A herniated disc can be a painful and frustrating setback for people with active lifestyles. If you’ve been diagnosed with a herniated disc, or if you think your symptoms may be the result of a herniated disc, you probably have questions about your condition and how best to resolve it.
What follows is an overview of exactly what a herniated disc is and some suggestions for what to do when non-surgical treatment for a herniated disc doesn’t work. You can use this information to resolve doubts and to form questions for your doctor.
What is a herniated disc?
Every spine consists of a line of segments separated and cushioned by pieces of soft tissue known as spinal discs. These discs protect the spinal cord and allow the spine to be more flexible. However, they are vulnerable to damage and degradation.
Each disc is made of a soft, jelly-like inner portion and a tough, protective outer portion. Poor posture, repetitive spinal stress, spinal injury, and/or the normal wear and tear of aging can cause the outer portion to rupture. When the outer portion of the disc ruptures, the inner portion can leak out and irritate nearby spinal nerves. This nerve irritation is responsible for the pain and discomfort reported by herniated disc patients.
What are common non-surgical treatments?
Herniated discs are not necessarily a serious problem. In fact, many patients show MRI evidence of a herniated disc but report no pain or discomfort whatsoever. Nonetheless, there are many treatments available to those who do report symptoms. Here are some of the most common non-surgical treatments for a herniated disc.
Pain Medication
Pain medication is one of the first non-surgical treatments for a herniated disc that doctors recommend to their patients. The two most common pain medications are non-steroidal anti-inflammatory drugs (NSAIDs) and steroids.
NSAIDS, such as ibuprofen, are popular painkillers around the world, but their long-term use is often associated with cardiovascular and gastrointestinal issues. For this reason, doctors sometimes hesitate to prescribe them for persistent symptoms. Steroids are another anti-inflammatory compound often used to address back pain. They can be administered orally or epidurally, but like NSAIDs, they have shown limited long-term benefit.
Physical Therapy
Physical therapy is another common way to address pain and discomfort caused by a herniated disc. Spine issues are often due to insufficient back muscle strength. For this reason, your doctor may prescribe physical therapy, which can strengthen your back muscles and reduce the strain on your spine. Physical therapy is typically more effective in the long term than pain medication.
Epidural Injections
An additional treatment for a herniated disc is an epidural injection. Much of the pain and discomfort caused by a herniated disc is due to inflammation and nerve irritation. For this reason, doctors sometimes inject steroids, which are strong anti-inflammatory compounds, directly into the affected area of the spine. The effectiveness of epidural injections depends on the patient, and they are often used in concert with other conservative treatments.
What should you do if non-surgical options don’t work?
Many patients find relief with some combination of pain medication, physical therapy and injections. However, others may wonder what to do when non-surgical treatments for a herniated disc doesn’t work. If you have tried conservative treatments but have not found the relief you seek, you might want to consider minimally invasive spine surgery.
Minimally invasive spine surgery
Minimally invasive spine surgery is a series of techniques used to resolve spine issues while minimizing surgical damage to healthy tissue. If you and your doctor have discussed your condition and have decided that minimally invasive spine surgery is the best way forward, you will first need to undergo a scan. Depending on your surgeon’s needs, an MRI, a CT scan or a myelography will be taken to help the surgeon locate your herniated disc and plan the best course of action.
For the operation itself, you will be safely under anesthesia. The first step in minimally invasive spine surgery is to use dilation technology, which allows the surgeon to move aside, rather than cut through, healthy tissue and access the herniated disc. Then, a fiber optic tube will be placed near the disc to help the surgeon visualize the operation. Once your surgeon has physical and visual access to the problematic disc, he or she will perform a microdiscectomy. A microdiscectomy involves removing the herniated section of the disc to relieve the nearby spinal nerves from irritation and compression.
In addition to a microdiscectomy, your surgeon may also find it necessary to perform a fusion. Sometimes removing disc material can cause the spine to lose stability. To address this concern, your surgeon may insert a bone graft into the unoccupied space between your spine segments. Talk with your doctor if you have any questions about your condition or minimally invasive spine surgery.
Final Thoughts
If non-surgical treatments for your herniated disc have not brought you the relief you seek, there is still a path forward. Minimally invasive spine surgery is a highly effective technique to resolve mechanical issues in the spine and bring patients back to a more active and comfortable lifestyle. You should use this guide to form questions for your doctor so you can feel more confident and informed about the health of your spine.
