What are the non-surgical treatment methods for lumbar disc herniation?

Lower back pain is among the most common orthopedic disorders. The source of pain in the lower back may be problems with the spine or other diseases. Lumbar disc herniation is one of the most significant diseases that cause pain in the lower back. Lumbar disc herniation, which can cause pain that will distract the person from their daily lives, can be successfully treated with physical therapy and rehabilitation applications together with medication treatments. Various methods such as injections and laser treatments are also used as part of the physical therapy and rehabilitation treatment of lumbar disc herniation. Surgical treatment may be required in 1-3% of lumbar disc herniations.

What is a lumbar disc herniation?

There are round and flexible structures called discs between the body parts of the small vertebrae in the spine. There is a gel-like structure in the inner parts of these discs and strong connective tissue fibers in the form of intertwined rings around this structure. The discs are subjected to various forces as the spine moves. Movements that involve rotation and bending at the same time push the discs harder. The fibers at the edge of the disc may become irregular and tear as a result of repetitive stretching and pressure. A sudden severe trauma can also cause disc damage. Lumbar disc herniation occurs as a result of the discs protruding from where they should be. A lumbar disc herniation causes pain that spreads to the lower back and legs, while a cervical disc herniation causes pain that spreads to the neck and arms.

Symptoms of a lumbar disc herniation that compresses the nerve can be listed as;

• Sharp, throbbing pain in the foot or leg,
• Burning sensation,
• Numbness, tingling
• Decrease or loss of sensation
• Weakness in foot or leg muscles.

What are the causes of a lumbar disc herniation?

Using a computer, tablet or mobile phone all day for work, education or hobby purposes, working for long periods of time in a sitting position without creating an ergonomic and healthy working environment, a sedentary lifestyle and being overweight increase the occurrence of back and lower back pain and prevent the preservation of the physiological curvatures of the spine. Incorrect posture causes the muscles in the back-lumbar region to lose their flexibility, weaken, lose the physiological curvature of the spine, and increase the pressure on the discs between the vertebrae. The water content and flexibility of the disc may decrease due to aging and calcification (spondylosis). Factors such as smoking and diabetes can disrupt the nutrition of the disc and pave the way for its wear.

How is the treatment of lumbar disc herniation done?

There are options such as medication and injection treatments, physical therapy and rehabilitation for the treatment of lumbar disc herniation. Within the scope of physical therapy and rehabilitation; hot/cold compressions, therapies containing electric current (TENS, electrical stimulation, etc.), ultrasound therapy, laser application, traction and massage are used. Movements that will stretch the lower back muscles, strengthen the lower back and abdominal muscles, and correct the posture are beneficial. All these treatments should be applied in fully equipped hospitals and health centers by physiotherapists and physical therapy technicians under the management of physical therapy and rehabilitation physicians. Physical therapy applications for lumbar disc herniation provide almost 90% success. Most of the lumbar disc herniations can shrink or disappear spontaneously with physical therapy or over time. A good physical therapy practice significantly increases recovery rates. Surgical treatment may be required in 1-3% of lumbar disc herniations. Conditions such as lower back pain that spreads to the leg and does not go away, progressive loss of strength in the leg and foot due to compression of the nerve root can be corrected by surgery.

What are the non-surgical treatments for lumbar disc herniation?

The vast majority of lumbar disc herniations can be eliminated by physical therapy methods without surgery. Various muscle relaxants and pain relievers can be used in treatment to resolve muscle spasm, reduce edema and pain. Hot-cold compressions, electric currents, vacuum interference, ultrasound, laser and magnetic field are among the physical therapy and rehabilitation methods used.

One of the most important reasons that increase pain in lumbar disc herniation is muscle spasm. Dry needle therapy is an important and effective treatment method used for pain that occurs due to muscle spasms. Dry needle application is a type of treatment applied to soft tissues and muscles, using acupuncture or special sterile needles to distribute the stiffness of the muscles and bring them back to normal. It is also known as intramuscular stimulation (IMS). There are no medications inside the needles. Needle lengths may vary depending on the size of muscles. The needles placed inside the muscles are moved back and forth to the left and right to soften the stiff muscles. With the dry needle method, which is usually a painless application, pain can be relieved without the need for any medication.

Chiropractic treatment is one of the oldest methods of treatment. In chiropractic treatment, manual manipulation and mobilization techniques are applied to blockages that have occurred in the spine or joints for various reasons, and mobility is restored to the spine and joints. Manual therapy is most often used for pain in the spine, namely in the lower back, back and neck.

Prolotherapy, it is a method aimed at treating joints, cartilage, ligaments and muscles by injecting fluid mixtures that will repair and strengthen tissues. This mixture is injected into damaged and painful areas of the body, joints and ligaments. It has a good anti-inflammatory effect, allowing these tissues to repair themselves and heal.

PRP, Prolotherapy with PRP (proloPRP), as well as injection methods such as neuraltherapy, allows the area to repair itself by increasing the blood flow to the applied area. PRP; (Platelet rich plasma) is the process of separating the plasma of the blood by a special process performed by withdrawing a small amount of blood from the person's body and administering it back to the body by injection. These methods activate the natural healing process of the body. Injections are usually given at intervals of several weeks, depending on the condition of the discomfort and the severity of the accompanying spasm.

Spinal needle therapy (spinal injections) is used to reduce pain and heal hernia in cases such as lumbar and cervical disc herniations and narrow spinal canal. By applying the drug mixture between the vertebrae, the shrinking the hernia can be achieved without surgery. After the intervention, 1-3 hours of rest may be required, there is no need to be hospitalized.

What helps relieve lumbar disc herniation pain?

In addition to drug treatments, physical therapy and rehabilitation practices are good for lumbar disc herniation pain. Resting is also effective in relieving pain in lumbar disc herniation. When the necessary treatments are taken and the patient feels better, they should definitely do exercises to strengthen the spine and muscles. Pilates, yoga and swimming are among the exercises that strengthen the spine.

Will a ruptured hernia heal?

A lumbar disc herniation occurs as a result of the protruding or tearing of the discs between the vertebrae from the place where they should be due to various effects. Damaged discs can heal over time. Pains caused by a hernia can also pass within a few weeks. During this time, rest, hot or cold compressions, physical therapy and rehabilitation treatments along with medications also contribute to recovery.

Prepared by the Medical Editorial Board. Our health library contents have been prepared for informational purposes only and with the scientific content on the registration date. For all your questions, concerns, diagnosis or treatment about your health, please consult your doctor or health institution.