Chronic back pain is one of the most common conditions that affect people. It can occur at any age but is more common after the age of thirty and increases as we get older. Degenerative disc disease affects most people. The disc is the shock absorber that is located between the vertebrae in the front of the spine. Discs are like jelly donuts. They have an outer part called the annulus, which is similar to a tire. It is a series of layers of connective tissue that join to the adjacent vertebrae and help support the spine. The nucleus is the central part of the disc that provides the shock absorber effect. It has proteins that attract fluid. Disc degeneration results in a loss of the fluid component of the disc, which leads to a loss of the height of the disc by 1-2 mm, which is why people shrink as they get older. This results in inflammation in the adjacent vertebrae. It also puts stress on the small joints in the back of the spine called facet joints, which leads to osteoarthritis.

Risk factors for disc degeneration and facet joint osteoarthritis are similar to that for arthritis in joints such as knees and hips. Genetics probably plays a factor in most people. We are programmed for the disc to wear out. Injuries can lead to damage of the joint and/or the facet joints, which initiates the degenerative process. Jobs that put stress on the spine like repetitive lifting can lead to degeneration of the discs and the joints. Being overweight also puts more stress on the spine and can cause or accelerate the degeneration.

There is no cure for degenerative disc disease or for facet joint osteoarthritis. Spinal fusions usually do not relieve back pain and often put stress on adjacent levels leading to further degeneration. Disc replacement surgery can be effective in certain people but determining who would benefit is often difficult and the surgery is not without risk. Cortisone injections are of no proven benefit for disc degeneration or facet joint osteoarthritis. Facet joint rhizotomy is a procedure that uses an electrode and electric current to cauterize the nerves to the facet joints. This procedure can relieve back pain for a year or so and can be repeated if pain recurs but it does not cure the underlying arthritis.

Stem cell therapy is a procedure that uses a person’s own healing capacity to treat the degenerative disc disease and the arthritis. Cells are harvested from the person’s bone marrow or from their fat tissue and then injected into the discs and the facet joints. Stem cells are able to reduce the inflammation in the disc and the joints and can lead to some healing or regeneration, which helps relieve the pain. This treatment is still experimental but studies in animals and in humans have been shown it to be beneficial. Future research will lead to a better understanding of how stem cell therapy works and the best method of performing the procedure.