Pain management for degenerative disc disease

1. Over-the-counter pain medicine such as acetaminophen (e.g. Tylenol) can help decrease pain associated with degenerative disc disease and can be used in conjunction with any of the anti-inflammatory medications. Actually, since its pain relief effect is totally different from anti-inflammatories, using both medications can be synergistic. Acetaminophen is such a good analgesic (pain reliever) it is put into most other commercially available narcotic pain relievers (e.g. Vicodin or Darvocet).

2. Narcotic pain relievers are all structurally related to heroin and are very effective at relieving pain, such as that from degenerative disc disease, in the short term. Unfortunately, they have a lot of side effects such as constipation and urinary retention, and have abuse potential. Many patients also have difficulty functioning while on the medication since it does affect ones cognitive abilities.
   
   Within about two weeks, continuous administration of oral narcotics leads to the body becoming habituated to the medication, so it does not seem to work as well. Many patients erroneously believe their pain from degenerative disc disease is getting worse since the medication does not seem to be effective, but they are just becoming habituated to the medication. In a minority of patients low dose chronic narcotic administration may be reasonable to help the patient function with less pain, but in most patients narcotics should only be used for postoperative discomfort, or briefly to help reduce pain for a patient who is having a severe flair of pain.

Chiropractic/osteopathic manipulations for degenerative disc disease
Chiropractic/osteopathic manipulations can be useful to relieve joint dysfunction in either the facet or sacroiliac joints that can be associated with the pain. Again, manipulations work best when combined with an active exercise program.

Electrical stimulation for degenerative disc disease
Electrical stimulation can sometimes be helpful to relieve back pain from degenerative disc disease, although there is little hard evidence in the literature to support its efficacy. It does, however, seem to reduce pain for some patients and helps them function better with less medication.

An example of electrical stimulation is Transcutaneous Electrical Nerve Stimulation (TENS) units. Pads are applied to the skin overlying the most painful areas and a low current electrical charge is transmitted to the skin. The theory is that the electrical signals help override the pain signals.