Treatment options for a lumbar herniated disk
Introduction to lumbar herniated disk treatment
The care of a patient with a lumbar herniated disk
is far from standardized and, to a certain extent, needs
to be individualized for each patient. A lumbar herniated
disk usually causes leg pain (sciatica or a radiculopathy)
and is often referred to as a pinched nerve, bulging
disk, ruptured disk, or a slipped disk.
The treatment options for a lumbar herniated disk
will largely depend on the length of time the patient
has had his or her symptoms and the severity of the
back pain. Generally, patients will be advised to start
with 6 to 12 weeks of conservative treatment (such
as physical therapy).
If conservative treatment for the lumbar herniated
disk does not provide pain relief after 6 to 12 weeks
it is reasonable to consider surgery. At times, if
there is severe pain and the patient is having difficulty
maintaining a reasonable level of functioning, surgery
may be recommended prior to completing a full 6 weeks
of conservative care for the herniated disk.
Most patients will heal a lumbar herniated disk on
their own, but it may take a prolonged period of time.
While there are no hard and fast guidelines for how
to heal a herniated disk, this article outlines some
general guidelines for conservative treatment options
and surgical treatments.
Conservative treatments for a lumbar herniated
disk
There’s a wide variety of conservative treatment
options for patients to try for treatment of a lumbar
herniated disk. The primary goals of treatment are
to provide relief of pain and to allow return to a
normal functional level.
The most common conservative treatment options for
a lumbar herniated disk include:
-
Rest, followed by slow mobilization
-
Pain medications
-
Chiropractic/osteopathic manipulations
-
Physical therapy
-
Epidural steroid injections
The recommended amount of conservative treatment for
the herniated disk needs to be individualized for each
patient. For those patients who are not in severe pain
and can function well, a longer period of conservative
treatment is reasonable (e.g. 12 weeks). For those
patients with severe pain that is not responsive to
conservative treatment, surgery to decompress the nerve
is a reasonable option to treat the lumbar herniated
disk.
Surgery for a lumbar herniated disk
If a patient does not feel better after 6 to 12
weeks of conservative care, then surgery may be considered
to treat the lumbar herniated disk. The goal of surgery
is to help alleviate the pain faster. If a patient
has severe pain and is unable to function at a satisfactory
level, surgery may be a good option even before six
weeks of symptoms.
Any patient who has progressive neurological deficits,
or develops the sudden onset of bowel or bladder dysfunction,
should have an immediate surgical evaluation as these
conditions may represent a surgical emergency. Fortunately,
both of these conditions are very rare, and most surgery
for a lumbar herniated disk is an elective procedure.
In recent years, the morbidity (such as post-operative
pain) of surgery for a lumbar herniated disk has decreased
and the results have improved, so surgery is generally
considered a very reasonable option to get better quicker.
Surgical treatment options for the lumbar herniated
disk include:
A lumbar microdiscectomy (also called a lumbar micro-decompression)
is considered the gold standard and is the most common
surgery to alleviate pain from a lumbar herniated disk.
Treatment options for a lumbar herniated disk
Introduction to lumbar herniated disk treatment
The care of a patient with a lumbar herniated disk
is far from standardized and, to a certain extent, needs
to be individualized for each patient. A lumbar herniated
disk usually causes leg pain (sciatica or a radiculopathy)
and is often referred to as a pinched nerve, bulging
disk, ruptured disk, or a slipped disk.
The treatment options for a lumbar herniated disk
will largely depend on the length of time the patient
has had his or her symptoms and the severity of the
back pain. Generally, patients will be advised to start
with 6 to 12 weeks of conservative treatment (such
as physical therapy).
If conservative treatment for the lumbar herniated
disk does not provide pain relief after 6 to 12 weeks
it is reasonable to consider surgery. At times, if
there is severe pain and the patient is having difficulty
maintaining a reasonable level of functioning, surgery
may be recommended prior to completing a full 6 weeks
of conservative care for the herniated disk.
Most patients will heal a lumbar herniated disk on
their own, but it may take a prolonged period of time.
While there are no hard and fast guidelines for how
to heal a herniated disk, this article outlines some
general guidelines for conservative treatment options
and surgical treatments.
Conservative treatments for a lumbar herniated
disk
There’s a wide variety of conservative treatment
options for patients to try for treatment of a lumbar
herniated disk. The primary goals of treatment are
to provide relief of pain and to allow return to a
normal functional level.
The most common conservative treatment options for
a lumbar herniated disk include:
-
Rest, followed by slow mobilization
-
Pain medications
-
Chiropractic/osteopathic manipulations
-
Physical therapy
-
Epidural steroid injections
The recommended amount of conservative treatment for
the herniated disk needs to be individualized for each
patient. For those patients who are not in severe pain
and can function well, a longer period of conservative
treatment is reasonable (e.g. 12 weeks). For those
patients with severe pain that is not responsive to
conservative treatment, surgery to decompress the nerve
is a reasonable option to treat the lumbar herniated
disk.
Surgery for a lumbar herniated disk
If a patient does not feel better after 6 to 12
weeks of conservative care, then surgery may be considered
to treat the lumbar herniated disk. The goal of surgery
is to help alleviate the pain faster. If a patient
has severe pain and is unable to function at a satisfactory
level, surgery may be a good option even before six
weeks of symptoms.
Any patient who has progressive neurological deficits,
or develops the sudden onset of bowel or bladder dysfunction,
should have an immediate surgical evaluation as these
conditions may represent a surgical emergency. Fortunately,
both of these conditions are very rare, and most surgery
for a lumbar herniated disk is an elective procedure.
In recent years, the morbidity (such as post-operative
pain) of surgery for a lumbar herniated disk has decreased
and the results have improved, so surgery is generally
considered a very reasonable option to get better quicker.
Surgical treatment options for the lumbar herniated
disk include:
A lumbar microdiscectomy (also called a lumbar micro-decompression)
is considered the gold standard and is the most common
surgery to alleviate pain from a lumbar herniated disk.
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