Treatment and Prevention of Lumbar Disc Herniations

Medications may include an anti-inflammatory to reduce swelling, a muscle relaxant to calm spasm, and a pain-killer (narcotic) to alleviate intense but short-lived pain (acute pain). Mild to moderate pain may be treated with non-steroidal anti-inflammatory drugs (NSAIDs). These work by relieving both swelling and pain. Discuss NSAID use with your physician first.

Usually, after the first 48 hours, heat therapy can be applied. Heat increases blood flow to warm and relax soft tissues. Increased blood flow helps to flush away irritating toxins that may accumulate in tissues as a result of muscle spasm and disc injury. Never apply heat directly to skin; instead, wrap the heat source in a thick towel for no longer than 20 minutes.

If leg pain is severe, or leg weakness is developing, the doctor may prescribe an epidural injection. An epidural is an injection of anti-inflammatory medication into the space near the affected nerves. You should discuss this option with your doctor and ask about potential side effects before beginning this treatment.

The doctor may recommend physical therapy. The doctor's orders are transmitted to the physical therapist by prescription. Physical therapy includes a combination of non-surgical treatments to decrease pain and increase flexibility. Ice and heat therapy, gentle massage, stretching, and pelvic traction are some examples.

In four to six weeks, the majority of patients find their symptoms are relieved without surgery! Be optimistic about your treatment plan and remember that less than 5% of all back problems require surgery!

Surgical Treatment
Spine surgery is considered if non-surgical treatment does not relieve symptoms. Constant pain, leg weakness, or loss of function requires further evaluation. Rarely, does a lumbar herniated disc cause bowel/bladder incontinence or groin/genital numbness, which requires immediate medical attention. If surgery is recommended, always ask the purpose of the operation and what results you can expect. Never be afraid to obtain a second opinion.

To relieve nerve pressure and leg pain, surgery usually involves a partial disc removal or discectomy. In addition, the surgeon may need to access the herniated disc by removing a portion of the bone covering the nerve. This procedure is called a laminotomy. Fortunately, these procedures can often be done utilizing minimally invasive techniques. Minimally invasive surgery does not require large incisions, but instead uses small cuts and tiny specialized instruments and devices such as a microscope and endoscope during the operation.

Prevention
Aging is inevitable, but lifestyle changes can help prevent lumbar disc disease. Risk factors include poor posture and body mechanics, weak abdominal muscles, smoking, and obesity. Start now to adopt habits that will help preserve your spine for the future.