Herniated Discs: Treatment Options and Effectiveness

Lumbar disc herniation

Hello Dr.
Chen: I often experience back pain that radiates down to my left calf.
An MRI indicated that I have a herniated lumbar disc.
I've heard about inversion therapy and its potential benefits, but I'm unsure about its effectiveness.
Does the rehabilitation department have this equipment? Thank you!

Shang Zhi, 30~39 year old female. Ask Date: 2007/07/13

Dr. Chen Xianchang reply Rehabilitation

Hello, thank you for your inquiry.
Here are my responses and suggestions:
1.
Our rehabilitation department currently does not have this equipment.

2.
The principle of the inversion machine is to secure the patient's lower limb and use body weight to decompress the lumbar spine.
However, the patient must be able to completely relax; tense muscles cannot be effectively stretched.
Additionally, the securing mechanism must be reliable; otherwise, falling could result in serious head and neck injuries.

3.
I recommend visiting the rehabilitation department for lumbar traction, which is safer and more reliable.

Reply Date: 2007/07/13

More Info

Hello,
Thank you for your question regarding herniated discs and the treatment options available. Herniated discs, also known as slipped or ruptured discs, occur when the soft inner gel of the disc bulges out through a tear in the tougher exterior. This can lead to pain, numbness, or weakness in the back and legs, as you are experiencing.

Treatment Options for Herniated Discs
1. Conservative Treatments: Most cases of herniated discs can be managed with conservative treatments. These include:
- Physical Therapy: A physical therapist can design a program that includes exercises to strengthen the muscles around your spine, improve flexibility, and promote better posture. This is often the first line of treatment.

- Medications: Over-the-counter pain relievers like ibuprofen or naproxen can help reduce inflammation and alleviate pain. In some cases, doctors may prescribe stronger medications or muscle relaxants.

- Epidural Steroid Injections: These can help reduce inflammation around the affected nerve roots, providing temporary relief from pain.

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 considered. Common surgical procedures include:
- Discectomy: Removal of the herniated portion of the disc to relieve pressure on the nerve.

- Laminectomy: Removal of a portion of the vertebra to create more space for the nerves.

- Spinal Fusion: In cases where stability is a concern, two or more vertebrae may be fused together.

3. Alternative Treatments: Some patients explore alternative therapies such as acupuncture, chiropractic care, or massage therapy. While these may provide relief for some, it's essential to consult with your healthcare provider before starting any alternative treatment.

The Role of Inversion Therapy
You mentioned the use of an inversion table, which is a device that allows you to hang upside down or at an angle. The theory behind inversion therapy is that it can relieve pressure on the spine and improve blood circulation. However, the effectiveness of inversion therapy for herniated discs is still debated among healthcare professionals.

- Effectiveness: Some patients report temporary relief from back pain and improved mobility after using inversion therapy. However, scientific evidence supporting its long-term effectiveness is limited. It may not be suitable for everyone, especially those with certain medical conditions such as hypertension, heart disease, or glaucoma.

- Availability: Inversion tables are not typically found in rehabilitation clinics, but some physical therapy centers may have them. It’s best to consult with your physical therapist or doctor to see if this treatment is appropriate for your condition.

Conclusion
In summary, while inversion therapy may provide temporary relief for some individuals with herniated discs, it should not be considered a primary treatment option. A comprehensive approach that includes physical therapy, medication, and possibly surgical intervention, if necessary, is usually the most effective way to manage symptoms and improve function.

I recommend discussing your symptoms and treatment options with your healthcare provider, who can tailor a plan specific to your needs. They can also guide you on the appropriateness of using an inversion table in your case.

Take care, and I wish you a speedy recovery!

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