With respect to many patients, a herniated lumbar disk will slowly improve over a time frame of a few days to weeks. Commonly, the majority of patients are free of symptoms by 3 to 4 months. Even so, certain patients do experience episodes of pain in the course of their recovery. If you reside in Columbia, Fulton, Centralia, or Mexico, MO, herniated disk treatment is an integral part of the recovery process for you to consider when deciding on a physician.
Nonsurgical Treatment
Initial treatment for a herniated disk is typically nonsurgical in nature. Treatment focuses on providing pain relief.
Nonsurgical treatment can include:
- Rest. One to 2 days of bed rest will often help alleviate back and leg pain. Do not stay off your feet for longer, however. When you return to activity, try to do the following:
- Take rest breaks all throughout the day, but stay clear of sitting for extended periods.
- Make all your physical activity slow and controlled, most especially bending forward and lifting.
- Change your daily activities to avoid movements that can cause even more pain.
- Nonsteroidal anti-inflammatory medications (NSAIDs). Medications like ibuprofen or naproxen can help ease pain.
- Physical therapy. Particular exercises will help strengthen your lower back and stomach muscles.
- Epidural steroid injection. An injection of a cortisone-like drug into the area around the nerves might provide temporary pain relief by reducing inflammation.
- There is good evidence that epidural injections can efficiently relieve pain in lots of patients who have not been assisted by 6 weeks or more of other nonsurgical care.
Surgical Treatment
Only a tiny percentage of patients with lumbar disk herniation in Central Missouri need surgery. Spine surgery is usually recommended only after a period of nonsurgical treatment has not relieved painful symptoms, or for patients who are experiencing the following symptoms:
- Muscle weakness
- Difficulty walking
- Loss of bladder or bowel control
Microdiskectomy. The absolute most prevalent procedure used to treat a single herniated disk is microdiskectomy. The procedure is done through a little incision at the level of the disk herniation and frequently involves the use of a microscope. The herniated part of the disk is removed along with any additional fragments which are putting pressure on the spinal nerve. A larger procedure might be required if there are disk herniations at more than one level.
Rehabilitation. Your physician or a physical therapist may suggest a simple walking program (like 30 minutes on a daily basis), alongside specific exercises to help bring back strength and flexibility to your back and legs.
To reduce the risk of repeat herniation, you may be disallowed from bending, lifting, and twisting for the first couple of weeks after surgery.
Considerations
With both surgical and nonsurgical treatment, there is a 5% to 10% chance that the disk may herniate once again.
The risk of nonsurgical treatment is that your symptoms may require a long time to deal with. Patients who try nonsurgical treatment for too long before electing to have surgical treatment might experience less improvement of pain and function than those who elect to have surgery earlier. Your doctor will talk with you about how long you should try nonsurgical measures before considering surgical treatment.
Surgical risks. There are minor risks associated with any surgical procedure. These include bleeding, infection, and reaction to anesthesia.
Specific complications from surgery for a herniated disk include:
- Nerve injury
- Infection
- Tear of the sac covering the nerves (dural tear)
- Hematoma causing nerve compression
- Recurrent disk herniation
- Need for additional surgery
Outcomes
Principally, the outcomes of microdiskectomy surgery are typically very good. Patients tend to see additional improvement of leg pain than back pain. The majority of patients have the ability to resume their normal activities after a period of recovery following surgery. Typically, the first symptom to improve is pain, followed by overall strength of the leg, and then sensation.
Over the last few years, there has been substantial research on the treatment of disk herniation. Your doctor will have the ability to speak with you about the advantages and disadvantages of both surgical and nonsurgical treatment. You simply need to make sure you are choosing someone who has been staying in the loop on these latest advancements. Dr. Kathleen Weaver in Mexico, Missouri keeps up to date on all the most recent advances in orthopedic medicine in the Mid Missouri area. Set up an appointment to see what Dr. Weaver can do for you.