Herniated disc treatment
The first point of contact for back problems or a herniated disc is usually your family doctor or an orthopedic surgeon. They will either refer you to a consultant or request a second opinion from another specialist, such as a neurologist. Back pain can have many causes and requires thorough examination and evaluation. Not all lower back pain in the lumbar spine necessarily means a herniated disc: every second person experiences back pain at some stage in their life, but only every twentieth has a herniated disc. Physical examination by your doctor is first and foremost aimed at identifying the exact cause of your back pain. If a herniated disc is discovered, the appropriate herniated disc treatment can be determined.
Symptoms determine the therapy
The treatment of the herniation depends on the level of discomfort. For patients with less irritation of the nerve roots, 70 – 90% of all patients, the Conservative therapy is always first in line in the treatment concept – which tends to consist of active (e.g. physiotherapy, back exercises) and passive treatments (e.g. heat treatment, massage) – supported by analgesics if required. Acupuncture, relaxation therapy, back training, or medical strength training have also proved successful for many patients. Nonsurgical conservative treatments provide a very good chance of a sustainable improvement in symptoms or even total freedom from discomfort.
If there are clear signs of compression of the nerves or the spinal cord, imaging can identify the exact cause or extent of the disc herniation. However, there is no direct relationship between image and symptoms; images may even have the negative effect of reinforcing the symptoms. Therefore X- rays or MRIs are only performed for serious problems (for example, neurological symptoms). During evaluation of the severity of the problem the intensity of pain is assessed and the length of time the dysfunctions have been apparent considered, particularly paralysis, disorders of bladder or rectal function. For severe dysfunctions such as these, a surgical approach to herniated disc treatment should be considered.
Conservative herniated disc treatment
Non-surgical therapies aim to relieve tension and pain, isolate and carefully rebuild and strengthen all core muscles. Special exercises, physiotherapy and medical strength training are particularly suitable for targeting the muscles.
Acupuncture, massage and heat treatment can relax tense muscles. Stretching is also often very helpful to relieve an intervertebral disc. In addition, pain and anti-inflammatory medication, as well as muscle relaxants can support the treatment. These are administered as tablets, injections or infusions. There is always a chance that the discomfort of a herniated disc improves or stops of its own accord, because the prolapsed tissue of the herniated disc gradually dries and shrinks. However, you can never predict the outcome with any certainty. Pain sometimes persists even when the MRI image indicates the disc herniation is reducing in size.
Herniated disc – surgical treatment
Most herniated discs in the lumbar spine respond well to conservative treatment. But disc surgery is a necessary option for certain symptoms, for example, paralysis due to nerve root compression, or persistent radicular pain without lasting improvement despite extensive conservative treatment. Over a longer period of time persistent pain can become chronic pain. And in addition to ongoing pain, there is also an increased risk of irreversible nerve damage, which tends to reduce the prospects of a cure. Intervertebral disc surgery may then be a necessary consideration.
Learn more about the options for disc surgery.
Prevention is better than cure
Get moving and keep moving! The best exercise is an endurance sport such as cycling, swimming, aerobics, walking, Nordic walking, hiking and dancing. Be careful with badminton, weightlifting, golf, hockey, rowing, alpine skiing and squash – these sports can strain your back.
Obviously there are many options for the successful treatment for a herniated disc. But in the end prevention is always better than cure. Get moving and keep moving! The best exercise is an endurance sport such as cycling, swimming, aerobics, walking, Nordic walking, hiking and dancing. Be careful with badminton, weightlifting, golf, hockey, rowing, alpine skiing and squash – these sports can strain your back.
Prevention and self-care: how to avoid a herniated disc
Everyday life is full of “back hazards” – modern lifestyle usually involves of a lot of sitting and lack of exercise. This means that our bodies, and especially our backs, do not get enough workout. If you do not train your back and abdominal muscles sufficiently, the muscles become weak and unable to cope with strain or overloading, which can lead to a herniated disc.
You can avoid this with an appropriate lifestyle and adequate physical activity. Relieve your spine with back-friendly lying beds, sitting, standing, carrying and lifting – it can be so easy!
- Sitting correctly: for those who have to spend a lot of time at a desk, standing up and stretching your legs regularly is important. A frequent change of sitting position also helps to relieve the back from time to time, and to keep it moving.
- Sleep properly: if you want to relax properly after a busy day, you need the right mattress. A flexible slatted frame and a high-quality mattress, which adapts to the body shape and is neither too soft nor too hard, are crucial.
- Lift correctly: it is very important not to overload the intervertebral discs by making sure you assume the correct posture when lifting loads. When lifting anything heavy your back should be kept straight and instead of bending over with a hunched back, you bend your knees.
Special back training not only teaches such techniques, but also relaxation methods, loosening, toning and stretching exercises to strengthen the muscles of the spine. Ask about courses at your local health center or fitness studio. Starting back training after disc surgery is really important!