When diagnosed with a herniated disc, many people automatically think of pain, complicated spinal surgery and lengthy rehab. But thanks to new treatment methods such as microtherapy, sufferers may be spared surgery. Microtherapy uses a fine injection needle to inject medication directly into the herniated disc, stimulating a healing process directly in the body.
The cause of the pain
A herniated disc often triggers painful inflammation of individual nerve roots in the spine. Bony narrowing of the spine or scarring from previous disc surgery can also cause similar pain. In many patients, the pain from the nerve roots in the spine radiates into the arms and legs. Because microtherapies attempt to contain this pain and address the cause of the pain, they are also called image-guided back pain therapies.
Reduced risk with microtherapy
Orthopedic surgeon Dr. Christian Mauch explains the advantage of the treatment, “Whereas a few years ago people operated quite generously, today they try to avoid extensive surgery as much as possible – thanks to refined and microtherapeutic methods. With the injection, there is little risk of long-term damage to sensitive structures such as nerves in the vicinity of the affected disc. Another advantage is that microtherapy is performed on an outpatient basis with only local anesthesia. Thus, a longer hospital stay is not necessary.”
Areas where microtherapy can be used
In principle, the various microtherapies can be used in all patients who experience painful irritation of the spinal cord nerves. Examples include:
- Herniated or bulging intervertebral discs.
- Stenosis (narrowing of the spinal canal)
- Acute or chronic lumbar pain
- Discomfort in areas of the sciatic nerve
- Facet joint arthrosis (vertebral joint wear).
- Degenerative spinal diseases
- Foraminal stenoses (bony constrictions of the spine).
What happens during microtherapy?
During the procedure, which lasts about 20 minutes, anti-inflammatory agents are injected directly into the disc under constant monitoring with the help of computed tomography (CT). First, the hollow needle, a millimeter-sized probe, is inserted precisely into the affected part of the disc, where the active solution is then injected. This solution causes the tissue to swell from grape to raisin size. At the same time, the painful nerve is temporarily numbed and the pain and inflammatory hormones are flushed away. The drugs used are usually cortisone or the body’s own substance orthokine. These agents are extremely effective even in comparatively small amounts due to local application. Since the needle is very thin, the treatment is painless or even pain-free, depending on the pain sensation. If there is an intolerance for the conventional drugs, microtherapy with natural remedies has also been possible for some time. Alternatively, a type of laser can be used to dissolve the damaged tissue.
Areas of application and types of microtherapy
After damage to the small vertebral joints, these treatments can find application:
- Facet blockade
- Facet infiltration
- Facet coagulation with laser
These nerve root treatments can help with nerve root pain:
- Periradicular infiltration
- Epidural infiltration
- Percutaneous laser nucleotonomy
To treat the narrowing of vertebral and nerve canals, these therapies can be considered:
- Periradicular injection
- Epidural injection
Duration of therapy
The duration of treatment with microtherapy depends on the intensity and frequency of complaints. As a rule, the method is repeated four to six times at intervals of two to four weeks. Thus, significant relief of pain or even complete freedom from symptoms can be achieved. Thereafter, a control MRI should be performed at intervals of three, seven and twelve months.
Side effects of microtherapy
Complications or severe side effects are rare with microtherapy. In some cases, minimal bruising may occur in the injection area.Occasionally, there is also a temporary numbness in the arms and legs. However, microtherapy is not advisable during pregnancy or in the presence of blood clotting disorders.
Preventing herniated discs
To avoid the need for microtherapy in the first place, you can do something good for your intervertebral discs on a regular basis. A healthy intervertebral disc contracts or expands depending on the load, absorbing important nutrients in the process. Therefore, regular exercise and avoiding too much stress on the intervertebral discs are particularly conducive to healthy intervertebral discs.
Assumption of costs by the health insurance
Most health insurance companies cover the costs of microtherapy completely or at least to a large extent. The portion of the cost covered usually depends on the extent of the disc changes, the severity of the pain, and what the particular clinic offers.
