms. The team correlates imaging findings with your clinical picture to determine whether the disc changes are actually causing your pain or are incidental findings.

How is DDD Treated?

Treatment depends on which structure is generating the pain. DDD can cause pain from the disc itself, from the facet joints (which become overloaded as the disc loses height), or from both. Dr. Carrera's team identifies the primary pain generator and targets treatment accordingly.

Conservative care: Physical therapy focused on core stabilization and spinal mechanics, activity modification, anti-inflammatory medications (NSAIDs like meloxicam), and nerve-calming medications (gabapentin, pregabalin, or amitriptyline) if there is any nerve irritation.

Epidural steroid injections: If DDD is causing nerve irritation or there is a component of disc bulging pressing on nerves, an epidural injection can reduce inflammation and provide relief. More on the epidural steroid injection page.

Facet joint treatments: As discs lose height, the facet joints behind the disc take on more load and often become arthritic. If facet joints are contributing to your pain, facet joint injections, medial branch blocks, and radiofrequency ablation (RFA) can target this component. More on the facet joint injection page and the RFA page.

Intracept (basivertebral nerve ablation): For patients whose pain is coming from the disc and vertebral endplate (vertebrogenic pain), Intracept is a single outpatient procedure that ablates the nerve inside the vertebral body responsible for transmitting the pain signal. Candidates typically have Modic changes on MRI and chronic axial back pain that has not responded to other treatments. Intracept offers durable relief - studies show pain improvement maintained at five years. More on the Intracept page.

PRP (platelet-rich plasma): PRP can be injected into the disc (intradiscal PRP) or into facet joints as a steroid-free alternative. The evidence for intradiscal PRP is still early, and it is considered on a case-by-case basis. More on the PRP page.

When Should I See a Specialist?

Consider scheduling an evaluation if your back or neck pain has lasted more than six weeks, is not improving with over-the-counter medications and activity modification, is limiting your ability to work or exercise, or if you have been told you have degenerative disc disease on imaging and want to understand your treatment options.

When is Surgery Needed for DDD?

Most patients with DDD do not need surgery. Surgery (typically a spinal fusion) is reserved for cases with severe, disabling pain that has not responded to an adequate trial of non-surgical treatments, or when there is structural instability. Dr. Carrera's team focuses on non-surgical options and will refer to a spine surgeon if your condition warrants surgical evaluation.

For Referring Providers

DDD is a broad diagnosis with multiple potential pain generators. Dr. Carrera's team differentiates between discogenic, vertebrogenic, and facet-mediated pain to target treatment appropriately. If your patient has chronic axial back pain with imaging showing disc degeneration, fax the referral to 720-455-3776. Include MRI reports if available. The team can typically see new patients within two weeks.

Patients in Castle Rock, Lone Tree, Parker, Highlands Ranch, Denver, Colorado Springs, and surrounding areas can call 720-455-3775 to schedule an evaluation.

Call 720-455-3775 to schedule an appointment