Regarding the treatment of the lumbar disc hernia; physiotherapy methods like therapeutic ultrasound, electrotherapy, and soft laser are implemented to resolve the bulging tissue by the body and to decrease the muscle spasms. Some special drugs (anti-neuropathy agents and certain special analgesics) may be needed for the concomitant nerve compression and neuropathic pain.
Epidural steroid injections, local anesthetic injections in the paravertebral muscles and dry needling, prolotherapy to the surrounding connective tissue and neuraltherapy applied to the subdermal neural structures are other non-surgical treatments used in the treatment of the lumbar disc hernia.
In recent years, the spinal compression treatment became also popular in the treatment of lumbar disc hernia. It is also known as “space therapy”. It is an effective physiotherapy method.
The manual therapy (or manipulation therapy) is also used in the treatment of pain in patients with lumbar disc hernia. Experienced physiatrists implement special maneuvers to the patients and assure the recovery of the natural movements in the affected body parts and joint and muscle tissues and thus the alleviation of pain.
In patients with pain related to the lumbar disc hernia, the physiatrist decides for the treatment method after a thorough physical, laboratory and x-ray examination. As soon as the pain is under control, the patients will be scheduled to a special exercise program and will be encouraged to follow it regularly.
Physiotherapy is useful for the relief of the muscle spasms and in the auto-repair process of the tissue in patients with cervical disc hernia. Therapeutic ultrasound and superficial heat application and electrotherapy may provide successful results in this group of patients.
Furthermore, local anesthetic injections and dry needling to the painful trigger points and the paravertebral muscles, prolotherapy to the connective tissue surrounding the neck, neuraltherapy applied to the subdermal nerve tissues, neural prolotherapy and manual therapy are alternative treatment methods.
The physiatrist decides for the treatment method after the physical, laboratory and x-ray examinations. After the relief of severe pain, the patient should be encouraged to implement the exercises for the cervical disc hernia.
Paresis, tingling, electric-like sensation and sensorial changes like loss of sensation may be encountered depending on the compressed nerve roots.
Ninety-seven percent of the patients with lumbar disc hernia can be treated without surgical intervention. Academic studies did not demonstrate any difference between surgical and non-surgical treatments regarding the clinical outcome after a 2-year follow-up period. This depends on the satisfying outcome achieved with injections, pharmacotherapy, and physiotherapy in the majority of the patients.
If the patient has severe and persistent pain and complains of incontinence, muscle weakness, and loss of sensation, surgical intervention may be needed. The physiatrist decides for the necessity of surgical intervention.
The pain treatment and physiotherapy will alleviate the pain within a few weeks. The herniated tissue, which is causing the lumbar disc hernia can completely shrink with proper treatment and lifestyle regulation approx. in 2.5 years. In young patients it can be shorter (6-12 months). Pain treatment can give satisfying results in a short time just like 1-2 weeks.