Herniated disc: physical, sport or surgery?
If a herniated disc is present, back surgery is not always necessary. A study in the scientific journal "The Lancet" seems to confirm this idea. So physicist, sport or surgery? To help you, Weasyo provides an overview of the latest recommendations.
What is a herniated disc?
Scientists agree that a herniated disc is a natural erosion of the intervertebral disc. It is generally characterized by a "bulge" towards the back of the spine (the back of the disc). This can be intermediate (middle), or eccentric to the left or right of the spinal canal.
Sometimes, the hernia can compress or irritate the nerves of the spinal cord and cause local or distant pain.
Herniated discs have also been found on MRI scans of people without symptoms...
When a patient suffers from low back (lumbar spine) or sciatica, the doctor generally sends him for an additional examination: a scanner or an MRI (magnetic resonance imaging).
The purpose of these examinations is to identify possible causes of the pain. However, the items on the imaging scans are not necessarily related to the symptoms that occurred!
A recent study analyzed the MRI findings of 3,110 patients and found that more than 50% of people between the ages of 30 and 39 had disc degeneration...without experiencing any pain. (3)
Another study found that a bulging disc may be present in more than 80% of people over 80 years of age but not experiencing any back pain.
The study shows that herniated disc is a natural degeneration of the intervertebral disc, and that it is not necessarily associated with the pain felt.
We therefore advise you to have your MRI or X-ray results analyzed by a qualified healthcare professional before assuming the worst. (2)
Your pain is not inevitable! It often decreases with the implementation of a specific conditioned treatment. (4) (5) (6)
Herniated disc: which treatment to choose? Medicines, physical therapy, or surgery?
The latest literary reviews on this topic were published in the famous scientific journal "The Lancet". (1) They have demonstrated that today's preferred treatments for low back pain management are not appropriate (2):
Medications, when used alone, are useless or even counterproductive. First, they do not act on the cause of the diseases but only on the symptoms. Secondly, they relieve patients only partially and expose them to side effects. Finally, if nothing changes at the situation level, it gives the illusion of results and thus leaves fertile ground for potential setbacks.
It is recommended to wear the lumbar belt only in the acute phase of pain. When used frequently, it inflates the muscles responsible for maintaining the back and stimulates anxiety during movement.
Likewise, the phases of rest in a sitting or lying position should be limited in time. They can be used in the event of crises but have risks, in the long run, of entering the patient into a vicious cycle of deconditioning and permanent pain fixation.
On the other hand, the study determined that resuming physical activity is beneficial for patients. It should be gradual and deliberate. For example, active walking is a simple and effective way to relieve symptoms and activate the back muscles. To learn more, seek advice from a healthcare professional on how to properly pack your back.
Finally, these studies confirm that specific and effective rehabilitation of the spine is the most appropriate treatment to date. It will significantly improve patients' quality of life by reducing their symptoms. Therefore, this rehabilitation includes mobilization, stretching and exercises to strengthen the back and abdomen ...
If a hernia is present, when should the surgery be performed?
Surgery should be considered either as an emergency (muscular paralysis, loss of sensitivity), or as a last resort after one or more physical treatments that have not produced results.
This surgical procedure is not trivial and shows, like any other intervention, risks of complications (infection, risks related to anesthesia, etc.).
Except for emergencies, consult a physiotherapist first. The operation will be chosen later if the symptoms do not resolve. In parallel with the sessions, exercise programs that will be carried out on their own at home significantly improve the results obtained. Ask your therapist about training movements.
A herniated disc is a natural wear and tear on the body that is not necessarily responsible for back pain. According to the extensive scientific study "The Lancet", additional examinations such as MRI or CT scans have a nocebo effect on treatment, and therefore should be limited in prescriptions. Several recent studies indicate that rehabilitation is the most appropriate treatment for this type of condition and that surgery should only be considered a last resort.
Mckenzie back rehabilitation appears to be very effective in treating low back pain and sciatica. It will allow patients to immediately feel the effects of the treatment on their symptoms and continue their rehabilitation between sessions thanks to a specific exercise prescription.