Herniated Disc - Treatment Options
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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.
Suggestions
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.
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Comments
Thank you gredmondson! I'm just thankful medical technology has advanced to the point that treatment options like these exist. I can't imagine what a life with a herniated disc was like in the pre-surgical era!
Back in 2003 I had back surgery L4-5 herniated disk did physical therapy turned out fine went back too my job,I also found at that time that I have degenerative disk disease last year I ruptured L4-5 again and also L3-4 so two this time had surgery January of this year and this time everything isnt fine I cant stand very long cant sit very long cant walk very far I have to lay down in bed and rest my body usually every hour for 20 min.surgeon says there nothing more he can do so he sent me to the pain clinic in may they gave me 4 steroid shots at once with no sedative It hurt so bad I was shaking Its still not any better do you think I should start over with MRI I wasnt sure you understood me on your other hub what do you think~cool~cya
Wow, that's serious, oberbreckling. Degenerative disc disease is really awful, and the fact that it's afflicted numerous discs is unimaginable. I hope you can find some sort of treatment that works and keeps you on your feet and out of pain. I can't imagine the spinal shots without some sort of sedative...
yeah the spinal shots were terrible you know how they put the needle in there then move it around a little until they get in the right spot well thats when they had my legs jumping around they were doing it with the needle legs were jumping and there telling me be still now WoW hahah yeah right! but I think im gonna go to the university have them take take a look then if thats that I guess Im done learn too live with it because of the narrowing of disk hieght the areas where the nerve root come off of the spinal cord and goes through the small opening those opening keep getting smaller result eventually pinched nerves thats the degenertive disk side of it anyway plus herniated disk I live on darvecet with a narcotic in them oh well I'll keep you up to date in the future~cool~cya!
Great overview. Back pain is a tough condition to deal with, and even if you choose surgery it seems that it doens't solve the problem way too often. I've had co workers who chose surgery hoping that it would finally cure the pain, and in the end wished they hadn't. A look at alternative treatments is certainly time well spent.
I went to a chiropactor and I started doing yoga and takeing fish oil natural stuff my back getting better I made the mistake by having back sugery never again .
Thanks for all your advice. I'm 53 yo female. I have L4-5 disc herniation. Been in agony for close to 3 months. I'm living on Advil, Tylenol, Tylenol #3 and Endocet. I haven't had a night's sleep in over 2 months. I'm so discouraged. My family is getting fed up with me. I'm struggling to do my job so I don't get fired.
I tried ice packs, Biofreeze, chiropractor, hasn't helped. I wake up in such agony in the middle of the night that I'm gasping with pain. I'm trying to distract myself for the hour until it kicks in and gives a bit of relief. I was told for medical reasons I'm not a surgical candidate. I'm feeling desperate. Standing is the worst and walking is almost as bad. Sitting seems the best although maybe I'm aggravating it by sitting so much.
Any help or words of encouragement will help me.
Paneera: my heart goes out to you. I know how unbelievably painful it can be, and the lack of relief and sleep can really wear you down. Did your doctor rule out the spinal steroid shots? They didn't work for me, but they have for others. It's a quick, relatively painless procedure, so it's worth a shot if your doctor thinks it can help you.
Thank you for answering so fast. My doctor didn't mention the steroid shots. He gave me Celebrex and sent me to a chiropractor, when that didn't help he gave me Endocet and a back surgeon consult. I asked him about physio and he said I could try it. I'll ask him about the steroid shots.
I was glad to have found your hub. I'm up during the night and I try to distract myself because that's when the pain is the most unbearable.
Thanks again for answering.
I herniated a disk in my lower back in Dec. 08. I was in so much pain I couldn't stand or walk normally. I finally went to the Doc and he gave me a muscle relaxer and vidocin for the pain. I was also sent to PT. It work a little bit, I could atleast stand and walk normally. However, I am still dealing with stabbing pains in my lower back and horrible siatic pain down my leg. I am not sure whether to go back to the doctor or just deal with the pain. I have been dealing with this for 5 months and I am getting really sick of the pain everyday.
Any suggestions would be great!
meg0317: I strongly suggest going back to the doctor. The sciatic pain down your leg means that your disc is still bulging and pinching your sciatic nerve. That will not generally resolve on its own, especially if it hasn't done so over the past 5 months. The pain will *not* get any better without treatment - trust me!
And if your doctor just tries to get rid of you with painkillers and PT treatment, get another doctor. You should get an MRI to confirm what's going on.
I herniated mt L6!-S1 one year ago, in that time I was misdiagnosed as having Piriformis syndrome by L.B.J. Hospital in Houston. Since then my left calf muscle and my left foot have atrophied and withered away by 20%! I was finally given a M.R.I. 8 months later, lo and behold, there was my smushed spinal cord! I have an appointment with a neurosurgeon on June 19th. I don't know if my leg will ever be the same! I've refused all pain meds. except for the first 2 weeks when the pain was excruciateing. I hope everyone hangs in there.
Hi all,
Megg - my story is almost identical - 3 yrs ao I fell down the stairs and have been treated for piriformis syndrome ever since even though I told them I didn't think it was correct (gut feeling?!). I was finally given an MRI 2 months ago and found HUGE bulge/herniated disc - I am in for surgery in 2.5 weeks time and am very anxious.
I hope you get some answers on June 19th.
Thanks for this blog, I've found it at a time when I really need this sort of information. I am most worried about recovery - I am a terrible patient and worried I will be able to rest up enough!
Oh, Helen! I'm so sorry to hear of your THREE years of misery! You'll be in my prayers, hang in there, if you're tough enough to tolerate all those years of discomfort, then I imagine you'll do well in recovery. You are stronger than you think.
Last december I had awaken with serious pains shooting down my right leg and right butttock. I've seen 3 different doctors, two of which recommended takiing painkillers the other advised to see a phsysiotherapist. I've now went to three physiotherapists, the first of which advised me on the exercises to do (laying on my back pushing upwards with hands) and the others more or less the same. Anytime I would go for a checkup they would simply put me on a bench, get me to do some stretches to see the process. Some comments where made but nothing productive or progressive. I have now stopped going for 3 months and continue to try stretching every 50min as its difficult when working in IT to get away. I asked to get a MRI done but 1 doctor advised it was not needed. The other two well said the same, it will pass and that i should just take painkillers. One of the physio's also said a MRI was not needed, just alot of exercise. Im only 27 and have no idea how my injury happened. I feel its because of the profession i'm in (sit at a computer). I'm not sure what else to do really. I have no faith in doctors to as each seem to have a different opinion. I just continue to break away for 15min to do some stretches then continue the day. When I get home i usually lay on my back and try to relax.
Don't forget about chiropractic care. It is a natural alternative and very effective for disc problems. Many chiropractors have the drx machine you mentioned also.
My mom had sergery for heel spurs about 25 years ago. She has pain in her heels again,and a burning sensation from the middle of her foot to her toes. She recently went to her doctor and he said she had a slipped disc in between #4 and #5 . Could this be causing her foot pain?
gredmondson says:
17 months ago
Livelonger, thanks for putting thid to paper (I just reallized what a dated expression that is!). I should say thanks for making this Hub. I've seen people up close who have terrible back pain, and it looks horrible because the pain is relentless. Congratulations on your personal success.