It is estimated that as many as 80 percent of people will experience back pain during their lifetime. Often these issues are caused by muscle strain or poor posture and will be resolved without treatment within a few days. However, sometimes the pain is caused by a more serious condition. Certain symptoms will help you determine whether you should seek help.
- Pain that interferes with everyday activities – If you are unable to go to work, get dressed, or perform regular daily errands, you might have a severe herniation that is best treated with surgery.
- Pain or numbness that extends to one or both legs – if your pain is more severe in your leg than your back, a nerve is most likely compressed. Leg weakness is often observed with this condition as well. Your surgeon might recommend surgery to avoid long-term nerve damage. (When herniation is located in the upper back, arm pain and numbness may occur.)
- Severe pain that keeps you from sleeping at night – If the pain is so severe it limits your sleep, your herniation may be too severe to benefit from physical therapy.
- Constant unbearable pain – if you are unable to stand for more than a few minutes, you are likely not able to participate in physical therapy to improve your condition.
- Loss of bladder or bowel control – If this occurs, tell your doctor immediately. Emergency surgery is necessary to prevent permanent damage.
These symptoms might indicate a serious injury called a disc herniation. Discs are soft tissue that sits between vertebrae to keep the bones from rubbing together and absorb shock from activity. A herniated disc occurs when the soft inside of the disc erupts through a tear in the disc’s rough outer exterior. The resulting pain, caused when disc material presses against a nerve, is often excruciating. A herniated disc is usually diagnosed through magnetic resonance imaging (MRI).
Sometimes a disc herniation is minor and can be treated through non-surgical techniques. Your doctor may suggest some non-invasive treatments before considering surgery.
- Anti-inflammatory and muscle relaxing medications – Relieving inflammation and muscle pain can help relieve pressure from the affected nerve.
- Physical therapy – When exercise is performed under the care of a doctor, the right techniques can help to heal the disc without surgery.
- Cortisone injections – These injections can immediately block pain to the affected nerve allowing you to participate in physical therapy for long-term improvement.
Have you Experienced Little or no Improvement with Therapy?
If you have been under a doctor’s care, and traditional medication or physical therapy isn’t yielding the desired results, you might be a candidate for surgery. Your spine doctor will likely order imaging in the form of an x-ray or MRI. The imaging results combined with the severity of your symptoms will determine if you should proceed with surgery. Some severe symptoms indicate when surgery will be the best option.
- Therapy shows little to no improvement – If you have participated in a therapy program for weeks with little to no change, you might be ready for surgery.
- Leg weakness does not improve or gets worse – Relieving pressure from the nerve early is most likely to prevent permanent weakness.
- MRI results show a large herniation – A large herniation takes longer to heal and is less likely to respond to therapy.
If you have been avoiding surgery because you have heard worrisome stories about large incisions and slow recovery time, you might not have up-to-date information. Today’s advanced tools allow surgeons to work with much smaller incisions, resulting in quicker surgeries and speedy recoveries.
Lumbar microdiscectomy surgery takes around a half-hour. The surgeon makes a small (1 – 1 ½ inch) incision. With the use of special tools, the surgeon removes the damaged portion of the disc. This relieves pressure from the affected nerve. The procedure is often outpatient surgery, and you will likely be allowed to return home the same day.
- Immediate relief of leg pain – Relieving pressure from the affected nerve means patients often feel no sciatica or leg pain immediately after surgery.
- Short recovery time – Patients are able to leave the hospital a few hours after surgery and only require minimal restrictions, usually regarding lifting and twisting.
- Lower chance of long-term damage – A nerve compressed over a longer period of time is less likely to fully heal.
- Ability to return to regular activities – Physical therapy might take months to be effective. If your condition severely impacts your life, surgery can help you heal faster.
The decision to have surgery is never one to be taken lightly. However, with the help of a Miami back specialist, you may realize it is the best way to finally relieve your pain.