Treatments for a Herniated Nucleus Pulposus
Most people know a herniated nucleus pulposus as a "slipped disk." The condition, which most often occurs in the lower spinal column, constitutes a leading source of chronic, severe and disabling back pain. A disk between vertebrae can become torn or worn by age or injury, causing the disk to rupture or its soft inner nucleus to swell. Treating a slipped disk can prove difficult; even surgery does not always relieve pain or restore function.
Rest
Unless a person has suffered a severe injury that necessitates surgical repair to the spine, the first approach to treating a herniated nucleus pulposus is always rest and a reduction in strenuous physical activity. Few patients need to go on complete bed rest, however, and even those who do should spend only one or two days off their feet, according to a fact sheet from the Mayo Clinic. Swelling in disk nuclei recedes within a month or two for most people who do not reinjure or restress the slipped disks.
Physical Therapy
When people with slipped disks recover enough mobility, flexibility and strength to exercise, their doctors usually prescribe courses of physical therapy. Physical therapy for a slipped disk ranges from the application of heat and cold to self-guided exercises programs and traction or ultrasound treatments by trained professionals. The duration and complexity of physical therapy depends on the degree of damage and the goals of treatment. Young people with physically demanding jobs typically receive more intensive physical therapy than retired senior citizens.
Pain Medications
The use of over-the-counter and prescription medications that reduce swelling and relieve pain usually factors into standard medical treatments for slipped disks. OTC nonsteroidal anti-inflammatory drug options include ibuprofen (Advil) and naproxen (Aleve). These also are available in prescription-strength versions, and two other prescription-strength NSAIDS often prescribed to people with slipped disk are celecoxib (Celebrex) and meloxicam (Mobic). A third medication option is an opioid analgesic. These products typically combine an OTC painkiller or an NSAID with a narcotic painkiller. Two products that a person with a slipped disk may take if no other medications provide relief are acetaminophen-hydrocodone (Vicodin) and ibuprofen-hydrocodone (Vicoprofen).
Muscle Relaxants
People with slipped disks often experience muscle spasms in their backs, which can contribute to the herniation of disks by putting pressure on vertebrae. These muscle spasms may occur because people adopt unhealthy postures to relieve back pain. A commonly prescribed muscle relaxant for people with slipped disks is cyclobenzaprine (Flexeril).
Surgery
The authors of a Medline Plus fact sheet list three surgical options for people whose slipped disks have not responded to any other treatments. With a procedure called chemonucleolysis, doctors inject an enzyme directly into the herniated portion of a disk's nucleus, and the enzyme destroys the swelling material. With a complete diskectomy, a surgeon removes most or all of a slipped disk. A microdiskectomy involves the surgical removal of portions of a slipped disk.
Acupuncture/Acupressure
Acupuncture and acupressure employ techniques from Chinese medicine to reduce pain and redirect flows of a life force called chi. If nothing else, having a skilled acupuncturist insert needles into the skin at specific spots along the spinal column triggers the release of pain-dulling endorphins into the patient's blood stream. Acupuncture needles may also temporarily block the transmission of pain signals from a slipped disk to the brain. With acupressure, a trained therapist applies varying degrees of pressure to the spot at which an acupuncturist would insert needles.
Massage and Adjustment
A deep-tissue massage can loosen spasming muscles, and chiropractic adjustments can realign vertebrae to relieve pressure on slipped disks. The Mayo Clinic notes that chiropractic techniques work best when the pain from a slipped disk is minor.
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