The pain resulting from a herniated disc can be almost unbearable as well as debilitating. There’s been some debate as to what the best treatment option for this condition is. Should you dull the pain with medication? Should you go the physical therapy route? Or does surgery trump all the other options? A debate on the subject has been raging on for years. Now, a recent study could help provide some answers — or at least some clearer guidelines.
Your spine consists of “vertebrae,” bones that are connected and cushioned by tissue called “discs.” Due to deterioration related to age or physical wear, or trauma caused by an accident, you might experience a herniated, ruptured, or slipped disc. What happens is that the center of the disc tissue protrudes through the outer layer, subsequently rubbing or pressing against the spinal nerves. This compression can lead to back pain and another condition called “sciatica.” Sciatica involves weakness and strange sensations in the leg, including numbness, tingling, and a burning type of pain.
Now, some doctors recommend trying different therapies before diving into surgery; however, is it just a waste of time for patients? Other physicians feel that operating on the herniated disc is the only sound choice to go with. However, is surgery the best option for everybody? Two studies published in the Journal of the American Medical Association (JAMA) decided to address this pressing issue.
In the first study, approximately 500 people experiencing both herniated disc and sciatica were split randomly to receive of two types of treatment. One treatment was surgery; the other consisted of various options, including physical therapy, counseling, at-home exercises, and drug treatment. At the end of the study, the patients who had surgery had more improvement in back pain, sciatica, and physical ability than the other group did. However, it should be noted that many study subjects switched between the two types of treatment, so the results aren’t as clear as one would expect in a good-quality study.
The second study was an observational one. It examined 743 people with herniated disc and sciatica, some of whom had undergone surgery and some of whom had opted for non-surgical methods of dealing with the problem. Over a period of two years, all study subjects experienced some improvement; nevertheless, the people who had the back surgery had better results.
What does this all mean? It appears that surgery has a slight edge over non-surgical methods when it comes to improving outcome for herniated disc/sciatica patients. However, these results also show that non-surgical methods work just as well for a large group of people.
So, really, the message is that you have options in dealing with the pain and disability caused by a herniated disc. Many people recover on their own, with simple rest and cold/hot compresses. Sometimes it takes medication, such as anti-inflammatory drugs, analgesics, and/or steroid injections. For some, ultrasound, massage, electric stimulation, or an exercise program could do the trick. And, obviously, surgery can be extremely effective.
Frequently, a combination of any of the aforementioned therapies could work. The point is that doctors should have their patients try the non-surgical tactics first, before even discussing surgery in most cases. Surgery should be the last resort to fix any kind of health problem; it’s not a quick fix.
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