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What Is The Treatment Protocol For A Herniated Disc?

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Posted on Thu, 8 Nov 2012
Question: What is the usually treatment protocol for a herniated disc ? My symptoms are numbness in my fingers , pins and needles in toes and tight forearms at times
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Answered by Dr. Saurabh Gupta (2 hours later)
Hello,

Thanks for posting your query.

I guess you are diagnosed with cervical disc herniation. The following is the treatment protocol options available to you:

1. First line of treatment for a cervical herniated disc is to take care of pain. Anti-inflammatory medications such as ibuprofen (e.g. Advil, Motrin) or COX-2 inhibitors (e.g. Celebrex) can help reduce the pain. For patients with severe pain from a herniated disc, oral steroids (such as Prednisone) may give even better pain relief. However, these medications can only be used for a short period of time (one week).

2. Additional conservative treatment options for a cervical herniated disc include-
*Physical therapy and exercise- Exercises can be used to help reduce the pain in the arm. In the initial period a physical therapist may also opt to use modalities such as heat/ice or ultrasound, to help reduce muscle spasm.
*Cervical traction- Traction on the head can help reduce pressure over the nerve root.
*Chiropractic manipulation.
*Osteopathic medicine.
*Activity modification- Avoid activities like heavy lifting (over 50 pounds), activities that can cause increased vibration and compression to the cervical spine (boating, snowmobile riding, running, etc.), and overhead activities that require prolonged neck extension and/or rotation.
*Bracing. In some instances a cervical collar or brace may be recommended to help provide some rest for the cervical spine.
*Injections. Epidural steroid injections or selective nerve root blocks can be helpful to reduce inflammation in cases of severe pain.

3 Surgical interventions may be recommended when all of the following are present:
* Definite cervical root compression on diagnostic imaging studies
* Concordance symptoms and signs of cervical root-related dysfunction, pain, or both
* Persistence of pain despite non-surgical treatment for a minimum of six weeks, or presence of a progressive, functionally important motor deficit, or
* Cervical cord compression with clinical evidence of moderate to severe myelopathy

In your case it is not clear if you have any weakness of arms. If there are no noticeable weakness anti-inflammatory drugs and one of the conservative line of treatment can be helpful, unless MRI scan reveal a definite cervical root compression. Discuss with your orthopedic surgeon about these options.

Hope this information suffices. Let me know if you have any more concerns.

Wishing you good health...

Regards

Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Saurabh Gupta

Orthopaedic Surgeon, Joint Replacement

Practicing since :2004

Answered : 5930 Questions

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What Is The Treatment Protocol For A Herniated Disc?

Hello,

Thanks for posting your query.

I guess you are diagnosed with cervical disc herniation. The following is the treatment protocol options available to you:

1. First line of treatment for a cervical herniated disc is to take care of pain. Anti-inflammatory medications such as ibuprofen (e.g. Advil, Motrin) or COX-2 inhibitors (e.g. Celebrex) can help reduce the pain. For patients with severe pain from a herniated disc, oral steroids (such as Prednisone) may give even better pain relief. However, these medications can only be used for a short period of time (one week).

2. Additional conservative treatment options for a cervical herniated disc include-
*Physical therapy and exercise- Exercises can be used to help reduce the pain in the arm. In the initial period a physical therapist may also opt to use modalities such as heat/ice or ultrasound, to help reduce muscle spasm.
*Cervical traction- Traction on the head can help reduce pressure over the nerve root.
*Chiropractic manipulation.
*Osteopathic medicine.
*Activity modification- Avoid activities like heavy lifting (over 50 pounds), activities that can cause increased vibration and compression to the cervical spine (boating, snowmobile riding, running, etc.), and overhead activities that require prolonged neck extension and/or rotation.
*Bracing. In some instances a cervical collar or brace may be recommended to help provide some rest for the cervical spine.
*Injections. Epidural steroid injections or selective nerve root blocks can be helpful to reduce inflammation in cases of severe pain.

3 Surgical interventions may be recommended when all of the following are present:
* Definite cervical root compression on diagnostic imaging studies
* Concordance symptoms and signs of cervical root-related dysfunction, pain, or both
* Persistence of pain despite non-surgical treatment for a minimum of six weeks, or presence of a progressive, functionally important motor deficit, or
* Cervical cord compression with clinical evidence of moderate to severe myelopathy

In your case it is not clear if you have any weakness of arms. If there are no noticeable weakness anti-inflammatory drugs and one of the conservative line of treatment can be helpful, unless MRI scan reveal a definite cervical root compression. Discuss with your orthopedic surgeon about these options.

Hope this information suffices. Let me know if you have any more concerns.

Wishing you good health...

Regards