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Dr. Andrew Rynne

Family Physician

Exp 50 years

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I have a herniated disk in my lumbar spine. Is surgery the only option ?

I have a herniated disk in my lumbar spine that is prolapsed 30% I have been told that surgery is the only option. I do not have debilitating pain I am Limited in range of motion and function both have been getting better with the phyio therapist. I was wondering if there are risks for not doing the surgery and just going with the physio. Is it possible that the body can heal itself or it surgery honestly the only awnser.
Tue, 10 Sep 2013
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Homeopath 's  Response
hi,
welcome to h & m,
for disc prolapse best available in homeopathy. you can treat your disease with medicines in homeopathy.medicines like pulsatilla ,mag phos,calc phos ,kalmia etc.so consult a homeo physician so that you can solve your problem.
take care.
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  User's Response
dawn's  Response
I will look for a local Homeopath to see if I can get more information.

I have been taking the numi juice and omega suppliments with allergies to sulfa and shellfish some of the natural remedies are not avalible to me but I have been taking the suppliments along with the traditional medical treatment I have come to the end of the traditional meds as they were all for pain now I will try the homeopath route and anyother option that may present itself.

I Thankyou for your time and your responce it means alot to me thanks again Dr. Sasi Kala.



Physical Therapist or Physiotherapist Shirish Sachdeva's  Response
Hello Dear,

I would like to make an emphasis here that you should continue the Physical Therapy you are taking for at least 2 months with initial 1 month as continuous therapy and next two months with the evaluation of the therapist can be made as alternate day session.

Also, add another supplement to your list - Methylcobalamine with 1500 mcg dose per day. It has an important role in your condition here. Brand name : Absolut-DM 1 at night before sleeping will definately help.

Do also take care of precautions which will prevent the increase of the slip further.

You will not require any surgery for sure.

Recover soon

Dr.Shirish Sachdeva
Orthopaedic & Neurological
Physical Therapy & Rehabilitation
Lifestyle Medicine Counsellor
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  User's Response
dawn's  Response

Dr.Shirish Sachdeva,

I thankyou for you message the hope of not needing surgery means the world to me.
I will look for the Absolut DM as soon as the stores open so I can start it as soon as possible.
I do have one question as you have stated.
"Do also take care of precautions which will prevent the increase of the slip further"
What percautions would you sugest I was just told to stop doing something if it hurts so I have not recived any really clear directions.
I will book into physio once a week for a min of two months then as you recomended go with what the theripists thinks.

Again I thankyou your time and information is appreciated more then you will ever know you have helped to give my life hope again in getting away from surgery. Many many thanks.
Physical Therapist or Physiotherapist Shirish Sachdeva's  Response
Hi Dear,

General precautions for a patient with disc slip would include:

1. Avoiding Forward bending
2. Maintianing a correct/erect posture all the time.
3. Not Doing activities involving heavy weight
4. Avoid use of Indian toilet seat
5. Avoid riding any bike/scooter/rickshaw
6. Prolonged sitting activities to be avoided
7. Maintainence of one posture for long time should be avoided
8. Use of a Belt may be advised in the initial stages
9. Physiotherapy forms an important aspect of strengthening your back. - "go for it"
10. Avoid any increase in weight.

You are most welcome dear, hope this helps.

Dr.Shirish Sachdeva
Orthopaedic & Neurological
Physical Therapy & Rehbailitation
Lifestyle Medicine Counsellor
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  User's Response
dawn's  Response
I have found this site http://northamericanspine.com/
they offer a non-invasive surgery that they say is way less risk then the traditional surgery..
Is this a good option or is it something to stay away from?
Orthopaedic Surgeon Dr. S S Soni's  Response
Hi,
Physiotherapy is a temporary measure in early cases. If you have unbearable pain & pain reappears when you stop physiotherapy, you should go for Surgical intervention(discectomy), since it is always better to have elective surgery than an emergency one.
Despite physiotherapy & all precaution disc bulge will increase with time & you have to very cautious throughout the life if you are adament not to go for surgery
there are very advance technique in discectomy now-a-days, which makes it very safe surgery & patient can perform all his routine work next day onward
I am doing discectomy with 1 inch incision by foraminotomy
You can contact me at drsssoni@gmail.com
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Physical Therapist or Physiotherapist Shirish Sachdeva's  Response
Hi Dawn,

Just to help you decide when to go for surgery, I would prefer you should go through these research studies (6 in number, all of them are abstracts, so it will bea easy for you to go through them). Think on your own and discuss with your clinicians.

http://journals.lww.com/spinejournal/abstract/1989/04000/nonoperative_treatment_of_herniated_lumbar.18.aspx

http://journals.lww.com/spinejournal/Abstract/1996/06010/Results_of_Surgery_Compared_With_Conservative.23.aspx

http://journals.lww.com/spinejournal/Abstract/1992/10000/The_Natural_History_of_Sciatica_Associated_with.13.aspx

http://journals.lww.com/spinejournal/Abstract/1998/01010/Contrast_Enhanced_Magnetic_Resonance_Imaging_in.15.aspx

http://journals.lww.com/spinejournal/Abstract/2001/03150/Long_Term_Outcomes_of_Standard_Discectomy_for.19.aspx

http://journals.lww.com/spinejournal/Abstract/1992/02000/Cost_Effectiveness_Analysis_of_Extended.10.aspx

Hoping its of help to you

Dr.Shirish Sachdeva
Orthopaedic & Neurological
Physical Therapy & Rehabilitation
Lifestyle Medicine Counsellor
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Orthopaedic Surgeon, Joint Replacement Dr. Abdullah Shafir. M's  Response
Hello
More than 90 % of herniated discs do not need surgery. Only if pain is very severe or there is numbness in both legs and radiating pain , or if your bowel and bladder habits are altered do u need to remove the disc by surgery. If you do not have any of the symptoms you can take physio and avoid surgery
Get well soon.
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Orthopaedic Surgeon, Joint Replacement Dr. Saurabh Gupta's  Response
Hello,
Thanks for writing to us.
You are suffering from prolapsed intervertebral disc( PIVD)where the nerves get compressed by the protruded disc. Having known this basic anatomy, you must avoid any activity that aggravates the condition, like bending forward and lifting heavy objects, sitting long hours on computer, inappropriate sitting posture, etc.
The medications will relieve pain and help muscles to relax. Physiotherapy shall also help a lot, especially exercises that strengthen your back. Kindly note that exercises should only be done when it doesn't hurt. Adequate rest and proper nutrition is equally important. Drink lots of fluids since dehydration affects the disc. If you feel better with this, surgery can be avoided.
Hope this helps you.You can cosult me again directly through my profile http://www.healthcaremagic.com/doctors/dr-saurabh-gupta/64132
Regards.
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Physical Therapist or Physiotherapist Arun kumar's  Response
ur on the ryt track .. continue with the physiotherapist .surgery is only the last option if everything fails .as u said ur pain is not debilitating ..
also do the proper lumbar stabilization exercises which will take care of ur future back pain .
do keep exercise routine and stay fit
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Physical Therapist or Physiotherapist Mathew Varghese's  Response
Regarding your case conservative management is the first option. If it fails resort to Invasive treatment and surgical procedures as a last resort or only in case of an emergency.Systematic and regular Physiotherapy is recommended under the guidance of an expert Spine Physiotherapist for good results.
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