My Spine - Lumbar
How is it treated?
There are always four options:
o treatment – This is acceptable if there is no serious nerve compression,
in other words, there is no spasticity or muscle weakness. There are always
people who choose this option for a variety of personal reasons. There is a
certain proportion of patients whose symptoms will get better with time with-
out an operation.
on-invasive treatment – The initial treatment for a lumbar disc herniation
is conservative treatment, which might include anti-inflammatory medica-
tion, analgesic medication, physiotherapy and other manual treatments such
as chiropractic treatment, pressure point therapy, massage therapy and trac-
tion. This would usually be followed for a period of at least six weeks.
Semi-invasive treatment – This includes procedures such as radiofrequency
rhizotomy, caudal or sacral block, epidural block and Nucleoplasty. These
treatments may be highly effective, have very few side-effects or complica-
tions and are performed as day procedures. These procedures have a very def-
inite place in the non-surgical management of lumbar disc disease.
If conservative management is unsuccessful, surgery is usually indicated. In
situations where there is muscle loss or sensation loss due to a compressed
nerve, surgery is considered much earlier. Compression that continues for too
long can cause permanent nerve damage. The longer the duration of the
symptoms, the less the chance of success when operating to decompress the
nerves.
Invasive (surgery) – The indications for surgery are:
1. Failed conservative management. This would include the use of analgesic
medication, anti-inflammatory medication, physiotherapy and chiropractic
treatment for a period of at least six weeks before surgery is contemplated.
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