In TAGS we commonly manage degenerative disc disease and knee osteoarthritis.
1. Degenerative Disc Disease :
Degenerative disc disease is an extensive progressive condition that has been found to be the cause of neck pain and lower back pain that could lead to radiculopathy, myelopathy, spinal stenosis, degenerative spondylolisthesis and herniation. This process takes place when the spinal discs that are found in-between the spinal bones (vertebrae) begin to wear out.
Degenerative disc disease (DDD) is typically due to excessive load bearing, poor posture, trauma, aging and genetic predispositions’. Patient typically present with symptoms such as spinal pain, weakness, numbness in limbs, shooting pain in the legs or arms. Possible complications of degenerative disc disease include bladder or bowel dysfunction or even saddle anesthesia due to the progression of the disease.
Diagnosis of degenerative disc disease is usually done by a thorough history taking, physical examination and may require diagnostics such as Magnetic Imaging Resonance (MRI) or X-rays to confirm the diagnosis.
2. Management of Degenerative Disc Disease :
Degenerative disc disease is usually treated with a combination of pain management therapy, physical rehabilitation, soft tissue therapy and spinal decompression traction. In most cases, pain and function improves with non-invasive management. However, if the condition continues to progress, some minimally invasive procedure may be introduced such as epidural injection, radiofrequency ablation (RFA) or even discectomy.
3. Knee Osteoarthritis (OA) :
Knee Osteoarthritis (OA) is a condition in which, the cartilage between joints begins to wear out .These will lead to increased friction between the bones resulting in pain, swelling, stiffness, reduced movement and sometimes the formation of osteophytes(bone spurs).
Knee Osteoarthritis is the most common type of arthritis that affects women more than men. While it can occur even in young people, the chance of developing osteoarthritis increases after the age of 45.
Some risk factors of knee OA includes, aging, obesity, genetics, gender, post traumtic injury, post surgical and metabolic disorder such as diabetes. Osteoarthritis usually develops slowly and progressively worsens over time.
The diagnosis of knee OA is established from X-Ray imaging to analyse the joint space, formation of bone spurs and to rule out other possible causes of knee pain. Knee OA can be categorized in to 4 stages, whereby stage 1 is considered to be mild with minimal narrowing of joint space and stage 4 is observed with severe loss of joint space , formation of bones spurs and subchondral sclerosis.
4. Management and Treatment of Knee Osteoarthritis :
Management and treatment of knee osteoarthritis can be broken down in to conservative and surgical intervention. Conservative treatments include physical therapy, activity modification, diet and bracing. Knee bracing which has the unloading effect on the knee joint is very effective to reduce joint pressure and inflammation. Surgical interventions include arthroscpoy and the last resort would be a total knee replacement if patient fails to respond to other treatments.