Treatment of Spinal Disc Herniation, Exercise, Home Remedies. Lumbar disc herniation is a common condition that frequently affects the spine in young and middle-aged patients.1,5,11 The lumbar intervertebral disc is a complex structure composed of collagen, proteoglycans, and sparse fibrochondrocytic cells that serve to dissipate forces exerted on the spine. As part of the normal aging process, the disc fibrochondrocytes can undergo senescence, and proteoglycan production diminishes. This leads to a loss of hydration and disc collapse, which increases strain on the fibers of the annulus fibrosus surrounding the disc. Tears and fissures in the annulus can result, facilitating a herniation of disc material, should sufficient forces be placed on the disc. Alternatively, a large biomechanical force placed on a healthy, normal disc may lead to extrusion of disc material in the setting of catastrophic failure of the annular fibers.5
Treatment of Spinal Disc Herniation
Before discussing surgery as an option, the surgeon may initiate the following nonoperative treatments. Specific treatment for lumbar disk disease will be determined by your health care provider based on
- Your age, overall health, and medical history
- The extent of the condition
- Type of condition
- Your tolerance for specific medications, procedures, or therapies
- Expectations for the course of the condition
- Your opinion or preference
Typically, conservative therapy is the first line of treatment to manage lumbar disk disease. This may include a combination of the following:
- Bed rest
- Patient education on proper body mechanics (to help decrease the chance of worsening pain or damage to the disk)
- Physical therapy, which may include ultrasound, massage, conditioning, and exercise
- Weight control
- Use of a lumbosacral back support
Medications Treatment of Spinal Disc Herniation
- Analgesics – Prescription-strength drugs that relieve pain but not inflammation.
- Antidepressants: A Drugs that block pain messages from your brain and boost the effects of endorphins (your body’s natural painkillers).
- Corticosteroids: Also known as oral steroids, these medications reduce inflammation.
- Muscle Relaxants: These medications provide relief from spinal muscle spasms.
- Neuropathic Agents: Drugs(pregabalin & gabapentin) that address neuropathic—or nerve-related—pain. This includes burning, numbness, and tingling.
- Opioids – Also known as narcotics, these medications are intense pain relievers that should only be used under a doctor’s careful supervision.
- Topical Medications – These prescription-strength creams, gels, ointments, patches, and sprays help relieve pain and inflammation through the skin.
- NSAIDs – Prescription-strength drugs that reduce both pain and inflammation. Pain medicines and anti-inflammatory drugs help to relieve pain and stiffness, allowing for increased mobility and exercise. There are many common over-the-counter medicines called non-steroidal anti-inflammatory drugs (NSAIDs). They include aspirin, ibuprofen (Motrin, Advil), and naproxen (Naprosyn, Aleve).
- Calcium & vitamin D3 – to improve bones health and healing fracture.
- Glucosamine & diaceraine can be used to tightening the loose tension and regenerate cartilage or inhabit the further degeneration of cartilage.
- Corticosteroid to healing the nerve inflammation and clotted blood in the joints.
- The dietary supplement to remove the general weakness & improved the health.
There is little evidence to suggest that drug treatments are effective in treating a herniated disc.
NSAIDs and cytokine inhibitors don’t seem to improve symptoms of sciatica caused by disc herniation.
We found no evidence examining the effectiveness of analgesics, antidepressants, or muscle relaxants in people with a herniated disc.
We found no evidence of sufficient quality to judge the effectiveness of epidural injections of corticosteroids.
With regard to non-drug treatments, spinal manipulation seems to be more effective at relieving local or radiating pain in people with acute back pain and sciatica with disc protrusion compared with sham manipulation, although concerns exist regarding possible further herniation from spinal manipulation in people who are surgical candidates.
Neither bed rest nor traction seems effective in treating people with sciatica caused by disc herniation.
We found insufficient evidence of advice to stay active, acupuncture, massage, exercise, heat, or ice to judge their efficacy in treating people with a herniated disc.
About 10% of people have sufficient pain after 6 weeks for surgery to become a consideration.
Both standard discectomy and microdiscectomy seem to increase self-reported improvement to a similar extent.
We found insufficient evidence judging the effectiveness of automated percutaneous discectomy, laser discectomy, or percutaneous disc decompression.
Surgical Treatment of Spinal Disc Herniation
When these conservative measures fail, surgery for removal of a herniated disk may be recommended. Surgery is done under general anesthesia. An incision is placed in the lower back over the area where the disk is herniated. Some bone from the back of the spine may be removed to gain access to the area where the disk is located. Typically, the herniated part of the disk and any extra loose pieces of disk are removed from the disk space.
Surgical treatment for a herniated disc will be based on the following
- The history, severity, and duration of pain
- Whether or not the patient has received previous treatments for disc disorders and how effective the treatments were
- Whether or not there is any evidence of neurologic damage such as sensory loss, weakness, impaired coordination, or bowel or bladder problems
Surgery for patients with disc disorders of the spine is usually recommended for those patients who do not find relief with non-operative treatment over a period of 6-12 weeks. Surgery is also recommended in patients who have a neurologic deficit (numbness, weakness or reduced function due to pressure on the spinal cord or nerves). Early intervention in those cases is best in order to maximize the likelihood of neurologic recovery.
Your surgeon may perform the following surgical procedures:
- Microdiscectomy: A procedure that uses a microscope and microsurgical tools to remove the portion of the disc that is pressing against the nerve, relieving the pressure caused by a herniated disc. Microdiscectomy is frequently performed for herniated discs in the cervical, thoracic, and lumbosacral spine. This procedure is performed under general anesthesia through a small skin incision over the spine. The muscles of the spine are gently elevated or spread apart to expose a small segment of the spine. A small amount of the back part of the spine, called the lamina and facet joint, is trimmed under high magnification of the microscope to provide safe access to the spinal canal. Using microsurgical techniques, our neurosurgeons identify and remove the herniated piece of the disc while protecting the compressed nerve. Most patients may go home either on the day of surgery or the next morning.
- Anterior (from the front) or lateral (from the side) surgical approaches may be required for large or calcified thoracic disc herniations that cause spinal cord compression.
- Anterior Cervical Discectomy and Fusion (ACDF): a procedure that involves the removal of the herniated disc in the cervical spine through the front of the neck. A fusion surgery may be required to make the spine stable after the discectomy.
After surgery, restrictions may be placed on the patient’s activities for several weeks while healing is taking place to prevent another disk herniation from occurring. Your surgeon will discuss any restrictions with you.
Others Treatment of Spinal Disc Herniation
Sixty percent of people with sciatica who didn’t get relief from other therapies and then tried spinal manipulation experienced the same degree of pain relief as patients who eventually had surgery, found a 2010 study in the Journal of Manipulative and Physiological Therapeutics. The 120 people in the study saw a chiropractor about 3 times a week for 4 weeks and then continued weekly visits, tapering off treatment as they felt better. In people who responded to chiropractic care, benefits lasted up to a year. “Spinal manipulation may create a response in the nervous system that relieves pain and restores normal mobility to the injured area,” says study researcher Gordon McMorland, DC, of National Spine Care in Calgary, Alberta. “It also reduces inflammation, creating an environment that promotes the body’s natural healing mechanisms.”
“You can get relief as soon as the first session, though it takes about 12 sessions to see improvement,” says Jingduan Yang, MD, assistant professor at the Jefferson Myrna Brind Center of Integrative Medicine at Thomas Jefferson University. A small study in the Journal of Traditional Chinese Medicine found that of 30 people with sciatica, 17 got complete relief and 10 saw symptoms improve with warming acupuncture, in which the needles are heated.
A study in the journal Pain reported that people with chronic back pain who practiced Iyengar yoga for 16 weeks saw pain reduced by 64% and disability by 77%. Although yoga’s effects on sciatica are less clear, gentle forms may be beneficial. By strengthening muscles and improving flexibility, a yoga practice can help sciatica sufferers “move and function better so they don’t fall into a posture that aggravates sciatica,” says James W. Carson, Ph.D., a psychologist at the Comprehensive Pain Center at Oregon Health & Science University. For extra grip and stability, try these grip socks from Natural Fitness.
Don’t expect a chilled-out spa massage if you have sciatica. In this instance, trigger-point therapy is best, says Jeff Smoot, vice president of the American Massage Therapy Association. The sciatic nerve sits underneath a muscle called the piriformis, which is located beneath the glutes. “When the piriformis muscle gets tight, it pinches the sciatic nerve, causing tingling and numbness down into the leg,” says Smoot. He applies pressure to irritated and inflamed areas, or trigger points, in the piriformis muscle, as well as in muscles in the lower back and glutes. Typically, Smoot schedules treatments 7 to 10 days apart. If patients don’t see progress by the fourth visit, “they need to try another form of therapy,” he says.
St. John’s wort oil, a liniment, is “one of my favorites for nerve pain,” says Tieraona Low Dog, MD, director of the fellowship at the Arizona Center for Integrative Medicine. Apply the anti-inflammatory oil two or three times a day where there’s pain. Another option: an OTC cayenne pepper plaster or cream; capsaicin, found in chiles, hinders the release of pain-causing compounds from nerves. For severe cases, Low Dog uses the prescription chile patch Qutenza, designed for shingles pain. “One application is effective for weeks,” says Low Dog.
Ice or Heat
Because the sciatic nerve is buried deep within the buttock and leg, ice or heat on the surface of the body won’t ease that inner inflammation. But the time-honored treatments can act as counterirritants—that is, “they give your body other input in the painful area, and that brings the pain down a notch,” says Ruppert. Apply an ice pack or a heating pad as needed for 15 minutes.
The herbal medication devil’s claw is “quite a potent anti-inflammatory, working like ibuprofen and similar drugs to inhibit substances that drive inflammation,” says Low Dog. She generally starts patients on 1,500 to 2,000 mg twice a day. Look for a brand that has a standardized extract of roughly 50 mg of harpagoside, the active compound. Safety reviews show that the supplement is well tolerated by most people but should be avoided by patients with peptic ulcers or on blood-thinning medications.
Epidural Steroid Injections
People whose pain doesn’t lessen within about a month and who aren’t helped by other therapies may find their pain remedied by an x-ray-guided injection of steroid into the lower back near the sciatic nerve, says Raj Rao, MD, a spokesperson for the AAOS. “The hope is to reduce inflammation within that nerve branch,” explains Rao. Because of concerns about side effects, such as loss of bone density, the epidural shots are limited to three a year.
Physiotherapy in Herniated Disc
In stage 1&2 of herniated disc physiotherapy must be applied to cure herniated his.I n the case of stage 3&4, physiotherapy can’t be applied due to avoiding another case of foot drop.
In accordance with NIH journal
Physical therapy often plays a major role in herniated disc recovery. Its methods not only offer immediate pain relief, but they also teach you how to condition your body to prevent further injury.
There are a variety of physical therapy techniques. Passive treatments relax your body and include deep tissue massage, hot and cold therapy, electrical stimulation (eg, TENS), and hydrotherapy.
Your physical therapy program will usually begin with passive treatments. But once your body heals, you will start active treatments that strengthen your body and prevent further pain. Your physical therapist will work with you to develop a plan that best suits you.
Passive Physical Treatments for Herniated Discs
- Deep Tissue Massage
There are more than 100 types of massage, but a deep tissue massage is an ideal option if you have a herniated disc because it uses a great deal of pressure to relieve deep muscle tension and spasms, which develop to prevent muscle motion at the affected area.
- Hot and Cold Therapy
Both hot and cold therapies offer their own set of benefits, and your physical therapist may alternate between them to get the best results. Your physical therapist may use heat to increase blood flow to the target area. Blood helps heal the area by delivering extra oxygen and nutrients. Blood also removes waste byproducts from muscle spasms. Conversely, cold therapy (also called cryotherapy) slows circulation. This reduces inflammation, muscle spasms, and pain. Your physical therapist may place an ice pack on the target area, give you an ice massage, or even use a spray known as fluoromethane to cool inflamed tissues.
As the name suggests, hydrotherapy involves water. As a passive treatment, hydrotherapy may involve simply sitting in a whirlpool bath or warm shower. Hydrotherapy gently relieves pain and relaxes muscles.
- Transcutaneous electrical nerve stimulation (TENS)
A TENS machine uses an electrical current to stimulate your muscles. It sounds intense, but it really isn’t painful. Electrodes taped to your skin send a tiny electrical current to key points on the nerve pathway. TENS reduces muscle spasms and is generally believed to trigger the release of endorphins, which are your body’s natural painkillers.
The goal of traction is to reduce the effects of gravity on the spine. By gently pulling apart the bones, the intent is to reduce the disc herniation. The analogy is much like a flat tire “disappearing” when you put a jack under the car and take pressure off the tire. It can be performed in the cervical or lumbar spine.
- Active Treatments You May Try in Physical Therapy
Active treatments help address flexibility, posture, strength, core stability, and joint movement. An exercise program may also be prescribed to achieve optimal results. This will not only curb recurrent pain but will also benefit your overall health. Your physical therapist will work with you to develop a program based on your specific diagnosis and health history.
- Core stability
Many people don’t realize how important a strong core is to their spinal health. Your core (abdominal) muscles help your back muscles support your spine. When your core muscles are weak, it puts extra pressure on your back muscles. Your physical therapist may teach you to core stabilizing exercises to strengthen your back.
Learning proper stretching and flexibility techniques will prepare you for aerobic and strength exercises. Flexibility helps your body move easier by warding off stiffness.
In contrast to simply sitting in a hot tub or bath like its passive counterpart, active hydrotherapy may involve water aerobics to help condition your body without unnecessary stress.
- Muscle strengthening
Strong muscles are a great support system for your spine and better handle pain.
Your physical therapist will teach you ways to condition and strengthen your back to help prevent future pain. You may learn self-care principles so you understand how to best treat your symptoms. The ultimate goal is for you to develop the knowledge to maintain a pain-free lifestyle.
It’s essential that you learn how to exercise and condition your back after the formal physical therapy ends. If you don’t implement the lessons you learned during physical therapy, you won’t enjoy its long-term results. By taking care of your back on your own, you may prevent further herniated disc pain
8 Best Exercises For Slipped Disc In Lower Back
Our spinal cord is supported by a number of muscles. Relevant exercises help relieve the pain and reduce the symptoms. Muscle exercises of those muscles associated with the affected area are necessary. Patients must know the region that has a slipped disc and then opt for exercises related to that muscle. The list of best exercises for the slipped disc are mentioned as follows:
- Abdominal Isometrics – It can be performed either on floor, mat or bed. This exercise involves moving your lower back towards the surface at which you are performing this exercise. Leg movement must be reduced in this exercise and stomach muscles must be made active. This reduces pain in lower back because of the attachment of abdominal muscles to the lower side of the vertebral column. Ten repetitions are effective.
- Crunches – Lie on a flat surface with knees bent. Cross your arm under your head, raise your head and chest in such a manner that your rib cage curl interiorly towards your backbone. Perform this exercise slowly and gradually. In the beginning, perform fewer crunches and repeat it daily and increase the number of turns as you gain strength.
- Lower back extension – Lie in an upside down position, raise your upper body with the help of elbow and hold up yourself in an elevated position for a short span of time and then slowly lower down. Please make sure that during this exercise you do not raise your pelvis girdle (hip region).
- Bilateral knee to the chest – Lay down on a flat surface and draw your knee towards your abdominal region, repeat it 5 times and then switch leg. You can also increase the number of turns each time you repeat it.
- Iso-hip flexion – Lay down over a flat surface and draw your knees towards your chest region in a 90-degree position with your stomach. Place your hands over your knees and then exert your hand pressure to lower your knee. Then utilize the knee pressure to resist the downward movement of your legs, in all both movements should just exert pressure and allow no movements. This position should be maintained for a few seconds and then lowered slowly and gradually.
- Air bike – Sit on a chair with your chest and shoulders supported. Align your knees and feet together and then bring them towards your body and perform a pedaling motion in the air then repeat the same motion while moving your knees farther away from the body. Follow ten repetitions each time and increase its number as you gain strengths
- Hamstring stretch: Lie on a flat surface with your knees bent, place your hands under your knees and then slightly pull your leg towards your chest, repeat it with another leg. This exercise must involve a stretch over lower thigh muscle
- Lumbar roll: Lie on a flat surface with your knee bent and your feet lying on the floor then move your legs together towards the right side and then towards your left side. Repeating these movements 5 times on each side.
The above mentioned best exercises for the slipped disc can be followed but if pain increases or muscle pain is persisting then quit these exercises right away. These exercises not only help in reducing the pain but they also activate efficient muscle movement. Along with these exercise tips, proper body postures must be also maintained to prevent further disc damages.
Home Remady for Herniated Disc/Slip Disc
In case of PLID home remedies are not special treatment just only home practice & creating public awareness. All should be done in PLID stage 1&2
Walking every day keeps muscle disorders away. Walking can also help to prevent herniated disc. Walk on a flat road for 20 minutes as many times as you can in a day. Take longer steps as it will help you to keep away the pain of herniated disc. Do not give strain to yourself as it might increase the pain.
Rest is essential for patients suffering from a herniated disc. Take short rest periods from time to time. When you are sleeping make sure you don’t stay in the same position for a long time. Do not sleep on your stomach. Also, take care of the mattress you are sleeping on. Don’t let it be too soft and spongy. Buy a mattress that has a good surface area and is soft in nature.
Physiotherapy And Yoga( only home practice)
Physiotherapy is a very cheap and good way of getting rid of a herniated disc from itself. Therapists will teach your proper exercises and stretches which will improve the disc shape to a great extent.
You will notice good differences while performing daily chores after just 4-5 sessions of therapy.
Physiotherapy also promotes faster healing of the disorder.
Turmeric contains curcumin which is a very good anti-oxidant and anti-inflammatory agent. This is why it stops the gel-like fluid inside the discs from coming out and bulge. It also shows antihistamine properties which help to reduce pain because of slowed blood circulation to the area of pain.
Dimethyl Sulfoxide (DMSO)
Dimethyl sulfoxide is a derivative from sulfur which has antioxidant properties as well as the organic sulfur present in it helps in the growth of new cells and detoxification of the body. The growth of new cells helps to replace the old cells of the discs and prevent the fluid from leaking outside.
Massage With Essential Oils
Massage with essential oils on the full body, especially on the spine and lower back regions, will help in good blood circulation and promote the growth of new cells. It will help relieve pain and promote better absorption of oxygen and nutrients. Essential oils will also regenerate the cells of the disc and hence stop the disc from getting slipped.
Acupressure And Acupuncture
In both techniques, the pressure is used for relieving the pain from the swelled area. In acupressure fingers, tips and elbow are used and acupuncture needles are used. But this should be done with the help of an experienced practitioner and not alone.
This is not recommended for patients having high blood pressure and for women who are pregnant.
TENS stands for Transcutaneous Electrical Nerve Stimulation and this is one of the best remedies for the herniated disc at home. This treatment uses low voltage electric current which is applied to the affected area and helps the body to release endorphin which decreases the pain.
Diet is necessary to keep away all types of bad conditions that might affect you. Drink a lot of water and eat a balanced diet. Take excess of fibers and proteins. During this condition, you should avoid dairy products and red meat. Also, avoid fat-free foods.
Epsom salt is one of the widely used natural painkiller and anti-inflammatory agent.
You can use this by adding 3-4 cups of salt in a hot water bath. Stay inside the bath for 15 minutes. It will help you achieve maximum relaxation.
Do not use this remedy if you are diabetic or pregnant. If you are on any type of medication consult your doctor before bathing in Epsom salt.
Horsetail is a herb which has high quantities of minerals in it. It nourishes our tissues and has the ability to heal broken bones and torn ligaments.
All you need to do is add some horsetail leaves to half a liter of water. Boil on low heat till the water quantity reduces to half its quantity. Cool the solution and filter it off. You can drink 5 ml of the solution thrice a day. It will heal herniated disc very fast.
California poppy is anti-inflammatory and analgesic in nature. This is what makes it a good treatment for the herniated disc.
You can tear the leaves of California poppy into small pieces and make a paste out of it using water. Use little hot water so that when you apply the paste to the affected area it is still warm.
White Willow Bark
White willow bark is used for reducing the discomfort of herniated discs. The chemical structure of this drugs shows a marked similarity to aspirin hence acts as an analgesic but doesn’t irritate your gut. It is also astringent and anti-inflammatory in nature.
This herb might react with drugs hence do consult your doctor if you are on any kind of medication.
Comfrey leaves have the power to heal bones and connective tissues of the body. All you need to do is take some fresh leaves and add it to cold water. Let it remain undisturbed for around 12 hours. After 12 hours heat the above solution and filter it. Add the filtrate to bath water and take a bath in it 2 times a day. Do not consume it orally because it contains hepatic-toxin alkaloids.
Boswellia is a naturally occurring painkiller which is a very effective remedy for a herniated disc.
All you can do is make a decoction of Boswellia and consume it 2 times a day to reduce pain and discomfort associated with herniated discs.
Boswellia is an organic painkiller that effectively treats the problem of a herniated disc. It is also an herbal cure for osteoarthritis.
Omega-3 Fatty Acids
Omega-3 Fatty acids are helpful in decreasing the inflammation and pain experienced due to herniated disc disorder. This acid forms collagen which is used by the broken discs for repairing itself.
Eat foods that are high in this kind of fats like fish, almonds, sprouts, and walnuts.
Colchicine is an active amino-alkaloid found in the plant of Kurchi or autumn crocus. This powder is obtained by crushing the seeds of the plant. It has anti-inflammatory properties which are effective against the slipped disc.
Make a paste with kurchi powder and honey and consume it once a day.
You can also make tea out of the powder or mix the powder in milk and have it once or twice a day.
Burdock contains a lot of anti-oxidants which is helpful to detoxify the body and remove all kinds of harmful substances and decrease the pain and inflammation in your body. It also treats arthritis.
Burdock can be consumed as a decoction once or twice a day.
Passionflower is helpful for slipped discs because the essential oils present is antispasmodic in nature. It reduces pain and inflammation.
You can massage with passionflower essential oil or take capsules made from it, however, do consult your doctor before taking capsules.
- If you are overweight, try to lose some pounds.
- Exercise every day.
- Lift things in a proper way, as guided by a therapist. Do not lift heavy weights.
- Stop smoking and drinking.
- Always make sure you are in the right posture whatever activity you may be doing.
- Wear flat and soft shoes. Avoid heels.
- Walk and move around cautiously.
Slipped discs can be really painful but with the right treatment and precautions, you can become as fit as you were before. So start taking home remedies and consult a doctor whenever you feel any kind of severe pain.