Changes in Symptoms of Herniated Discs During Treatment

Symptoms of herniated disc changes?

Medical History: I have been experiencing lower back pain for over a year.
Since the symptoms were not severe, I only recently sought treatment from a rehabilitation specialist.
The physician diagnosed me with mild Herniated Intervertebral Disc (HIVD).
During my initial visit, the doctor performed several special tests, but none triggered my symptoms.
After an X-ray, it was determined that I have HIVD at the L4-L5 level, and I began treatment involving heat therapy, electrical stimulation, and spinal traction.
It has been about three weeks since then.
Subjectively, I feel no discomfort after traction; however, the overall level of pain is similar to what it was before seeking medical attention, although the frequency of pain seems to have increased.
Two days ago, I noticed that standing with my feet together and bending forward at the waist triggered my symptoms, with pain radiating from my lower back to the back of my thighs.
I understand this indicates a worsening condition.
The physician prescribed a maximum traction weight of 44 kg, and I am currently at 30 kg.
My questions are: 1.
Why has my condition worsened after starting treatment? Is this a common occurrence? (As for the past year, the pain was localized to my left lower back, but in these three weeks, it has extended to my posterior thighs.) 2.
Should the treatment plan be adjusted moving forward? Should I increase the weight or stop traction altogether? Thank you, doctor, for taking the time to respond!

bem, 20~29 year old female. Ask Date: 2015/10/20

Dr. Xu Yongnan reply Rehabilitation

1.
This is possible, but not common.
2.
It is recommended to consult a neurosurgeon.

Reply Date: 2015/10/20

More Info

Understanding changes in symptoms related to herniated discs during treatment can be complex and often varies from patient to patient. Based on your description, it seems you are experiencing a worsening of symptoms despite undergoing treatment for a herniated intervertebral disc (HIVD) at the L4-L5 level. Let’s address your concerns systematically.

1. Why Symptoms May Worsen During Treatment: It is not uncommon for patients to experience an increase in symptoms during the initial stages of treatment for a herniated disc. This phenomenon can occur for several reasons:
- Inflammation and Irritation: The treatment modalities, such as traction, may initially irritate the surrounding tissues or the nerve root, leading to increased pain. This is particularly true if the herniated disc is pressing on a nerve root, as the treatment may cause temporary inflammation.

- Changes in Activity: As you begin treatment, you may be more aware of your body and its responses, leading to a heightened perception of pain. Additionally, if you are engaging in physical therapy or exercises that challenge your back, it may exacerbate symptoms temporarily.

- Natural Fluctuation of Symptoms: Pain from a herniated disc can naturally fluctuate due to various factors, including activity levels, posture, and even stress. It’s possible that the increase in pain is part of the natural course of the condition rather than a direct result of treatment.

2. Next Steps in Treatment: Given that your symptoms have worsened, it is crucial to reassess your treatment plan. Here are some considerations:
- Consult Your Physician: Before making any changes to your treatment plan, it is essential to discuss your symptoms with your physician or physical therapist. They can evaluate your condition and determine if the current treatment is appropriate or if modifications are needed.

- Adjusting Traction Weight: If you are currently using 30 kg of traction and experiencing increased pain, it may be wise to reduce the weight or temporarily halt traction until your symptoms stabilize. Your healthcare provider can guide you on the appropriate adjustments.

- Incorporating Other Therapies: Depending on your response to treatment, your physician may recommend additional therapies such as manual therapy, specific exercises to strengthen the core and back muscles, or modalities like ultrasound or electrical stimulation to manage pain and inflammation.

- Monitoring Symptoms: Keep a detailed log of your symptoms, including when they occur, their intensity, and any activities that seem to exacerbate them. This information can be invaluable for your healthcare provider in tailoring your treatment plan.

3. Long-term Management: Managing a herniated disc often requires a multifaceted approach. In addition to physical therapy, consider lifestyle modifications such as:
- Posture Awareness: Maintaining good posture while sitting, standing, and lifting can help reduce strain on your back.

- Regular Exercise: Engaging in low-impact activities, such as walking or swimming, can promote overall spinal health without exacerbating symptoms.

- Weight Management: Maintaining a healthy weight can reduce the load on your spine and potentially alleviate some symptoms.

In conclusion, while it can be concerning to experience increased symptoms during treatment for a herniated disc, it is not uncommon. Close communication with your healthcare provider is essential to ensure that your treatment plan is effective and adjusted as needed. Remember that recovery from a herniated disc can take time, and patience, along with adherence to a comprehensive treatment plan, is key to achieving better outcomes.

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