The spine is composed of the vertebrae and their bony projections. Between every two vertebrae is a “disc” which acts to absorb compressive forces on the spinal column. The spinal cord runs behind the column of vertebrae and is surrounded by the bony spinal column.
Discs are made of a semi-fluid inner material (nucleus pulposus) enclosed in an outer ring of cartilage (annulus fibrosus). The outer cartilage ring can bulge or even rupture and cause pressure on a spinal nerve as it exits the spinal canal. A ruptured (prolapsed or slipped disc) is called a disc herniation.
This may spark up inflammation and sciatica, with pain shooting down one’s leg.
Treatment options for a herniated disc
When a patient today presents with a herniated cervical or lumbar disc with clinical evidence of nerve root irritation (sciatica or “pinched nerve”), he or she has several choices: no surgery, traditional open surgery, microscopic surgery or micro-endoscopic surgery.
If he or she chooses no surgery, evidence shows that the herniated disc will probably decrease in size or disappear within a few weeks or months. If he or she chooses surgery, the course of recovery may be shortened, but the long term result of surgery versus conservative therapy is much the same.
The only instance where surgical decompression is absolutely necessary is when there is progressive (worsening) arm or leg weakness or when bladder or bowel continence is clearly in jeopardy.
Conservative management of a herniated disc consists of non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin) and physical therapy. In the case of moderate to severe pain, judicious use of opioid medication is appropriate. A 5 day course of oral corticosteroids may be administered in an effort to relieve the inflammation of the irritated nerve root.
Chiropractic treatment may help relieve the nerve root pinching and spinal decompression therapy may help as well. Published studies have shown that over 85% of patients receive Pain Relief with a course of spinal decompression therapy.
If these measures fail, an epidural corticosteroid injection may be beneficial. This procedure involves injecting corticosteroid medication into the space just outside of the outer membrane of the spinal cord where the affected nerve exits the spinal canal. The purpose is to bathe the irritated nerve root with a high dose of cortisone to suppress the inflammation.
It may take a series of epidural injections to provide optimal relief. These can be performed over a series of 6 to 8 weeks, with the option of repeating the series every few months. These injections maintain minimal risks, and provide on average 75% good to excellent results.
For symptomatic disc herniations, with proper pain management treatment over 95% of patients are able to avoid surgery. The top pain management doctors in Las Vegas are with Nevada Pain. The doctors are Board Certified, Award Winning and offer over 50 different treatment options for acute and chronic pain.
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