Time of occurrence
In general, it is not possible to say when these symptoms appear after the operation. However, an important documentation of the time of occurrence is important for therapy and prognosis, which is why it is necessary to carefully observe how the pain develops in the period after the operation. Indicators for the presence of a post-nucleotomy syndrome is the perceived persistence of the original symptoms even after the operation. The recurrence of disc protrusions or herniated discs (reprolapses) also speaks for postnucleotomy syndrome.
Prevention
The most common cause of post-nucleotomy syndrome is acting too early before the exact cause of pain has been identified. An accurate and correct diagnosis and careful assessment of the benefits and risks of surgery is therefore the most effective prevention of post-nucleotomy syndrome. Detailed discussions with the attending physician (orthopedist or neurosurgeon) are therefore absolutely necessary prior to surgery, unless it is a rare emergency that requires immediate surgery.
Only in exceptional cases can post-nucleotomy syndrome be treated surgically. Possible surgical treatment options here would be renucleotomies, stiffening, stabilization or the use of disc prostheses. In most cases, however, only conservative therapeutic methods (for example, in the form of medication) are available for the treatment of chronic pain.
First choice here are peripherally acting painkillers (analgesics), so-called non-steroidal anti-inflammatory drugs (NSAIDs). Treatment with muscle relaxants or centrally acting analgesics is also possible. In this therapy of chronic pain, care must be taken to avoid any possible dependence on painkillers, and for this reason the treatment must be carried out by an experienced pain therapist or in a pain clinic.
Further, special therapy of pain is a special medical field and requires a lot of experience, because mostly very individual combinations of different pain therapies are used in combination. This procedure (combination concept) is known as multimodal and means that the pain is approached in a targeted manner with different therapies in parallel. The following methods, among others, are available for this purpose: Often an antidepressant is used in addition to the painkillers, so that the pain medication with its many side effects can be reduced.
- Drug treatment
- Therapeutic local anesthesia
- Pain Acupuncture
- “transcutaneous nerve stimulation” (TENS)
- Physiotherapy
- Progressive muscle relaxation
