Degenerative Joint Disease


What is Degenerative Joint Disease?

Degenerative joint disease is just another phrase to describe osteoarthritis. Your cervical, thoracic and lumbar regions of your spine are composed of 23 intervertebral discs, 24 vertebrae and 48 facet joints. Your facet joints help make your spine a wonder of flexibility. They are also prone to osteoarthritis, the most common form of spinal arthritis.

Degenerative joint disease produces an immune response that degrades the healthy cartilage and soft tissues located at the joints. This arthritic process forms osteophytes that become bone spurs which form along the facet joints. The bone spurs can narrow foraminal openings and cause spinal stenosis. Some researchers view osteoarthritis as the primary cause of degenerative disc disease including bulging and herniated discs and age-related spondylosis.

How common is degenerative joint disease of the spine?
Osteoarthritis of the spine is quite prevalent. Estimates range from 40% to 85% of the US population have some form of osteoarthritis of the lower spine. Currently, an estimated 27-million patients are adversely affected by osteoarthritis(1). The consensus among researchers is that most arthritis is derived from genetics, so blame your parents, not your high school football coach.
Is there a cure for degenerative joint disease?
It is sobering for doctors to say this, but there is no cure for spinal osteoarthritis. Often, when treatment begins, the most critical issue is managing chronic pain. Acetaminophen will reduce pain while the nonsteroidal anti-inflammatory drugs (NSAIDS) such as aspirin, naproxen and ibuprofen will treat pain and inflammation.

For intense pain, some doctors may prescribe opioid-based pain relievers and muscle relaxants. Dr. Nourian’s conservative treatment will avoid opioids and treat the chronic pain with a combination of holistic alternatives such as acupuncture, Tai-Chi, yoga, Pilates, and structured, low-impact, exercise programs, including water therapy with pool-based resistance training. Acupuncture and epidural corticosteroid injections may also be components of Dr. Nourian’s treatment plan.

Dr. Nourian understands the psycho-social component of degenerative joint disease and is accustomed to working with his patients’ therapists, psychiatrists and loved ones to develop the optimal treatment plan for their lifestyle. Part of Dr. Nourian’s lifestyle plan may include suggestions for a new diet to reduce weight, control stress and fight inflammation. If you are a smoker, he can help you kick the habit as well.

For those patients who do not respond to non-surgical therapies, Dr. Nourian may request imaging tests such as X-rays, myelograms, magnetic resonance imaging (MRI) and computed tomography (CT) scans. All appropriate surgical options will be reviewed carefully, especially if spinal stenosis worsens, incontinence occurs, or walking becomes difficult. The most common surgeries for spinal arthritis are vertebral fusions and cervical and lumbar microdecompression treatments such as microlaminectomies and microlaminotomies. All of Dr. Nourian surgeries are opioid-free which reduces the risk of drug dependency in the future.

How does arthritis of the spine affect the “Three-Joint-Complex” of the spine?
The human spine is a masterpiece of flexibility that has helped us evolve as highly mobile and nimble hunters. One of the keys to our success as hunters is our ability to stand and turn in almost any direction at a full run which is greatly facilitated by the flexibility and strength of our spine which weighs less than a pound. One of the biomechanical wonders of our spine is the three-joint-complex that is repeated along our cervical, thoracic and lumbar spine. This flexible spine unit consists of the vertebrae, the facet joints, and the intervertebral discs which are linked together by ligaments and supported by muscles along the spine.

Spinal osteoarthritis attacks the hinges of the three-joint-complex, especially the facet joints. There are two facet joints on each side of the vertebrae. The cartilage and ligaments of these protective bones develop synovitis which triggers the body’s immune system to generate histamines that cause inflammation. The immune response leads to bone spurs and facet joint syndrome. As a result, adjacent intervertebral discs begin to weaken and herniate. Gradually, over the years, a strong, flexible skeletal system becomes unstable and painful.

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Bulging/Herniated Discs

Disease & Disorders







Spinal Stenosis

Stiff Neck


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Specialist in treating a wide variety of injuries and conditions that impact bones, joints, ligaments, tendons, muscles and nerves.



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What Patients Think About Dr. Nourian

Awesome awesome doctor!!!very nice to all his patient! Dr. Nourian is very kind and caring. A very pleasant man and easy to communicate with. He saw my son when he injured his hip and He took extra good care of him. After 2 wks he was able to resume sports. He’s not only a very good orthopedic surgeon but also an amazing Spine doctor. He always make sure he always gets the job done. 2 Thumbs up to this Doctor!!!??

Regz Ramos


Dr. Nourian was fantastic! He was able to alleviate my back pain. I would recommend him to anyone

Nikesh Patel


Dr. Nourian is the best. His bedside manner is friendly and professional and his staff is excellent. I went to see him after a terrible whiplash injury when I rear-ended while driving. After receiving my MRI results, the doctor was quick to reach out and went over my options with me. He really cares about his patients.

Michelle Sadighpour Shophet


Dr. Nourian is an outstanding physician. I injured my back while exercising recently. I went to see him, and he explained my injury to me in detail. He told me that my injury would most likely heal without surgery, but if I needed surgery in the future he would get me through it. He is honest, intelligent, and forthcoming. I am thankful for him as my spine physician.

Michael Broukhim


Dr. Nourian was absolutely fantastic. I was struggling with intense lower back pain. He took his time 40 minutes to be exact to see me and review everything with me after another follow up we decided to do surgery. Thank god!!! I’m back to working out, picking up my child, and living my best life. I was so hesitant to do surgery but he was a true god send. He would call me weekly to see how I’m doing.

Sara Sadig


Dr. Nourian is smart, caring, attentive and super knowledgeable. I highly recommend him as an orthopedic surgeon!

Sharon Darouvar Greiner


Great with patients and consciences of patient’s time as well as needs. He will spend time to assure the patients with respect to treatment plan and follow-up was amazing with my auntie’s back issues.

Connie Esparza


An extremely knowledgeable doctor with wonderful bedside manner. He clearly explained every step of the procedure and eased all my worries. My back is feeling great thanks to Doctor Nourian

Ashley Sadig


After seeing three doctors and all of them saying I should operate Dr Nourian was able to address and issue without and surgery. I got an epidural and did physical therapy and I’m able to run around with my grand child. He’s truly a gem. Everyone at the office was friendly and supportive.

Katrin Sadighpour


Dr. Nurian explained everything very well and preformed the surgery exactly as planned. I woke up pain free and the surgery pain was gone in five days. Could not give him enough praise.

Wade Savage