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General Practice 2023

Hédisk treatment: remédias, surgery or physical therapy?

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Hédisk treatment: remédias, surgery or physical therapy?
Hédisk treatment: remédias, surgery or physical therapy?

The first form of treatment that is usually indicated for a herniated disc is the use of anti-inflammatory drugs and physical therapy, to relieve pain and reduce other symptoms, such as difficulty moving the limbs or tingling.

Other alternative options, such as acupuncture, Pilates or the use of some teas, can also help to complement medical treatment, enhancing the effect of medications and reducing discomfort even more.

However, as a herniated disc is an alteration that causes compression of the disc that is between the vertebrae, projecting it out of its space, sometimes these treatments are not enough to restore quality of life to the person, in which case, surgery for herniated disc is indicated.


1. Treatment with drugs

Recommended treatment for a herniated disc includes the use of medication, such as:

  • Anti-inflammatories, such as Ibuprofen, Diclofenac or Ketoprofen: help reduce inflammation and pain caused by intervertebral disc compression;
  • Analgesics, which can be weaker, such as Dipyrone or Paracetamol, or more potent, such as Tramadol or Codeine: help relieve pain and discomfort caused by disc compression vertebral;
  • Muscle relaxers, such as Cyclobenzaprine or Baclofen: to reduce pain caused by muscle spasms in the back or legs;
  • Anticonvulsant drugs, such as Gabapentin or Pregabalin: these are used, in this case, to relieve pain caused by the compression of nerves near the hernia;
  • Corticosteroid injections into the spine, such as Betamethasone or Prednisone: to reduce inflammation at the herniated disc site.

The use of anti-inflammatory drugs, despite having a good effect especially in pain crises from lumbar hernia, should not be used too often, as they cause many side effects, such as stomach irritation or change in function of the kidneys.

In cases of need to use medication for a long time, analgesics, muscle relaxants or anticonvulsants, prescribed by the doctor, are the best options.

2. Physiotherapy for herniated disc

In addition to medication, the orthopedist can also advise you to have physiotherapy sessions, where exercises are performed and positions are learned that are important to complete the treatment with medication and reduce pain. See all about how physical therapy for herniated discs works.

The duration of physiotherapy treatment depends on the type of hernia and the intensity of the symptoms presented, but it can vary from 1 month to 6 months, or more.

3. Natural treatment

There are ways to relieve the pain caused by a herniated disc with home treatments, which can, in some cases, replace or reduce the dose of medication. The main ones are:

  • Acupuncture: helps to eliminate pain using small needles that are inserted into pressure points to provoke an analgesic action;
  • Pilates: Pilates posture and stretching exercises can help stabilize a herniated disc and decrease pain. It is important that Pilates classes are done by a physical therapist;
  • Massage: if performed by qualified professionals, experienced in treating spinal diseases, it can relieve symptoms, due to muscle stretching and relaxation;
  • Natural herbs: some plants can be used to make plasters, season foods or make teas, such as cloves, ginger, cinnamon, fennel or cat's claw, for example, which have anti-inflammatory action. Learn tea recipes that are great natural anti-inflammatories.

In periods of crisis, you should rest for a few hours, but always prefer movement because this reduces the stiffness of the muscles and helps in pain control. But it is important to avoid making great efforts such as cleaning, or lifting heavy objects because this way the spine is more protected, avoiding manipulation or movements that can cause inflammation to worsen.

See, in the following video, tips from a physical therapist that can help improve the symptoms of a herniated disc:

4. Surgery for herniated disc

Surgery to treat a herniated disc is indicated mainly if it is of the extruded or sequestered type, when there has been no improvement in symptoms with the use of medication and physical therapy, or when the symptoms are so intense as to cause loss of strength and incapacity.

The procedure is performed in a surgical center, under general anesthesia, removing the disc from the affected spine, with a small cut, followed by joining the vertebrae or replacing the disc with an artificial material. It can be performed by the orthopedist, but also by the neurosurgeon, as it affects important parts of the spinal nervous system.

Another surgical option is the endoscopy procedure, in which the affected disc is removed through a thin tube introduced through the skin, with a camera at the tip. Despite being simpler, this type of procedure is performed in specific cases, authorized by the surgeon, depending on his experience and the affected spine site.

What is recovery like

After the procedure, the person can be discharged in 1 or 2 days, but must stay at home for 1 week, doing simple tasks such as personal care and walking short distances. A collar or vest may be required for 2 weeks to avoid forcing the site and provide security for the person.

Most activities, such as working, are already allowed after this period, but physical activities that require effort are allowed after 1 month.

Signs of improvement

Signs of improvement in a herniated disc usually appear about 3 weeks after the start of treatment and mainly include a reduction in pain and a decrease in the difficulty in moving the limbs.

Signs of worsening

Signs of a herniated disc worsening are more frequent when treatment is not working and include difficulty walking, standing or moving the body, as well as loss of sensation to urinate or evacuate, for example.

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