Treatment of the herniated disc

Therapy

As with many diseases, conservative and surgical treatment (OP) is available for the treatment of herniated discs. Which form of therapy (what can be done) should be used, must always be decided individually. At this point both forms of therapy are briefly described.

Which treatment is the best for you should not depend on your sympathy regarding a therapy form. Together with your treating physician you should work out the best way to treat your herniated disc. Most herniated disks can be brought to complete healing by conservative measures. Today, surgery is only used in a small percentage of cases. You can find more detailed information about the surgery under our topic: Surgery of a herniated disc

Conservative treatment of herniated disc

Except for acute, median prolapses, which can lead to severe impairments and imply motor and sensory deficits, the herniated disc is generally treated conservatively at first. First, the spine is relieved by bed rest. This immobilization can last for a period of four to six weeks. Under certain circumstances, bed rest can cause complaints (back pain) in the lumbar spine area, which can be alleviated by a so-called stepped bed. If the cervical spine is affected by a herniated disc, immobilization can be achieved with a cervical cuff.

Physiotherapy / physiotherapy

By strengthening the back muscles within the scope of physiotherapeutic measures, an improved muscular guidance of the spinal column is achieved, which ultimately also results in less strain on the intervertebral disc. The physiotherapeutic measures within the scope of conservative treatment of the herniated disc represent a very important area. Here we have developed a completely separate area with our physiotherapist in the team: More on the subject: Physiotherapy for a slipped disc Kinesiotapes can also be used in the case of a slipped disc.

Tapes help to relieve the tense muscles in a herniated disc. Not only for spinal diseases – like the herniated disc – the drug therapy (pharmacotherapy) plays an important role in the so-called pain therapy. With regard to the herniated disc, it is particularly the non-steroidal anti-inflammatory drugs, the NSAIDs, such as: which are used and are usually administered as tablets, capsules or suppositories or in the form of intramuscular injections or intravenous infusions in the case of a herniated disc.

For the above-mentioned drug treatment of the herniated disc, drugs for muscle relaxation (muscle relaxants, e.g. Sirdalud®) can also be prescribed, which can potentiate the pain-relieving effect caused by non-steroidal anti-inflammatory drugs. Relaxants reduce some of the symptoms by relieving muscle tension. If the herniated disc has progressed so far that the damage is already affecting the peripheral nerves, as is the case with nerve root damage, for example, antidepressants or anticonvulsants can raise the pain threshold.

Chronic pain which is constant and no longer performs the actual function of pain, the warning function, can be prescribed by opiates or opioids administered by the doctor, for example in the form of a so-called pain patch. Taking medication over a certain period of time can lead to sometimes considerable side effects. Self-therapies should therefore be avoided in any case.

A pain therapy of the herniated disc always belongs in the hands of a doctor. Only he can prescribe the right treatment by assessing the individual extent of the disease. – Ibuprofen

  • Diclofenac (e.g. Voltaren®)
  • Indomethacinor
  • COX-2 inhibitorCelebrex®Arcoxia®,
  • Celebrex®
  • Arcoxia®,
  • Celebrex®
  • Arcoxia®,

Cortisone is a commonly used drug for back problems.

It is usually injected intramuscularly in the hip/buttock area, which in many places is also done by the family doctor when patients with severe back problems come in. Cortisone also plays a decisive role in the treatment of herniated discs. Cortisone belongs to the so-called glucocorticoids, which among other things have an anti-inflammatory effect.

Since inflammations also provoke pain, cortisone can thus prevent or alleviate the occurrence of pain. In addition to the anti-inflammatory effect, cortisone also causes the tissue to swell so that less pressure is exerted on the nerve root and the symptoms of a herniated disc are reduced. Cortisone does not necessarily have to be injected, but can also be used in the form of tablets or infusions.

The conservative treatment options are indicated in 90% of cases today. Only 10% of disc herniation patients ultimately need surgery due to the severity or non-response to conservative treatment. Therefore, especially the physiotherapy with appropriate exercises has a very high priority.

In general, all exercises are suitable that stabilize the posture, improve coordination and are gentle on the spine. Since the herniated disc is a sign of wear and tear, it is also important to counteract the wear and tear by relieving the intervertebral discs by releasing tension. The relief of the intervertebral discs also plays an important role.

The intervertebral disc is like a kind of sponge that can soak up water and nutrients in a healthy state. This is no longer possible through compression whereupon a herniated disc is also created, so that special exercises for a herniated disc are designed to ensure the nutrient supply for a part of the disc by relieving it. Special massages, water gymnastics, endurance sports, Pilates exercises, special back training and muscle building exercises can achieve this effect.

The mobility is improved by the stretching exercises. In order to strengthen the muscular apparatus and thus give the spine more stability, it is important to train both the stomach and the back. Endurance sports include hiking, Nordic walking, swimming, cross-country skiing and endurance cycling.

When swimming, you should only avoid backstroke or crawl swimming and breaststroke. The advantage, as with underwater gymnastics, is that under water the joints and spine are less stressed. In general, the purpose of sports exercises is to build up the muscles and release tension.

Furthermore, the aim of physiotherapy is to stimulate the metabolism and circulation. On the one hand, this also promotes the nutrition of the intervertebral disc and regeneration processes and, on the other hand, the body can offer more resistance to tiring work by strengthening muscles and endurance, so that physical overloading has no damaging effect on our spine. The perception training should be integrated into the therapy in addition to the strength training against the background that one gains an awareness of what is good for the back and which movements or activities are not beneficial in the healing process of a herniated disc.

Often patients are still treated with painkillers in the initial phase of physiotherapy. But not only the exercises are important, but also the consideration whether something should be changed in the everyday conditions. It can be very helpful to have your desk chair, desk, keyboard etc.

adjusted to improve your posture. Patients also need to be aware that they should no longer lift heavily in everyday life. .

Contraindicated for a herniated disc are sports that exert compression or strong pressure on the spine (e.g. riding). Also, rapid twisting movements or abrupt hyperextensions should be avoided. This includes playing tennis or squash, for example.

In the past, it was believed that after a herniated disc, one should spare the back by resting. However, this attitude is long outdated, because it has been proven that active muscle strengthening and tension release can alleviate the symptoms of the herniated disc and positively influence the recovery phases. In addition, one’s own activity promotes the nutrition of the intervertebral disc; on the other hand, prolonged sitting or even the outdated assumption of quiet sparing show a negative influence on the nutrition of the disc and thus the healing process. In conclusion, it can be said that physiotherapy with a variety of approaches and exercises allows an individual conservative treatment of a herniated disc. Since the topic is so extensive, we have set up a completely independent topic that deals with physiotherapy and exercises after a herniated disc.