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How to treat a herniated disc?
Intervertebral discs help cushion the force and impact of the spine. What we often say of intervertebral disc herniation refers to the protrusion of the nucleus pulposus tissue inside. Patients may be very painful, but not all patients feel pain. Only when the nucleus pulposus tissue compresses the nerves does it cause severe pain. Don’t worry, although it takes a long time, many patients can recover without surgery.
Method 1: Recognize herniated disc
Understand the symptoms. The most common areas of disc herniation are the waist and neck. If it happens in the lower back, your legs may hurt. If it happens to the neck, your shoulders and arms may be painful. Symptoms include limb pain. The pain may increase when you cough, sneeze or perform certain movements. Tingling. This is because the nerves connected to the limbs are compressed by the protruding nucleus pulposus. Muscle weakness. If the lower back is affected, you may trip and fall easily. If the neck is affected, you may not be able to lift heavy objects.
If you think you have a herniated disc, see a doctor. The doctor will conduct an examination to confirm the source of the pain. He will ask about your medical history, including whether you have been injured recently. He will also test yours: reflex actions. muscle power. Coordination, balance, and walking ability. Tactile. The doctor may test whether you can feel light touch and vibration in various parts of your body. The ability to lift the legs or move the head. These actions will pull the spinal nerves. If the pain or numbness increases, it may be a herniated disc.
Under the advice of a doctor, perform an imaging examination. These tests can rule out other causes that may cause pain and allow the doctor to see what’s wrong with your intervertebral discs. If you are pregnant or think you may be pregnant, you must tell your doctor. The doctor will take this into consideration when making recommendations. X-ray examination.
The doctor may ask you to take an X-ray to confirm that the pain is not caused by an infection, tumor, fracture, or misalignment of the spine. The doctor may also recommend that you have a chirograph at the same time. The radiographer will inject the contrast agent into the spinal fluid to help the doctor see clearly the location of the nerve compressed by the intervertebral disc under X-ray fluoroscopy. Computer tomography.
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| X-ray fluoroscopy |
In this procedure, you have to lie on the scanning table and be pushed into the scanning machine. The scanner will continuously take several X-rays of the inspection site. The doctor may ask you to hold your breath temporarily to get a clear image. You will not have any pain, but you may be asked not to eat for a few hours before the test. This examination takes about 20 minutes or less and can help the doctor confirm the location of the affected intervertebral disc.
Magnetic resonance imaging (MRI)The MRI scanner uses radiofrequency electromagnetic waves to obtain images of the examination site, which is especially useful for confirming the position of herniated discs and compressed nerves. You won’t hurt, but you may need to lie on the scanning table and be pushed into the scanning machine. The scanner makes a lot of noise, and the doctor will ask you to wear headphones or earplugs. The inspection process may take up to one and a half hours. This is the most sensitive imaging test and the most expensive.
Perform a neurological examination. If the doctor is concerned about damage to your nerves, he may ask you to conduct nerve conduction tests and electromyography. During the examination, the doctor will stimulate the nerve with small electrical impulses to see if it delivers electrical impulses to specific muscles. In the EMG examination, the doctor will pierce a very thin needle electrode into the muscle to measure the electrical impulse in the body. These two tests may make you feel uncomfortable.
Method 2: Treatment and lifestyle changes at home
If necessary, you can apply ice or hot compresses. The most clinic recommends using ice or hot compresses to cope with the pain caused by a herniated disc. So should I compress it cold or hot? It depends on the stage of injury. In the first few days of injury, you can use ice packs to reduce inflammation and edema. Wrap an ice pack or a bag of frozen vegetables in a towel. Leave it on for 10 minutes, then let the skin warm up. Do not apply the ice pack directly to the skin. After the first few days, you can use warm compresses to relax tight muscles. Wrap a hot water bottle in a towel, or use an electric heating pad. Do not apply hot objects directly on the bare skin to avoid scalding the skin.
Try to stay active. You may need to rest for the first few days of a herniated disc. But staying active afterward can prevent your body from becoming stiff and help you recover faster. Consult your doctor or physical therapist about exercises that are suitable for you. Do not engage in activities that will aggravate the condition, including fetching, lifting, and carrying heavy objects. The doctor may recommend you to swim. Water can support your weight and relieve spine pressure. He may also suggest that you ride a bicycle or walk.
If your doctor allows, you can try to do pelvic tilting exercises. Lie on your back, bend your knees, and place your hands under your waist. Tilt your pelvis back, pressing your hand down. Repeat 10 times. If this action makes you feel pain, stop immediately and consult a doctor. Perform hip-clamping exercises. Lie on your back, bend your knees, put your hips in the middle, and hold this position for 5 seconds. Repeat 10 times. You should not feel pain. If it hurts, please stop immediately and discuss it with your doctor.
Adjust the sleeping posture. Sleeping in a posture that reduces the pressure on the spine and nerves may relieve the pain. The doctor or physical therapist may suggest you: sleep on your stomach, put some pillows on your abdomen, and arch your back. This reduces the pressure on the nerves. Curled up like a fetus with a pillow between your knees. The side with the herniated disc is facing upwards. Lie on your back with some pillows under your knees so that your hips and knees are slightly bent and your calves are parallel to the bed. During the day, you can lie on the ground with your feet on a chair.
Get social support. Being afflicted by illness for a long time can be very stressful and may cause depression and anxiety. Maintaining a social network can help you cope with your illness and feel less alone. You can get social support through the following methods: Chat with friends and family. You can ask them to do some physical work that you can no longer do.
Consult a counselor. He can teach you some coping skills and confirm whether you have unrealistic expectations for recovery. The doctor may be able to recommend specialists who help patients cope with pain. Join a mutual aid group. You will not feel so alone, and you can learn from other patients how to deal with a herniated disc.
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| X-ray fluoroscopy |
Decompression. Stress makes you more sensitive to pain. As long as you master the skills to cope with stress, you may be able to withstand pain better. The following stress reduction methods are useful for some people: meditation, deep breathing, music, or art therapy, imagining a calming picture, gradually tightening and relaxing different muscle groups.
Consult a physical therapist for other treatments. Maybe you can change your moving or sitting posture to avoid aggravating the condition. You can also relieve pain in other ways. However, you have to consult a doctor first to make sure these methods are safe for you. The methods that a physical therapist may use include: temporarily wearing protective gear on the neck or back to protect and stabilize the spine traction therapy Ultrasound therapy Electrical stimulation
Method 3 take medicine
Use over-the-counter painkillers to cope with moderate pain. If the pain is not severe, the doctor may recommend that you take over-the-counter medications first. Medicines that a doctor may recommend include ibuprofen (brand name Advil, Motrin IB), or naproxen (brand name Aleve). Although non-steroidal anti-inflammatory drugs are useful, they may not be suitable for you if you have high blood pressure, asthma, heart or kidney problems.
It is best to ask your doctor before taking these medicines, otherwise, they may affect other medicines, including herbs or dietary supplements. It is well known that non-steroidal anti-inflammatory drugs can cause stomach ulcers. If over-the-counter medications still do not work within 7 days, please consult your doctor.
Use prescription drugs to relieve severe pain. Based on your symptoms and medical history, your doctor may recommend you to take: medicines for neuralgia. These drugs are becoming more and more popular because the side effects are not as severe as narcotic drugs. Common drugs include gabapentin (trade name Neurontin, Gralise, Horizant), pregabalin (trade name Lyrica), duloxetine (trade name Cymbalta), tramadol (trade name Ultram).
Narcotic Drugs. When over-the-counter medications are not strong enough and medications for neuralgia are not helpful, doctors will prescribe these medications. They may cause side effects such as drowsiness, nausea, confusion, and constipation. These drugs usually contain codeine or paracetamol and oxycodone (trade names Percocet, Oxycontin).
Muscle relaxants. Some patients have muscle cramps and feel very pain. These drugs can help them. The common medicine is diazepam. Some muscle relaxants can cause drowsiness and dizziness and are best used at night before going to bed. Check the instructions on the package to make sure you can drive or operate machinery after taking the medicine.
Inject cortisone to relieve pain. Cortisone can inhibit inflammation and swelling. If necessary, the doctor may recommend cortisone injections directly into the painful area. The doctor may also use oral steroids to help you reduce swelling. Doctors often use corticosteroids, hoping that once the inflammation is reduced, the body will heal slowly and naturally, so that the patient does not need to undergo surgery at an early stage, and may even not need surgery at all. Long-term use of high doses of cortisone can cause weight gain, causing depression, diabetes, high blood pressure, osteoporosis, increased bruising, acne, and susceptibility to infection.
Discuss the operation with the doctor. If other methods cannot improve the symptoms and the nerves are severely compressed, the doctor may recommend surgery. The doctor may recommend several different operations: discectomy. In this operation, the doctor will make an incision in the herniated disc to remove the damaged disc. If the damaged area is large, the doctor may remove the entire intervertebral disc.
If so, he may implant a fusion to fix the upper and lower vertebrae to keep the spine stable. This process is called fusion. Artificial disc replacement. In this operation, the doctor removes the damaged intervertebral disc and replaces it with an artificial intervertebral disc. Endoscopic laser discectomy. In this operation, the doctor will make an incision in the herniated disc, insert a thin tube with a lens at the front end, and then use a laser to remove the damaged disc with the aid of the lens.
During the postoperative recovery period, follow the doctor’s instructions. Surgery can help most patients, but it will take several weeks for you to recover. You may need to recuperate for two weeks to one and a half months before you can go back to work. If you find signs of postoperative complications, please contact your doctor immediately.
Although rare, possible complications include infection, nerve damage, paralysis, bleeding, or temporary insensitivity to touch. The effect of spine surgery can be maintained for a period of time. If the patient’s two vertebrae are fused together, the load will be transferred to the adjacent vertebrae, and surgery may be required in the future. You must ask the doctor if you still need surgery in the future.
If you cannot walk or stand, have extremely weak muscles, or have problems with your bladder, seek immediate medical attention.
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