Herniated Disc: Non-surgical Treatment First

The initial treatment for a herniated disc is usually conservative and nonsurgical. Your doctor may prescribe bed rest, or advise you to maintain a low, painless activity level for a few days to several weeks. This helps the spinal nerve inflammation to decrease.

A herniated disc is frequently treated with nonsteroidal anti-inflammatory medication if the pain is only mild to moderate. An epidural steroid injection may be performed utilizing a spinal needle under x-ray guidance to direct the medication to the exact level of the disc herniation.

Your doctor may recommend physical therapy. The therapist will perform an in-depth evaluation; which combined with the doctor’s diagnosis, will dictate a treatment specifically designed for patients with herniated discs. Therapy may include pelvic traction, gentle massage, ice and heat therapy, ultrasound, electrical muscle stimulation, and stretching exercises. Pain medication and muscle relaxants may also be beneficial in conjunction with the physical therapy.

Surgery
Your doctor may recommend surgery if conservative treatment options, such as physical therapy and medications do not reduce or end the pain altogether. He or she will talk to you about the types of spinal surgery available, and depending on your specific case, will help to determine what procedure might be an appropriate treatment for you. As with any surgery, a patient’s age, overall health, and other issues are taken into consideration when surgery is considered.

The benefits of surgery should always be weighed carefully against its risks. Although a large percentage of patients with herniated discs report significant pain relief after surgery, there is no guarantee that surgery will help every individual.

You may be considered a candidate for spinal surgery if:

• Back and leg pain limits normal activity or impairs your quality of life
  
• You develop progressive neurological deficits, such as leg weakness and/or numbness
  
• You experience loss of normal bowel and bladder functions
  
• You have difficulty standing or walking
  
• Medication and physical therapy are ineffective
  
• You are in reasonably good health

Surgical Terms

Artificial disc surgery – Surgical replacement of a diseased or herniated lumbar disc with a manufactured disc. The CHARITÉ™ artificial disc consists of a plastic core between two chrome plates that lock into the spine.

Discectomy – Surgical removal or partial removal of an intervertebral disc.

Laminectomy – Surgical removal of most of the bony arch, or lamina of a vertebra.

Laminotomy – An opening made in a lamina, to relieve pressure on the nerve roots.

Spinal Fusion – A procedure in which bone is grafted onto the spine, creating a solid union between two or more vertebrae; and in which instrumentation such as screws and rods may be used to provide additional spinal support.

NeurosurgeryToday.org
September, 2005

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