For some, back pain can be alleviated with rest and at-home remedies; for others, not so much. This can be a result of a herniated disc. Fortunately, many herniated disc treatments are available to help get patients back on track—let us look at five of the most effective.
Diagnosing a herniated disc
To determine the most effective herniated disc treatment option for each patient, we must first verify its presence. Our diagnostic process includes imaging testing, physical examination, and a neurological assessment. We may begin by asking the patient what action resulted in their pain. This can include a fall, an accident, or incorrectly picking up a heavy object. It is also good to document how long symptoms have been occurring and if they worsened over time. Considering most patients try to self-medicate with over-the-counter medication, bring a list of medications and daily dosages to the appointment.
From this conversation, the provider will determine what type of imaging test the patient will undergo. An X-ray cannot detect a herniated disc, but it will rule out other issues impacting the surrounding structures, such as infection, broken bone, tumor, or general alignment issues. A myelogram involves the provider injecting a dye into the vertebrae (spine) before conducting a CT scan. This dye will highlight pressure on the spinal cord, usually resulting from a herniated disc. A CT scan is a series of X-rays from various angles, creating cross-sectional images of the spinal column and surrounding structures. On the other hand, an MRI involves a strong magnetic field to create images of the body's inner structure to detect the presence of a herniated disc and its precise location.
The physical examination is simple, with the provider gently pressing on or around the problem area to determine its tenderness. They will also check for signs of discoloration or heat, which can indicate more troubling issues. Lastly is the neurological assessment. It will involve the provider checking patients' reflexes, muscle strength, and ability to walk, twist, turn, and feel sensations. This portion of the process is often the deciding factor in determining the first treatment option.
5 most effective herniated disc treatment options
1. Oral medication
Oral medications are mainly for those who have a slight to moderate herniated disc, considered a conservative treatment option. These can include neuropathic drugs, muscle relaxers, or opioids. Neuropathic drugs can alleviate nerve impulses, significantly decreasing pain levels. Muscle relaxers are often for those with spasms. Opioids are for those showing no signs of improvement with neuropathic or muscle relaxant prescriptions. However, it may only be a short supply with no refills.
2. Cortisone injections
If the pain does not improve with oral medication, the provider will move to corticosteroid injections. This herniated disc treatment involves injecting medicine directly into the area around the spinal nerves. It involves the guidance of spinal imaging for more accuracy. Some patients may only require one injection, while others may require several over a few months.
3. Physical therapy
Some people make the mistake of trying to perform physical therapy techniques at home. Considering they do not know the exact position or severity of their herniated disc, it often worsens the condition. Our team can provide strategic physical therapy techniques, such as soft tissue mobilization and spinal adjustments, without damaging the surrounding structures.
Soft tissue mobilization involves applying manual pressure to the muscles and tissue, reducing inflammation, relaxing tense muscles, and improving circulation. Alternatively, spinal manipulation also requires manual pressure but targets the precise area of the spine where the herniated disc is located. The aim is to reduce the pressure on the vertebrae, reigniting the patient's ability to twist, turn, and walk without pain.
4. Decompression therapy
Like manual therapies, decompression therapy aims to relieve pressure on the spine resulting from the herniated disc. However, it involves stretching the spine instead of relying on applied pressure. Patients will lie on a specialized table that gradually moves, creating a traction-like effect on the spine. This movement creates a "negative" force inside the disc, encouraging the herniated material to retract.
5. Surgery
Surgery is only for the most severe cases and for those who have seen no improvement in at least six weeks of any of the above treatments. There are two surgical options. The first and most common of the two is removing the portion of the disc that is protruding. The second, most rare, involves removing the entire disc and fusing the vertebrae with a bone graft. This will be followed by a months-long healing process, including installing metal hardware in the patient's back to provide stability.
Let us help put an end to your pain
Our team of professionals can diagnose and treat herniated discs. If you want to learn more about our different herniated disc treatment options, contact our Ooltewah area office and schedule an evaluation.
Request an appointment here: https://sjrm-tn.com or call Spine & Joint Regenerative Medicine at (423) 424-1529 for an appointment in our Ooltewah office.
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