Disc Herniation-Surgery is Not Only Option

I recently had two patients come into my clinic with  severe episodes of back and leg pain. Both of these patients were pretty miserable and had difficulty even walking, sitting, and sleeping. They both were normally very active and found that they could not do many of the things they would regularly do. Both were told they needed surgery, but they did not want to take that step and came to see me for help in getting over it without surgery-and they both did!.........

Now to preface this article, there are times when surgery is definitely indicated. If a patient has lost the ability to go the bathroom normally, has a recent change in balance, and has weakness that is getting worse in muscles that correspond with MRI findings, then surgery might be indicated. Both of these gentleman had an MRI confirmed herniated disc in their low back. One of them had some weakness in the ability to lift their foot, but it did not worsen throughout treatment and in fact, it improved. They both had significant pain and limitation in function that really impacted their lives but maybe most importantly, they wanted to get better without surgery-and they did. How did this happen?

First, they learned that despite what the MRI showed when they were having their severe pain, this likely would improve if given time. Research has shown that the majority of disc herniations (up to 83%) will resolve on their own. The body views a significant disc herniation as a problem and will send chemicals to the area to remove the herniated material away from the nerve. Once they knew this (and were reminded of this frequently) they were able to have a mindset to try and "wait it out."

In addition, they were taught ways to help manage and/or relieve some of their symptoms throughout the day. This included using certain positions or movement that felt better and lessened their leg pain. Also, we were able to find certain movements and positions that definitely made them worse and they were advised to avoid these for a period of time. ​Some hands-on treatment was also provided to move the spinal segments where they were having pain which also helped relieve some symptoms and allowed them to move better. 

A big part of their recovery was education about finding activities that they could do to stay moving. They both chose activities that they would normally do, but they just did them for shorter periods of time. Throughout this, they were educated on how much pain is ok to have, how to know if they did too much, and how to progress if it seemed like they did too little. This allowed them to feel in control of their symptoms and allowed them to maintain some physical activity which will help with their recovery. 

As they gradually felt better over 4-8 weeks, they started to do more of the things they enjoyed and we started to reintroduce them to movements and positions that they initially were told to avoid. They also were shown things to do to improve spine motion and blood flow throughout the body to help the healing process. 

As I said at the beginning, both of them ultimately fully recovered and have returned to doing all of the things they would normally be doing. It was not easy for them-there were plenty of ups and downs throughout their recovery and it took quite a bit of time (about 3 months). However, they made it!

I share this because you all need to know that surgery is not the only option for a herniated disc. In fact, many times spinal surgery is NOT the best option and should only be used as the last option. However, many patients are not told this. Most back and leg pain caused by a herniated disc can be treated without surgery when given the right treatment, education, and perseverance. 
Feel free to reach out if you have questions. 

Thanks for reading.
Bob