Herniated Disc - Treatment Options
If you've found out that you have a herniated disc (also known as a slipped disc or ruptured disc), then you have a few options to resolve this painful problem. I began to notice the pain from my herniated disc (L5-S1) late last year, and it took almost 6 months of trial and error to have it corrected.
1. Wait it out
Mildly herniated discs often resolve themselves by taking it easy (avoiding any exercise except walking). Natural movement of the disc between vertebrae, and flow of fluids in and out of the disc material, will allow the disc to assume its normal shape and heal.
If your sciatic pain gets slowly better, then easing up on your activity is probably what you need.
2. Spinal steroid shots
Corticoid steroids injected into the disc area can also help contract the disc material and also the tissues surrounding it, reducing pressure on the sciatic nerve and easing up on the pain.
The injection is a quick and relatively painless outpatient procedure. They sedate you intravenously and give you two quick injections to your spine. I felt a sudden shock of pain each time but it didn't last. Afterwards, you're still a little groggy from the sedation, but within an hour or two you're back to normal. You will probably have to take the day off work as I had to.
These normally come in a series of three, each requiring your health insurance's approval. Your doctor will evaluate how you feel about 10 days after the procedure. Your pain might get worse 3-4 days after the injection, but should improve by day 10.
Read Nashville G-man's epidural steroid injection experience.
3. Spinal Decompression
I tried this but discontinued treatment after 9 sessions.
Another method you'll find a lot of offers for on the Internet is spinal decompression, using a table like the DRX9000. This table, similar to a traction table, puts you in two harnesses: one around your torso, and another around your pelvis. It then pulls each in opposite direction, in order to pull on the spine, and allow your vertebrae to separate and allow your disc to recede.
I don't know how much of the marketing pitch is scientifically proven - there's a noticeable paucity of peer-reviewed data on its effectiveness - but if you're feeling desperate and really want to avoid surgery, then I suggest at least looking into it (although I do not recommend it personally).
4. Surgery (discectomy)
This was the final step in my personal dealings with my herniated disc, and the only one that offered any relief. It's been about 6 weeks since my procedure, and I have had no sciatic pain whatsoever.
The procedure is done on an outpatient basis, and takes the neurosurgeon about 45 minutes.
1. You are put under twilight (full) anesthesia.
2. The surgeon makes an incision in your back, about 3 inches tall. He/she cuts muscle and surrounding tissues to get to your spine.
3. In most cases, he/she performs a laminectomy; a cut to the lamina (fan-shaped bone) is made so that the surgeon can safely reach the disc and spinal cord.
4. The spinal cord is pulled aside, and the surgeon cuts off the disc material that has herniated. The disc material is not spongy or jelly-like; it has the consistency of raw steak.
5. The spinal cord is placed back and your muscles and skin are sutured closed.
6. You spend about a couple of hours in the recovery room where you regain consciousness, and then another 1-2 hrs in the outpatient ward.
I personally had a successful surgery. I did not feel pain at all. There was definite soreness in my lower back for a few days (from the cut-through muscles) and I wasn't able to stoop down or lift anything heavier than 10 lbs for a couple of weeks.
I took a week and a half off work, but most of that was weaning myself off a very, very heavy dosage of painkillers I was on for months.
Please read ktrapp's Hub on microdiscectomy (she discusses her son's experience with an L4/L5 herniation and his eventual surgical procedure).
Of course, my main suggestion is finding a highly competent spine doctor and neurosurgeon, and following their recommendations.
If you live in the East Bay of California, I would highly recommend these two doctors:
- Spine specialist: Dr Michael Park - offices in Oakland and Lafayette
- Neurosurgeon: Dr Gordon Tang - office in Berkeley, near Alta Bates Medical Center
I couldn't possibly have been happier with their quality of care.
Update: almost 9 years later
It's been almost 9 years since I had my discectomy and, fingers crossed, I'm still feeling fine. Every once in a while I'll feel the faintest glimmer of the same, shooting pain, but it passes fairly quickly. My scar is also fading a little bit, but it is still visible and probably always will be.
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