Dr. Lee June-ho


By Dr. Lee June-ho
Contributing Writer

Back pain is one of the common illnesses such as flu or headache that many suffer from daily, and approximately two out of three adults are reported to have taken time off work or visited a hospital with a back complaint.

For the middle-aged, after a thorough physical and neurological examination by the physicians and some x-rays on their first visit, they are frequently referred to have some ``narrowed disc space''. They also recommended to take an MRI exam for the possibility of having 'degenerative disc disease'.

This terminology of ``degenerative disc disease'' is a kind of misnomer that the general population often incorrectly refers to as 'back pain'. The true 'degenerative disc disease' is a medical term that refers the 'herniated intervertebral disc disease'. Discs in the spine dehydrate, or dry out, and lose their ability to act as shock absorbers between the vertebrae. There is minimal blood supply to the discs so they lack the ability to heal or repair themselves.

So the true ``degenerative disc disease'' that requires surgical treatment comprises of less than 10% of the 'back pain' patient population. Because of this confusing terminology, a lot of patients have tendency to spend money on a useless medical procedure for the sake of getting over this 'degenerative disc disease' which they actually do not have.

The etiology of this ``disc'' is quite varied as the multiple structural and functional degenerative changes in the human lumbar vertebra correspond to the aging process. Therefore diagnosing the correct symptom and getting the proper management for the specific ``back pain'' should be beyond what x-rays or MRIs demonstrate.

Choosing treatment should take into account the degree of discomfort and limited movement, through a thorough consultation with a doctor.

The option of conservative management, such as physiotherapy or drug medication, should be higher for patients who seldom suffer from back pain but with ``pretty narrowed disc space.'' Active management, surgery, should be recommended for the other patients who barely manage their daily activities without medication yet show no evidence of ``degenerative disc disease.''

This flexibility on the choice of proper treatment should be decided by ``myself'' based on ``my symptoms'' and not just to correct the incorrect ``degenerative disc disease'' or the ``narrowed disc space'' that the x-ray shows.

The writer is a neurosurgeon at Chungdam Wooridul Hospital