Brief Answer:
Depends on your symptoms

Detailed Answer:
Good evening. In all honesty it's the symptoms that matter mostly as opposed the presence of a "disintegrating disc." In other words, if what the radiologist read is merely what he sees on a scan which was obtained without any significant symptoms then, if I were the patient I would not do anything with that information from an interventional point of view since you'd be treating the radiograph as opposed to the patient.

If, however, the symptoms you have are pain or other symptoms such as numbness and tingling, then, it depends on the severity of the symptoms as to what I would recommend. If the symptoms are mild to moderate in severity then, a conservative approach such as physical therapy, or as you've already done pilates, as well as stretching types of exercises seen in YOGA or just stretching exercises given to you by PT would be my choice of approach. Aquatherapy would also be a viable and good idea under any circumstance.

If the symptoms you had were moderately severe or severe in their intensity then, it would also depend on whether or not muscle weakness were involved that corresponded to the nerve distribution of where that disk were located and if so, how much weakness and how rapidly it were evolving which would guide choices or decisions. In that case, I would recommend getting an EMG/NCV study and then, consulting surgery since evolving weakness is troubling for a situation that could leave the patient relegated to a wheelchair type of scenario which we would want to avoid at all costs.

If pain were severe in the absence of any weakness with or without feelings of numbness and tingling then, I believe I would definitely recommend physical therapy (especially aquatherapy), TENS unit application, and then, appropriate medications for neuropathic pain (avoid narcotics/controlled substances if at all possible). If the pain gets severe enough or refractory to medications then, I would consider surgery otherwise, I'd hold off on any surgery for as long as possible since it is frequently the case that surgery for symptoms of nothing but pain or numbness/tingling can result in WORSE symptoms.

The use of supplements such as chondroitin sulfate or calcium supplementations (whether prescription or over the counter) have been pretty much been shown to be of little to no value in the long run and they end up costing quite a bit of money depending upon brand name vs. generic purchases and so I don't recommend using these agents with any expectation that they should help remedy any situation.

The use of spinal cord stimulators have never been popular with me at least because I've seen what I feel an abundance of patients who get little to no significant relief despite a surgical procedure that ends up placing a device in the body which in all probability must remain in place for the rest of the patient's life. For these reasons I don't recommend this approach.

Finally, in the realm of surgery is a newer technology which I've seen some success in a few patients is the use of the artificial disk to replace the deteriorating one. Again, this procedure should not be by first intention but rather only when conservative approaches fail to satisfactorily improve the patient's condition.

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