Herniated discs represent a significant musculoskeletal problem that can noticeably affect quality of life. This condition, which can manifest with symptoms such as low back pain, leg pain, numbness, and limited movement, often leads to concerns about the necessity of surgical intervention among patients. Today, non-surgical treatment options for herniated discs are considered within the scope of non-surgical approaches for suitable patients. The treatment plan is personalized by the physician according to the patient's clinical condition and the characteristics of the herniation.
What Is a Herniated Disc?
A herniated disc can occur due to the wear and tear or displacement of the flexible disc structure between the vertebrae over time. Weakness or tearing in the outer part of the disc causing the inner part to protrude outward can put pressure on the surrounding nerve tissues. This pressure can lead to symptoms such as pain radiating to the back, hips, legs, and feet, numbness, and muscle weakness over time.
The severity of a herniated disc and the clinical picture it presents varies from person to person. Therefore, each herniated disc case does not require the same treatment approach.
What Are the Causes of a Herniated Disc?
A herniated disc often develops not due to a single cause but through accumulated structural strains and lifestyle factors over time. Reduced durability of the discs between the vertebrae can lead to the disc tissue protruding outward and putting pressure on the nerves.
The main causes contributing to the formation of a herniated disc are:
- Age-Related Degeneration
Over time, the discs between the vertebrae lose their flexibility and water content. This can make the discs more prone to wear and herniation.
- Incorrect Posture and Improper Movements
Sitting for long periods at a desk, lifting heavy objects with a bent posture, or sudden twisting movements can place excessive pressure on the lumbar spine. Over time, this pressure can weaken the disc structure.
- Overloading
Lifting heavy loads with improper technique or applying sudden and high force to the lumbar region can cause damage to the discs.
- Inactive Lifestyle
Not engaging in regular exercise can lead to the weakening of the abdominal and back muscles. Reduced muscle support may place more load on the discs of the spine.
- Excess Weight
Excess weight gain can impose an additional load on the vertebrae in the lumbar region. This can cause the discs to wear out more quickly.
- Traumas and Accidents
Sudden traumas such as falls, accidents, and sports injuries can also cause damage to the disc structure, leading to the development of a herniated disc.
- Genetic Predisposition
In some individuals, the discs may wear out more easily due to the structural characteristics of the connective tissue. Family history is among the factors that increase the risk of a herniated disc.
How Is a Herniated Disc Treated?
Treatment of a herniated disc is planned individually, considering the degree of herniation, the patient's complaints, quality of life, and neurological findings. The main goals of treatment are to reduce pain, control the pressure on the nerve, and support the patient's daily life functions.
Interventional Treatment Methods
In some patients, pain may not be controlled despite conventional conservative treatments. In such cases, interventional treatment methods can be considered before moving to surgery. These methods:
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Are applied under imaging guidance
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Aim to intervene directly in the area causing pain
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Can be planned as an alternative or supportive option to surgery
The suitability of each patient's condition is different, and decisions are made through physician assessment.
Surgical Treatment for Herniated Discs
Surgical treatment generally comes into consideration in cases such as:
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Progressive muscle weakness,
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Severe nerve compression,
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Problems with urine–fecal control,
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Long-lasting and treatment-resistant pain.
What Are Non-Surgical Treatments for Herniated Discs?
Non-surgical treatment for herniated discs encompasses methods aimed at reducing pain and functional loss associated with herniated discs without surgical intervention. Especially for patients with mild to moderate herniated discs without progressive neurological loss, these treatments can be planned upon a physician's evaluation. The goal is to control pain, reduce pressure on the nerve, and support the patient's daily quality of life.
Medication and Rest
In the acute phase of a herniated disc, anti-inflammatory drugs, pain relievers, and muscle relaxants can be used to control pain and reduce muscle spasms. Short-term rest is coordinated to manage daily activities in a controlled manner.
Physical Therapy and Rehabilitation
Physical therapy programs aim to strengthen muscles, increase spinal stability, and reduce pain. Treatment includes:
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Hot and cold applications, muscle relaxation,
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Electrical stimulation therapies (such as TENS),
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Ultrasound and laser applications,
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Methods such as traction and massage.
Exercise and Lifestyle Adjustments
Exercise programs guided by physicians and physiotherapists can strengthen the back and abdominal muscles, reducing the load on the spine. Additionally, adopting proper posture habits in daily life helps control pain.
Nerve Blocks and Steroid Injections
Interventional injection treatments such as epidural steroid injections or nerve blocks can be applied to alleviate nerve root irritation and reduce inflammation due to a herniated disc. These methods can help rapidly reduce pain and support the physical therapy process.
Ozone Therapy
Ozone therapy for herniated discs is a non-surgical method aimed at reducing the size of the structure pressing on the disc by applying ozone gas in a controlled manner to a specific area, thereby reducing pain. It can be considered, especially in cases unresponsive to medication and physical therapy.
Manual Therapies and Supportive Methods
In some centers, manual therapy, dry needling therapy, PRP and prolotherapy are used as supportive approaches to help control herniated disc symptoms. These aim to reduce muscle tension, increase local circulation, or support tissue healing processes.
Frequently Asked Questions
Is non-surgical treatment for herniated discs suitable for everyone?
Non-surgical treatments for herniated discs are evaluated by a specialist physician based on the herniation degree, the patient's complaints, and neurological findings.
How long does it take for non-surgical herniated disc treatments to show effect?
The duration of effect varies depending on the method applied and the patient's clinical condition. Some patients may experience relief quickly, while others may require longer follow-up.
How early should treatment for a herniated disc begin?
Early assessment when symptoms associated with a herniated disc appear can aid in planning a healthier treatment process. Early diagnosis can facilitate easier pain control and help prevent progressive issues.
What should patients with herniated discs pay attention to in daily life?
Patients with herniated discs should avoid sudden movements and heavy lifting that strain the lumbar region. Additionally, adopting proper postural habits and adhering to physician recommendations play a supportive role in the treatment process.
