Aside from causing pain and discomfort, a herniated disc can have long-lasting effects. Knowing what types of herniated disc treatment options are available can help you understand the recommendations your doctor or surgeon may be making.
What is a Herniated Disc?
Is a herniated disc creating uncomfortable symptoms for you? Known by a wide number of names, a herniated disc occurs between the bones of your spine.
To better understand the nature of this condition, it’s important to have a basic idea of how the spine is structured. Your spine consists of 33 individual bones. Each of these bones stacks and interlocks with the others to form your spinal column.
The spinal canal runs through the center of these bones to form a channel for your spinal cord and nerve roots. Between each of the bones is a rubbery disc. These are known as intervertebral discs and provide cushioning and support between each individual vertebra, aiding in twisting, bending and protecting the bones from wear.
Occasionally, a disc may “rupture” or herniate. When this happens, the tough outer layer of the disc tears or bursts, allowing the gel-like inner contents to push into the spinal canal.
Many times, there are no symptoms or very mild symptoms from a herniated disc; however, when there is spinal cord or nerve root compression it can bring on a number of uncomfortable or even debilitating symptoms.
Herniated Disc vs. Bulging Disc
You may hear the terms herniated disc, bulging disc, ruptured disc, slipped disc, prolapsed disc – what is the difference? Nothing, really. These are all names commonly used for the condition known as a herniated disc.
Often times, doctors will use these terms interchangeably, building some confusion. Regardless of which name you’re familiar with, the causes, symptoms and treatments are all the same.
Herniated Disc Treatment and Surgery Options
Depending on the severity of your ruptured disc and the symptoms it is causing, your doctor will be able to guide you to the best non-surgical bulging disc treatments and slipped disc surgery options available.
Non-surgical Herniated Disc Treatment
The majority of patients who suffer from pain from a disc herniation will never need surgery. Usually, the body heals itself over time. As a result, many doctors and surgeons will first recommend a non-surgical approach. Your symptoms may be manageable without surgical intervention. Below are some of the non-surgical options your doctor may discuss with you.
The pain and discomfort of a herniated/bulging disc may be relieved with the use of a variety of medications. The first to consider is a class of drugs known as non-steroidal anti-inflammatory (NSAIDs) medications. These drugs work to reduce inflammation and provide an analgesic effect.
Oral corticosteroids are sometimes used as treatment. These drugs reduce inflammation, which can increase pressure on the nerves and the spinal cord.
Narcotic pain medications are also sometimes used for short-term pain relief, but given the potential for patients to develop an addictive dependency, they are rarely used for any length of time.
In addition, certain drugs such as gabapentin have been used with success in reducing nerve pain associated with a ruptured disc.
The main drawback to using medications is that they don’t actually address the root cause of the pain and discomfort. They only relieve symptoms and can sometimes come with pretty intense side effects.
Your surgeon may refer you for physical therapy to help with symptoms of your herniated disc. Through strengthening and increasing flexibility around the affected disc, support may be provided to help minimize the symptoms and relieve some of the strain being placed on the damaged disc. The advantage of physical therapy is that it is non-invasive and doesn’t involve drugs. Even if more intensive treatment is required later on, physical therapy can improve the general strength of your back or neck.
Some people prefer not to take oral steroids, or the location of their herniated disc is such that it creates a great deal of inflammation. An option many people explore is an injection of corticosteroids into the area of the damaged disc. This helps decrease inflammation and can last from a few weeks to a few months, making it useful if you are still undecided about undergoing surgery.
The main drawback to steroid injections is that they have to be done with some regularity and don’t always address the symptoms adequately. There is also a very small chance of the injection damaging a nerve.
Herniated Disc Surgery
Depending on the symptoms caused, the location of the herniated disc and your lifestyle, you and your surgeon may determine that surgery is the best course of action.
Modern surgical techniques have opened the door for much less invasive surgeries and quicker recovery times. Microdiscectomy is one such technique now often utilized for herniated disc surgery.
This procedure is performed under general anesthesia by a neurosurgeon or spine surgeon. One or more small incisions is made, allowing the surrounding muscles to remain intact. This is critically important for more rapid bulging disc surgery recovery. Using a specialized surgical instrument, the damaged disc is located. Your surgeon then carefully removes part or all of the disc. If he or she feels that the area will be weakened by the disc removal, a fusion may also be performed.
Fusion surgery is performed to help provide stability to your spine. It also provides added protection to the spinal cord – particularly in instances when the disc or a portion of bone is removed.
Fusion surgery involves your surgeon creating a “bridge” using bone grafts and sometimes instrumentation such as plates, rods and screws. As the bone grows in, it creates a solid column between vertebrae, providing your spine with newfound stability between two or more vertebrae.
Disc Replacement Surgery
Another surgical option is a disc replacement. A prosthetic disc is used to fill the space where the damaged disc once was. This is an excellent option for those that are worried about losing mobility in their necks or may lead a particularly active lifestyle.
Surgical Recovery Timeline
Because most herniated disc surgeries are now less invasive, the recovery time is much quicker. You can expect to spend anywhere from one to five days in the hospital, although depending on the procedure, it may be done as same-day surgery.
Once you’re home you’ll need to take plenty of time to rest and let your body heal. Usually, by the second week, you’ll start feeling more energetic and the pain will have decreased. You’ll also need to go in for a follow-up with your surgeon to make sure everything is healing properly.
Those working in light-duty occupations, such as working at a desk, should be able to return to work in as little as three weeks or less. If you have undergone a lumbar discectomy, you can expect to spend more like two to four weeks in recovery. Despite the recovery timeline, many patients are able to return to a modified work schedule the week following their procedure.
Most people find they’ve completely healed within about six months. Obviously, as each individual is different, your recovery timeline may be longer or shorter.
Risks of Surgery
As with any surgery, there are potential risks. Some of these can include:
- Incomplete fusion
- Continued pain
It’s important to talk with your surgeon about any possible risks that may outweigh the benefits of a particular procedure.