Lumbar Disc Herniation: Do Conservative Treatments Make a Great Option?

One of the proposed reasons why people suffer from low back pain is lumbar disc herniation. It is a common type of degenerative disc disease. Usually, lumbar disc herniation is treated surgically, but can also resolve with conservative treatments.

A recent study says that there’s little difference with the results between undergoing surgery and not receiving any, 2 and 5 years after being diagnosed with lumbar disc herniation.

The research also shows that undergoing conservative treatments has its own benefits along with reducing or completely getting rid of the symptoms within a few weeks.


On a side note…

Another research article displays scans only show something serious going on in a super tiny minority of people with back pain

Research shows if you take people without back pain and get a CT Scan or MRI:

37% of 20 year olds
80% of 50 year olds
96% of 80 year olds
Have “disc degeneration”

30% of 20 year olds
60% of 50 year olds
84% of 80 year olds
Have “disc bulging”

These changes are just a normal part of the ageing process.

It’s important you understand what is influencing your back pain, it rarely just happens!

There is a good chance that the findings on your scan are not the cause of your pain – hence no amount of surgery will help.

(Brinjikji, et al Am J Neuroradiol. 2014 Nov)


What is Lumbar Disc Herniation?

The spine is made of vertebrae. Those are individual bones that stack up to make your spine. Between the vertebrae are rubbery cushions that shaped like a disc.

Disc herniation can occur in any area of the spine but is more common in the lumbar area.

Lumbar disc herniation happens in your lower back. A herniated disc means there is a problem with one of the spinal disc.

Think of a jelly doughnut. The exterior of a spinal disc is tougher but the inner part is softer. When a disc herniates, the softer gel part pushes out through the tougher exterior.

Disc herniation can cause irritation to the nearby nerves, resulting in pain, numbness or weakness. However, many people do not experience symptoms from a herniated disc.

Disc herniation can be caused by wear and tear of the disc or spinal injury. As you age, your discs become more dehydrated and less flexible. On the other hand, a spinal injury can cause micro tears or cracks in the hard external layer of the disc. This can cause the gel to push outside through the outer layer’s tears or cracks, resulting in a disc that is bulged or break open.

The symptoms of a herniated disc include:

  • Intermittent or continuous back pain
  • Muscle spasm in the back
  • Sciatica
  • Leg weakness/numbness
  • Reduced reflexes at the knee or ankle
  • Problems with bladder or bowel function

Conservative Treatment: What the Study Says

In a meta-analysis published in the 2017 Pain Physician, a group of researchers looked at 11 cohort studies. They found that the resorption rate of lumbar disc herniation in these studies is 66.66% and suggested that conservative treatment may be a first choice to cut costs associated with surgery bills.

The researchers selected all peer-reviewed cohort studies on lumbar disc herniation with conservative treatment from the year 1990 to 2015 that used MRI or CT to measure the size of the disc protrusion.

The 11 studies were from UK, Japan, France, Korea and Italy, although most were from UK and Japan. In Japan, the resorption rate was 62.58%. In the UK, the rate is at 82.94%.

The conservative treatments in the study include oral steroids, NSAIDS, massage, physical therapy and manual adjustment.

The Benefits of Conservative Treatments

Lumbar disc disease is usually treated with surgery, but in the article, the surgical outcome is not much different from conservative treatment. For over 20 years, MRI and CT have shown that conservative treatment can also lead to resorption of the herniated disc.

The benefits that people might get from conservative treatments are reduced complications, less suffering, reduced costs and improved quality of life.

Because none of the reviewed studies were randomised controlled trials and has barely enough data, more study is needed.

However, the 66.66% rate is high that you can tell that there are a lot of cases of herniations where they can resolve with just conservative treatments.

Surgery is supposed to be a last resort if everything else fails to improve your condition.

So it’s better to think twice, thrice, or even 10 times before getting into a surgery.

Go with a conservative treatment first. If you have low back pain from lumbar disc herniation, physiotherapy can help in getting it sorted.

Schedule an appointment with a Perth physiotherapist. Get in touch with us today on 9272 7359!

 

Reference:

Zhong M, Liu JT, Jiang H, Mo W, Yu PF, Li XC, Xue RR. Incidence of Spontaneous Resorption of Lumbar Disc Herniation: A Meta-Analysis. Pain Physician. 2017;20(1):E45–E52.