Introduction
In order to avoid surgery for a herniated disc, it is also possible to treat it conservatively. This means that the symptoms of the herniated disc, such as pain in the back, tingling and numbness, can also be treated well with medication. A very important drug in the conservative therapy of the herniated disc is cortisone, a glucocorticoid, which has anti-inflammatory and immunosuppressive effects. Cortisone ensures that patients do not experience pain, do not develop inflammation in the affected area of the spine and, in addition, that their nerve cords are not permanently affected. It is possible to administer cortisone in the form of tablets, infusions or injections.
Therapy options with cortisone
For the treatment of the symptoms, which can include pain, tingling and numbness in a herniated disc, an improvement can occur within a few hours by taking cortisone. In some cases they are administered as tablets. The patient can simply take them according to the instructions.
Since a herniated disc often causes severe pain in the back, the tablets are given in high doses. – Cortisone in tablet form
- Prednisolone
In addition, it is possible to carry out a cortisone therapy with infusions in case of a herniated disc. The medication is administered directly into the bloodstream via a venous access.
Prednisolone is dispensed for dissolution, so that an infusion can be made. However, this requires a longer stay in hospital. The infusions are often administered for up to 10 days.
How many times a day the patient receives the drug through the vein depends on the single dose and of course on the extent of his symptoms, which are caused by the severity of the herniated disc. One advantage of this form of administration is that the active ingredient of the drug is absorbed into the bloodstream very quickly and can develop its effect. An initial improvement of the symptoms often occurs after the first infusion within the first two hours, if the drug is very effective and well tolerated by the patient.
It is also possible to inject cortisone directly and locally at the painful area of the spinal column. This method is particularly popular when the patient is in acute and severe pain, but it does not eliminate the prolapse of the intervertebral disc. The advantage of this method is the fast and longer lasting effect directly on the spot.
The pain and an imminent inflammation can be quickly prevented. As a rule, the injection is given once a week and can be repeated several times, depending on the extent of the pain and the further treatment options. PRT – Periradicular Therapy – is a method of diagnosis and treatment for so-called radicular pain, which can occur, for example, after a herniated disc.
In this procedure, an injection of cortisone is guided under the control of a CT scan past the spinal cord to the nerve root, which is thought to be responsible for the pain. If the CT then shows that the needle tip has reached just before the nerve root, the cortisone is administered from the syringe. It is intended to have a local effect here and thus treat swelling or inflammation of the nerve root, which should also reduce the existing pain.
In the ideal case, this therapy is even sufficient to achieve complete freedom from pain. In this therapy, the patient is positioned on the abdomen and receives a local anaesthetic so that the pain caused by the injection is not too severe. It is important that the skin area is well disinfected beforehand.
The doctor can now place the syringe under visual control. This ensures that the syringe has both the right depth and the right direction. At the same time, the risk of damaging other important structures, such as the spinal cord, is minimized.
This periradicular therapy takes approximately 5-10 minutes to complete. After the injection, the patient should avoid sports, heavy lifting and even driving, as the local anaesthetic can cause short-term sensory disturbances and paralysis. However, these symptoms will disappear after about two hours. Further information on this topic: Periradicular therapy
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