Herniated Disc Treatment

By Justin Carmel, DPT

Herniated Disc Treatment

What are Symptoms of a Herniated Disc?

One sign may be where the pain is. Although herniated disks can happen in any part of your spine, they are most common in the lower part of your backbone (the lumbar spine), just above your hips. The pain may spread from your back to your buttocks, thighs, and even to your calves. Discomfort from a herniated disk usually gets worse when you’re being active and lessens when you’re resting. Even coughing, sneezing, and sitting can worsen your symptoms because they put pressure on pinched nerves. A herniated disk also can give you a feeling of tingling or numbness. The affected part of your back may also feel weak. Age also plays a role. As you get older, your disks tend to break down and lose their cushioning which makes a herniated disk more likely.

What Causes a Herniated Disc?

A herniated disc occurs when the outer ring becomes weak or torn and allows the inner portion to slip out. This can happen with age. Certain motions may also cause a herniated disc. A disc can slip out of place while you are twisting or turning to lift an object. Lifting a very large, heavy object can place great strain on the lower back, resulting in a herniated disc. If you have a very physically demanding job that requires a lot of lifting, you may be at increased risk for herniated discs.  It is important to learn the correct way to lift objects. 

Overweight individuals are also at increased risk for a herniated disc because their discs must support the additional weight. Weak muscles and a sedentary lifestyle may also contribute to the development of a slipped disc. As you get older, you are more likely to experience a herniated disc. This is because your discs begin to lose some of their protective water content as you age. As a result, they can slip more easily out of place. They are more common in men than women.  Please watch this video on a herniated disc.

Can a Herniated Disc Heal on its Own?

A number of patients do get better on their own, but it’s really more appropriate to say that the symptoms improve, rather than that the herniated disc actually heals. The inflammation can subside, and if the disc fragment was small, the patient’s pain may go away in a matter of weeks. It’s important to realize, though, that even if a patient feels better as time goes on, there’s a risk for another flare-up in the future. There’s still a hole in the outer ring of the disc, so a sudden movement can cause more disc material to herniate out, placing more pressure on the nerves and leading to another episode of inflammation.

Is Non-surgical Herniated Disc Treatment Available?

Conservative herniated disc treatment and therapy often begins with medication, physical therapy and physical medicine and pain management. In some cases, restricted activities may be necessary until the pain subsides. Treatments include:

Medication

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen are the first-line medications for a bulging disc. For more severe pain, prescription medication may be necessary. In some cases, a muscle relaxer can help if there are muscle spasms.

Physical Therapy for Herniated Discs

A physical therapist can prescribe positions and exercises designed to minimize the pain of a bulging disc by relieving pressure on the nerve. Exercise is an essential component of rehabilitation in almost all cases of back pain. JOI has 12 rehab locations in NE Florida.

Physical Medicine and Rehabilitation

Spinal mobilization can be moderately effective for low back pain that has lasted for at least a month. The treatment is best for low-back pain. JOI Physicians perform spinal injections within our facilities to help with pain management for spine and other types of injuries.

Medical Massage Therapy for Herniated Discs

This hands-on therapy often provides short-term relief for patients dealing with chronic low-back pain. JOI offers Medical Massage Therapy. Watch this VIDEO for more information.

Ultrasound Therapy and Traction

The back is treated with sound waves, which are small vibrations that are produced to relax body tissue.  Traction is another modality which can certainly help decrease pain.  Manual or mechanical traction can be performed in physical therapy.  Home traction units have also been used for patients conservative care.

Heat or Cold

Initially, cold packs can help relieve pain and inflammation. After a few days, switch to gentle heat for relief.

Limited bed rest

Too much bed rest can lead to stiff joints and weak muscles, which can complicate recovery. Instead of remaining in bed, rest in a position of comfort for 30 minutes, and then go for a short walk or do some light work, avoiding activities that worsen the pain.

Braces and Support Devices

These devices can help by providing compression and stability to help reduce pain.
Steroids: Cortisone injections (epidural steroid injections) can provide longer-term relief, because the medicine is injected into the area around the spinal nerves. Oral steroids can be helpful in reducing swelling and inflammation.

Spinal Decompression Therapy

A non-surgical form of intermittent spinal traction can help reduce bulging discs symptoms. Pain relief may last for months at a time.

Electrotherapy or E-stim

Treatment often includes using a transcutaneous electrical nerve stimulator (TENS). More advanced treatments can consist of percutaneous electrical nerve stimulation (PENS), and repetitive transcranial magnetic stimulation (rTMS).

Stem Cell Therapy

Medical researchers believe the harvesting and re-injecting the body’s own stem cells may help repair worn-out discs.

Surgery for a Herniated Disc

In most cases, surgery must remove a herniated disc to relieve pressure on the nerve roots. This procedure is called a discectomy. First, a portion of the lamina, or the portion of the vertebra that forms the roof over the spinal nerves, is removed. This creates a window into your spine, allowing the nerves to be pulled to the side so the herniated disc can be seen. Once the disc material is removed, most of the nucleus pulposus is removed to prevent the disc from herniating again. The nerves in your back become free of pressure and irritation, and the lamina and area of the disc that is removed fill with scar tissue very quickly.

What is Herniated Disc Surgery and Recovery Like?

The recovery time you experience after surgery will be dependent on the type of surgery you have for your herniated disc and the type of job you perform. For example, a person who has a desk job will likely be able to return to work sooner than a person who has a more physically demanding job. Additionally, a patient who undergoes a minimally invasive spine surgery has a shorter recovery time than a patient who undergoes traditional open back surgery. To learn more about Mazor X Robotic Assisted Spine Surgery watch this VIDEO

For many minimally invasive spine procedures, you can be back to your normal activities as quickly as 3-4 weeks after your procedure. If you engage in high-intensity work or athletic activities, your doctor may ask you to avoid these activities a few weeks longer, just to be sure that your herniated disc has healed properly. If your disc surgery requires spine stabilization, also known as a spinal fusion, your doctor may bring you along more slowly even though you may be feeling great.

Whether you are suffering from back issues, joint pain, or injuries resulting from any activity, JOI has 12 physical therapy clinics conveniently located in Jacksonville and Northeast FL who specialize in orthopedic rehab.  To schedule physical therapy at JOI Rehab, please call 904-858-7045.

If you are interested in scheduling an appointment at JOI Orthopedic Spine Specialist, please call 904-JOI-2000, schedule online or click below.  Come see us!

By: Justin Carmel, PT