What Is The Treatment For Herniated Disc In Lower Back

Check Out This Video About Herniated Discs From Our Chiropractor Dr Oliver:

Other herniated disk treatment options include:

Rest often a couple of days of rest will help to calm severe pain caused by lumbar disc herniation. However, its important that you dont rest for longer than this as it can actually worsen pain and stiffness.

Anti-inflammatory medications medications such as ibuprofen and naproxen may help to reduce inflammation and relieve pain.

Physical therapy performing specific exercises to increase range of motion and strengthen muscles in your lower back and core may help to relieve pain and reduce your chance of re-injuring yourself.Spinal manipulation manipulation of the joints of the lower back may help to improve range of motion and decrease pain.

Massage therapy may help to increase blood circulation and relax muscles thereby helping to reduce pain.Epidural steroid injections injection of corticosteroids into the affected area may help to reduce local inflammation and relieve pain.

What Are Herniated Discs

As we said earlier, spinal discs separate each individual vertebra and soak up shock. Without them, the bones in your spine would grind against each another, and you’d be unable to absorb the impact of trauma and body weight.

More than just protective, these cushions also give the spine flexibility, making movements such as twisting and bending possible.

Like yin and yang, discs are both soft and hard at once. Theres a tough outer layer, called annulus fibrosus, and a soft, gel-like center, called nucleus pulposus. Fibers on the outside of each disc helps them attach to vertebrae and stay in place.

If the strong outer layer of the disc ruptures, the gel-like center can leak into the spinal canal: the passage that contains the spinal cord and spinal fluid. Pain strikes when that gel and potentially part of the outer disc and inner gel presses against the nerve roots that run along the spinal column.

The result can be intense pain in your back, along with weakness in an arm or leg. Numbness can also occur, since the nerve signals are being blocked. Making it all more troublesome is the fact that the gel can release a chemical irritant that may contribute to nerve inflammation and pain.

Herniated discs can compress nerve roots and even the spinal cord itself.

Will A Herniated Disk Get Worse

An untreated herniated disk can get worse. Thats especially true if you continue the activities that caused it for instance, if it developed because of your work. A worsening ruptured disk may cause chronic pain and loss of control or sensation in the affected area. See your healthcare provider if you still have symptoms after four to six weeks of conservative care.

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Causes And Risk Factors

Bulging disks result from a reduction of gel in the disk center. Less gel causes the disk to become compressed and start to bulge.

The gel in a spinal disk naturally wears away over time. A bulging disk is usually the result of aging, but it can also be due to spinal injury, such as the result of a car accident. An injury could also push a bulging disk to become herniated.

Another risk factor is physical activity, which may weaken the back and abdominal muscles, placing additional pressure on the vertebrae.

Some physically demanding jobs may also increase the risk of a bulging disk , such as those that frequently involve lifting heavy objects.

Treatment For A Slipped Disc From A Gp

A GP might prescribe a stronger painkiller, a steroid injection or a muscle relaxant to use in the short term.

If your symptoms do not get better, a GP might recommend further tests, like an MRI scan.

They might also refer you to a physiotherapist. Physiotherapy from the NHS might not be available everywhere and waiting times can be long. You can also get it privately.

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Physical And Neurologic Examination Of The Lumbar Spine

A complete physical and neurologic examination can reveal defects at specific levels. The first assessment in the physical examination is a search for any external manifestations of pain, including an abnormal stance. The patient’s posture and gait should be examined for sciatic list, which is indicative of disc herniation. The spinous processes and interspinous ligaments should be palpated for tenderness. Range of motion should be evaluated. Pain during lumbar flexion suggests discogenic pain, while pain on lumbar extension suggests facet disease. Ligamentous or muscular strain can cause pain when the patient bends contralaterally.

Motor, sensory and reflex function should be assessed to determine the affected nerve root level8. Muscle strength is graded from zero to 5 . Examination of the lumbar spine by neurologic levels is helpful in locating the source of the patient’s symptoms .

Nerve root tension signs are often used in the evaluation of patients suspected of having a herniated disc. The straight-leg raising test is performed with the patient in the supine position. The physician raises the patient’s legs to approximately 90 degrees. Normally, this position results in only minor tightness in the hamstrings. If nerve root compression is present, this test causes severe pain in the back of the affected leg and can reveal a disorder of the L5 or S1 nerve root.

How Does It Feel

A herniated disk can cause pain, tightness, numbness, weakness, or tingling in the neck, back, arms, or legs. If the bulging or leaking disk pushes on a nearby nerve, pain or muscle weakness may result. If the bulging or leaking disk does not push on a nerve, pain or disability may not occur. Although back or neck pain can be caused by a herniated disk, other factors may be involved. Your physical therapist can test for and rule out other possible conditions.

If a herniated disk is severely pressing on a nerve, or is pressing on the spinal cord, surgery may be needed to immediately relieve that pressure. Your physical therapist can help determine whether either of these conditions is occurring, and will work closely with your physician and surgeon to determine the correct treatment.

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Medication For The Pain

There are a number of different medications for the relief of sciatic nerve pain caused by a slipped disc. Most of these are painkillers, but you can also use muscle relaxants and . The following medications are the most commonly used. They are all available without a prescription when taken at a low dose:

Some of the medication options have to be prescribed by a doctor. These include:

Anticonvulsants and antidepressants are typically not used unless the symptoms last for a longer period of time or the painkillers don’t provide enough relief.

What Are Nonsurgical Treatment Options For Herniated Discs

Most people who have herniated discs respond well to conservative treatment and do not require surgery.

“Often, there won’t be one single strategy to address herniation in a non-surgical way. You’ll be encouraged to adopt some healthy lifestyle practices along with targeted treatment like physical therapy,” says Nikhil Jain, MD, clinical spine surgery fellow at University of Louisville School of Medicine. “Even if genetics is playing a role, there’s a great deal you can do to improve spinal function.”

In addition to physical therapy and pain-relieving medications as recommended by your doctor, these are a few things you can do to feel better.

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Herniated Disc Exercise : Reduce The Radiating Leg Pain

The first thing you have to do is to try to reduce the radiating pain. You can do this by stretching your back backward as far as possible. It is called extending your back.

You can do this in two ways: While standing or while lying in a prone position. Ill discuss the one in when you stand because thats the easiest one for most people.

It will instantly relieve your leg pain.

Perform the exercise like this:

• Place your index fingers on the painful spot in your back
• Apply pressure in a forward direction
• Now bend all the way backward
• Make sure also to extend your neck for maximum result
• Hold this position for 3 seconds
• Repeat this ten times

You can also see how to perform the exercise in the video.

Make sure that you perform this exercise several times a day. Its especially important to complete the activity every time youve to bend forward or lifted something.

When youve performed the exercise, you will notice that the radiation in your leg reduces and sometimes even totally disappears.

It is what you want to achieve.

When you feel the radiation coming back into your leg, its time to do the exercise again. You want to keep the radiation away so that the intervertebral disc has time to recover.

You can also use this back stretcher to reduce the pressure on your nerves. It does the same as the exercise but it easier to do for some people.

Exercise Relaxation And Positioning

In the past, people who had a slipped disc were typically advised to stay in bed for one to two weeks. Nowadays the opposite approach is taken: people are advised to stay active instead. This is because remaining in a lying position for a long time can make muscles and bones weaker, which can end up causing other problems.

Studies have shown that physical activity can improve mobility. However, whether people keep up with exercise or rest instead wasn’t found to influence the back pain itself. So it is a good idea to try to carry out your normal daily activities as much as the pain allows. Exercise has also been proven to effectively prevent back pain from returning.

Relaxation exercises may also be worth a try to help relieve back pain. How you perceive pain and how well you cope with it can be influenced by your mind.

If the pain is very severe, though, there is sometimes simply no other way to deal with it than to lie down and find a position that puts as little strain on your back as possible. Many people find the “psoas” position comfortable: While lying on your back, you put your lower legs on a raised platform high enough so that your knees are bent at a 90-degree angle. But it is important not to stay inactive for too long.

Psoas position

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How Is A Bulging Disc Different From Herniated Disc And Which Is Worse

Now that we know what a bulging disc is, lets discuss disc herniation.

In most simple terms, a herniated disc is when the fluid material from the disc ruptures through the outer layer of the disc and now spills out the back, which can directly compress on spinal nerves and spinal structures. If you use the water balloon example from above, but now imagine the balloon has burst under pressure Thats a herniated disc.

As you can see a herniated disc might be worse. But still many patients with Herniated discs/Bulging discs have NO symptoms, so its important to get proper diagnoses for your specific situation.

Usually bulging disc can be resolved over time if managed well, whereas the herniated disc will just scar down since the annulus has ruptured.

A nice visual spine model is provided below differentiating between normal, bulging, and herniated discs:

Tips For Relieving Pain From Herniated Discs

Do you experience achy or sharp radiating pain to your shoulder, arm, buttock or leg? This may be an indicator of a bulging or herniated disc in the neck or back. Between each of the vertebrae that make up your spine are small cushions called discs.

Herniated discs are more common in the 30-50 age bracket. A herniated disc is when the material inside the disc pushes outwards, irritating the nerve exiting at that level. This can be on either side of the spine and depending on the nerve affected in the neck or back, can cause radiating pain, numbness and loss of sensation.

Most people are able to relieve their pain from a herniated disc using medications and physical therapy, with improvements seen in about four to six weeks. However, in cases where the pain is very severe, surgery may be used as a last resort treatment.

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Other Conservative Treatments That Support Physical Therapy

In certain cases, physical therapy alone may not be enough to completely resolve low back and radiating leg pain caused by herniated discs. In these cases, physicians will likely recommend additional treatments in conjunction with physical therapy to maximize the benefits of both.

Other common conservative treatments used to manage herniated disc pain include:

Summary

Physicians have several interventions which they may recommend ancillary to physical therapy to maximize pain reduction. All of them involve some type of medication, so itâs important to receive medical advice from your physician about each of them to determine which may be best for you.

Herniated Disc Exercise : Increase Lower Back Stability

The second exercise is designed to reduce the pressure on your lower back and the affected disc. We will do that by training the little muscles around your back.

The increased stability will also reduce the pressure on the disc. The muscles will take over some of the weight, which helps the disc.

You can perform this exercise in the following way:

• Lay down on your back
• Bend your knees
• Cross your arms over your chest
• Now lift your pelvis
• Hold this position for 10 seconds
• You can increase the difficulty by extending one leg and keep it slightly above the ground

You can also see how to perform the exercise in the video.

Try to perform this exercise 2 times a day. Also, try to increase the time you hold your pelvis up to 15 or 20 seconds.

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Conservative Care For A Herniated Disc Why It May Not Work For You

This is why many doctors will recommend many and varied courses of conservative care before recommended spinal surgery.

Here are our articles on conservative care for herniated disc:

• epidural steroid injection. In this article, back pain treated with epidural steroid injections and Prolotherapy is compared. We will answer common patient questions such as: Do epidural injections help herniated, slipped, bulging discs?
• Chiropractic care, physical therapy, and various spinal and muscle stimulators.

Is Discography Useful

The Discography or discogram procedure usefulness a test and evaluation tool is controversial. Like an MRI it may show things that are not the root cause of the problem. In the procedure, a dye is injected into the discs to look for cracks or other abnormalities. Sometimes several discs are injected. Like an MRI, the discogram may show damage that is not causing symptoms, so the discogram may be leading doctors to treat something that is not the problem.

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When To See A Doctor

Most simple back pain will start to improve within a day or two of restricted activity and over-the-counter medication. If you find yourself taking more and more pills to relieve back pain, or if the pain is getting worse, you’ll want to contact a back specialist. After a thorough medical history, physical examination, and diagnostic tests a doctor may be able to determine if there is a specific cause of your pain and will recommend appropriate treatments.

Not all chronic pain is treatable. Pain management is an integrated approach to making pain tolerable by learning physical, emotional, intellectual and social skills. This may include exercise, physical therapy, medication, relaxation, acupuncture, behavior changes, biofeedback, hypnosis, and counseling. When you use pain management techniques, you stay in control of your own health. These techniques also help the brain produce it’s own pain medications called endorphins, which literally means “morphine within” .

Proper Bending And Reaching Technique

Proper Bending and Reaching Technique : Please be aware that bending and lifting are contraindicated after lumbar fusion/kyphoplasty procedures. This technique is provided for the rare occasions when you absolutely require objects being picked up from the floor. Note that the subject has arranged herself in a position where she can use the leg as a lever arm to pull her body back up to its standing posture while maintaining a flat back.

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When Should I See A Doctor

Initially, you can treat herniated disk pain at home. But you should see your doctor if:

• Pain interferes with daily life, like going to work.
• Symptoms arent better after four to six weeks.
• Symptoms get worse.
• You develop loss of bladder or bowel control.
• You notice tingling, numbness or loss of strength in your arms, hands, legs or feet.
• You have trouble standing or walking.

Percutaneous Disc Decompression For Herniated Discs

Decompression is a term used to describe the treatment of a compressed disc that is causing bulging or herniation. Percutaneous disc decompression involves dissolving or removing parts of a herniated disc to alleviate back pain. This therapy is used for patients who present with low back pain and numbness with pain radiating down one or both legs. Most patients who undergo this procedure have an MRI that shows a modest herniated disc. In other words, this treatment is not for people with severely herniated discs.

The treatment involves placing a needle into the herniated disc using X-ray guidance. Depending on the type of decompression therapy, excess disc tissue is either dissolved through radio waves or removed by a revolving needle. The result is decreased pressure on the disc and adjacent nerves. Although some studies show effective pain relief, we believe the long-term effects of removing tissue are not worth the short-term pain relief.

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