Spinal disc herniation?
Hello, doctor! I have been experiencing persistent pain in my left lower back for a long time.
It worsens after even slight physical activity or poor posture, lasting for several days.
Today, I visited Kaohsiung Municipal United Hospital for an X-ray, and the doctor informed me that there is a herniated disc in the lumbar region, which is causing an increased distance between the vertebrae.
I may need to undergo rehabilitation for some time, and if that doesn't work, surgery might be necessary.
This news is quite devastating for me, as I don't recall any injury to my lower back.
How did it escalate to the point of needing surgery? Additionally, my job requires me to stand or sit for long periods, which would make it difficult to work if I can't do either.
Could you please advise if there are any other treatment options besides rehabilitation or surgery? Can I still engage in sports like basketball? What lifestyle changes should I make to prevent further deterioration? Are there any rehabilitation clinics in the Fengshan area that you would recommend? Thank you!
bèndàn, 20~29 year old female. Ask Date: 2007/05/09
Dr. Su Hongci reply Rehabilitation
Hello: I believe your issue is "lumbar disc herniation." Between the vertebrae, there are intervertebral discs that serve as cushioning support.
When these discs are subjected to excessive force or undergo degeneration due to aging, they can herniate, potentially compressing nearby nerves and causing weakness or numbness.
Individuals in occupations that require prolonged standing or sitting, those who frequently bend to lift heavy objects, athletes, and pregnant women in the later stages of pregnancy due to increased abdominal weight are more susceptible to this condition.
Initially, symptoms may present as general lower back pain or discomfort, but if left unaddressed without proper posture adjustments or effective lumbar relief exercises, it can develop into a herniated disc.
Common treatment options include:
1.
Medication: Non-steroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, opioid analgesics, and antidepressants.
2.
Rehabilitation Therapy:
- Heat Therapy: Enhances local blood circulation, relaxes muscles, and alleviates pain.
- Lumbar Traction: For patients with herniated discs compressing the sciatic nerve, lumbar traction can help; it can also relax tight back muscles.
- Electrical Therapy: Relieves pain and promotes muscle relaxation.
- Strengthening Exercises, Stretching, Relaxation Training, and Posture Correction: These aim to strengthen the back muscles and improve flexibility, maintaining proper spinal curvature and stability.
It is advisable to temporarily avoid strenuous activities and engage in gentler exercises like swimming or Pilates.
If exercise causes discomfort, rest and cease the activity.
3.
Surgical Treatment: Traditional surgery, titanium intervertebral spacers, microsurgery, endoscopic surgery, and implanted artificial discs should be evaluated by a specialist in neurosurgery based on individual circumstances.
Precautions include:
1.
Avoid prolonged standing; frequently shift your weight while standing.
2.
Maintain proper sitting posture using a high-back chair, avoid slouching, and ensure correct posture while driving, avoiding long periods of driving.
3.
During acute pain, it is advisable to rest in bed for 1-2 weeks as much as possible.
4.
When lifting objects, keep your back straight, squat down, and lift with your legs rather than your back.
5.
When picking up items from the ground, keep your back straight and squat down instead of bending directly at the waist.
6.
Consider using a lumbar support belt to alleviate discomfort.
7.
It is best not to sleep on a mattress that is too soft; opt for a mattress that supports the spine or a firm board bed.
For rehabilitation services in the Fengshan area, you can visit the Taiwan Society of Physical Medicine and Rehabilitation website at www.pmr.org.tw.
Wishing you health and happiness!
Reply Date: 2007/05/09
More Info
Understanding spinal disc herniation is crucial for anyone experiencing back pain, especially if it leads to symptoms like numbness or weakness in the legs. A herniated disc occurs when the soft inner gel of the disc bulges out through a tear in the tougher exterior. This can compress nearby nerves, leading to pain, numbness, or weakness in the affected area.
Treatment Options
1. Conservative Management: Most cases of herniated discs can be managed without surgery. This includes:
- Physical Therapy: A physical therapist can design a program tailored to your needs, focusing on strengthening the core muscles that support the spine, improving flexibility, and teaching proper body mechanics to avoid further injury.
- Medications: Over-the-counter pain relievers like ibuprofen or naproxen can help reduce inflammation and alleviate pain. In some cases, your doctor may prescribe stronger medications or muscle relaxants.
- Epidural Steroid Injections: These can provide temporary relief by reducing inflammation around the affected nerve roots.
2. Surgical Options: If conservative treatments fail to relieve symptoms after several weeks or if you experience significant weakness or loss of bladder/bowel control, surgery may be necessary. Common procedures include:
- Discectomy: Removing the portion of the disc that is pressing on the nerve.
- Laminectomy: Removing a small section of bone over the nerve root to relieve pressure.
- Spinal Fusion: In some cases, fusing two or more vertebrae together may be recommended.
Recovery Tips
- Activity Modification: Avoid activities that exacerbate your pain. This may include heavy lifting, prolonged sitting, or standing. Incorporate frequent breaks if your job requires long periods of sitting or standing.
- Exercise: Engage in low-impact activities like walking, swimming, or cycling, which can help maintain fitness without putting undue stress on your back. Always consult with your healthcare provider before starting any new exercise regimen.
- Posture and Ergonomics: Pay attention to your posture while sitting and standing. Ergonomic chairs and desks can help reduce strain on your back. When lifting, use your legs instead of your back to minimize the risk of injury.
- Weight Management: Maintaining a healthy weight can reduce the strain on your spine and lower back.
Lifestyle Changes
- Sleep Position: Sleep on your side with a pillow between your knees to keep your spine aligned. If you prefer sleeping on your back, place a pillow under your knees.
- Stress Management: Stress can lead to muscle tension, which may exacerbate pain. Techniques such as yoga, meditation, or deep-breathing exercises can be beneficial.
- Regular Check-ups: Keep in touch with your healthcare provider to monitor your condition and adjust your treatment plan as necessary.
Rehabilitation Centers
In the Fengshan area, you may want to consider visiting local hospitals or rehabilitation centers that specialize in physical therapy for spinal conditions. Look for facilities that have certified physical therapists with experience in treating spinal disc issues. You can also ask your primary care physician for recommendations.
Conclusion
While the prospect of surgery can be daunting, many individuals with herniated discs find relief through conservative treatments. It’s essential to stay active within your limits, maintain a healthy lifestyle, and follow your healthcare provider's recommendations. Always consult with your doctor before making any significant changes to your treatment plan or activity levels. With the right approach, many people can return to their normal activities, including sports, while managing their condition effectively.
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