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Non-Surgical Treatment Options for a Herniated Disc

Dr. Anand Blog Article

December 20th 2017

With the 2017 football season well underway, player injury tracking is on many fantasy fans' radar screens. We want to know which athletes from our favorite teams are on the IR (injured reserve) or are PUP (physically unable to perform) and why. I recently noticed a player or two working on recovery from a herniated disc, and I saw many comments on the presumed prognosis and whether this injury will eventually lead to surgery. It got me thinking about how the general public sees spine injuries and how our collective mind sometimes leaps to surgery as a forgone conclusion for effectively treating such conditions. In reality, the scariest part of some spine conditions is their medical names, and most won't require surgery to correct them or to restore function or normal range of motion. A herniated disc is one of them.

Frequently referred to as a slipped disc or ruptured disc, let's first define what's meant by the term "herniated disc." Some quick anatomy notes: A spinal disc is the soft gel-like cushion between each of the vertebrae, the stack of bones that comprise the spinal column. A disc acts like a shock absorber for daily living, cushioning your spine against damage from the repetitive impact of walking and running, for example. A herniated disc occurs when the tougher exterior of the disc tears and the softer gel-like substance inside begins to protrude out through the tear. These are most often found in the discs of the low back (lumbar spine) and sometimes in the neck (cervical spine). There are a variety of factors that can cause a disc herniation, the most common of which is degeneration, or simply put – aging. It can also be caused by repeatedly using the back muscles to lift or twist heavy objects, instead of using the leg and thigh muscles.

Regardless of the cause, it may surprise you to know that many people have a disc herniation without even knowing it because they don't experience any symptoms. This is because the herniation itself isn't entirely the problem. In fact, disc herniation results in symptoms when the damaged disc pushes out enough to irritate the nerves near the spine. In people who experience this, the chief complaint is pain that radiates or extends to the arm (if the disc herniation is in the neck) or leg (if the herniation is in the low back). Other symptoms can include numbness or tingling in the extremities, as well as weakness of the muscles surrounding the nerves that are affected.

When these symptoms occur, medical evaluation from a spine health expert is crucial to avoid complications or further damage. But I promise you, it won't automatically lead to surgery. A herniated disc diagnosis comes after a physical exam and thorough medical history, sometimes with an imaging study or nerve tests ordered to pinpoint the exact location.

The first order of business in herniated disc treatment is called conservative therapy. You'll begin with simply avoiding the positions and activities that bring on pain. Now, this doesn't mean you'll lie still. Rather, you'll likely be given a set of exercises to perform that can help reduce pain while simultaneously strengthening the spine. Anti-inflammatory medication is also usually prescribed to help reduce the irritation of the nerves surrounding the herniated disc. Depending on your precise diagnosis and health history, the medication prescribed can range from over-the-counter options if the pain is mild-moderate to cortisone injections if the pain is more severe. Often, these conservative options are enough to relieve herniated disc symptoms within a few weeks. When herniated disc pain doesn't resolve within a few weeks, your doctor may prescribe physical therapy to help guide you through positions and exercises designed to reduce pain.

If these conservative treatments fail to provide relief from herniated disc symptoms, only then will a spine expert suggest surgery, and this will be required for very few people with this spinal condition. Even if surgery is suggested, there are minimally invasive optionsthat can help and may include just removing the portion of the disc that is protruding.

Again, there are a variety of spinal conditions and types of back pain that won't require surgery to fully resolve. So, if a herniated disc has your favorite football player currently on the sideline, take heart, fantasy football fans. Odds are he'll be back on the field before the season is over.


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