The spine is a necessary bone structure in our bodies. Consisting of small, interconnected bones (vertebrae) that are cushioned by pillow-like discs, the spine is an important support system that allows us to function properly in our everyday lives.
Our vertebrae are protected by discs that consist of a tough outer layer (annulus pulposus) that surrounds a nucleus. Discs reside between each vertebra and act as tiny shock absorbers for our spines. However, complications can occur when the nucleus begins to push out of the outer layer of the disc. These are called herniated discs, also known as a slipped disc or ruptured disc. They can occur anywhere in the spine, although it is more common in the lower back (lumbar spine).
Causes and Symptoms of Herniated Discs
Herniated discs often take place because of injury or strain. However, they could also be due to old age as it is often one of the first signs of a degenerating spine.
Genetics could also play a role – research has shown that disc herniation is common in individuals with multiple affected family members.
Symptoms vary from person to person. If the disc herniation does not create pressure on a nerve, there will most likely be little to no back pain. However, if there is nerve irritation, the patient may experience numbness or weakness in areas that the nerve connects to. Herniated discs are usually accompanied by prior back pain.
How to Treat Herniated Discs
Herniated discs often heal on their own within a couple of months. The healing process can be accelerated with proper treatments, such as:
Walking
Doctors suggest limiting strenuous exercise for a few days. However, walking is tolerated and encouraged due to its various benefits. Walking increases blood plow, flushes out toxins, and, most importantly, increases flexibility in the lower back. Specific muscle groups such as hamstrings, erector muscles of the spine, and hip flexor muscles are activated and stretched during a brisk walk. Spinal ligaments and tendon flexibility also increases, which improves the range of motion in your back.
Avoid Bedrest
Too little activity can lead to stiff joints and weak muscles. Bedrest slows the exchange of fluids around the spine, which can cause swelling and inflammation to persist. In order to assist healing processes in the spine, rest for thirty minutes then move around a little bit; go for a walk or do some work around the house. Research has shown that people who maintain normal activities during their recovery have reduced pain and increase their ability to function.
Apply Heat or Ice
Ice packs can provide relief from pain and inflammation. Apply ice for fifteen minutes to relieve tension and decrease swelling, pain, tension, and muscle spasms. Heat can relax the muscles, increase blood flow, and facilitate movement in the spine.
Physical Therapy
Although physical therapy can’t directly target the herniated disc, it can strengthen the muscles that surround the lumbar spine. Strong muscles create a balanced spine and decrease the risk of injury. Physical therapy may include treatments such as:
- Deep tissue massage
- Hot/cold therapies
- Electrical stimulation
- Hydrotherapy
- Exercise
Anti-Inflammatory Medication
Over the counter pain medication, such as tylenol, ibuprofen and other acetaminophens can reduce inflammation and ease the pain that accompanies a herniated disc. Doctors are most likely to prescribe over the counter medications if pain is less severe.
Cortisone Injections may be recommended if pain persists. Cortisone is a type of steroid that relieves inflammation in specific areas. Injections have minimal side effects and can easily target an area of pain, such as the area around the spinal nerves. Although a cortisone shot is not a pain reliever, it reduces inflammation which can lead to less pain over time.
Opioids are rarely considered and are typically the last resort in terms of medications. Due to their highly addictive properties, opioids are not typically prescribed for herniated discs. If other medications fail to relieve pain from a herniated disc, doctors may give short-term opioid prescriptions that include but are not limited codeine or an oxycodone-acetaminophen combination (percocet, roxicet, etc.).
Opioids are rarely considered and are typically the last resort in terms of medications. Due to their highly addictive properties, opioids are not typically prescribed for herniated discs. If other medications fail to relieve pain from a herniated disc, doctors may give short-term opioid prescriptions that include but are not limited codeine or an oxycodone-acetaminophen combination (percocet, roxicet, etc.).
Surgery
Although few people need surgery for a herniated disc, it is an available option if pain persists after six weeks and other treatments fail. However, it is important to weigh the risks of surgery; surgical treatment does not always result in a healed and healthy spine. Surgery should only be considered if the patient has:
- Poorly controlled pain that interferes with daily life
- Conservative treatments (medication, physical therapy, etc.) are ineffective
- Numbness or weakness in the body
- Difficulty standing or walking
- Loss of bladder and bowel function
A herniated disc is a common and treatable condition that typically resolves itself in one or two months. In order to aid the healing process, doctors may recommend conservative, at-home remedies, such as walking, limiting bed rest, and over the counter medications. However, if pain persists, a more advanced treatment may be recommended. Although surgery is not a common treatment for herniated discs, it is an available option. To decide what is best for you, consult your doctor.
