Hi bodhisattva,
Here are a few resources that should introduce you to non-surgical
options for treating a Herniated Disc. Your wife?s doctor will
probably discuss them before mentioning surgery, but this way you will
hopefully be informed ahead of time and be able to make the most
appropriate decision regarding treatment options.
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Description
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First, all herniated discs require similar treatment, however it does
vary depending on the location along the spine. Most herniated discs
occur in the lumbar (lower) area, and the vast majority of information
about this problem is specifically for lumbar herniations. Only about
1% of all herniated discs occur in the thoracic area, due to the fact
that far less motion and stress occurs there. However, I have made
sure to keep the information here only about herniations specifically
in the thoracic area, a good outline of which can be found at:
[ http://www.drdillin.com/education/definitions_thd.htm ]
Second, it appears that surgery is only a last option if any of the
other options are unsuccessful:
?Surgery is eventually considered for about 10% of people who have
herniated discs.1 Surgery can be appropriate for people who have
progressive nerve damage or severe weakness or numbness, or for those
whose pain is not improved after 4 to 6 weeks of nonsurgical
treatment.?
[ http://www.healthwise.org/kbase/topic/major/HW226016/trtover.htm ]
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Treatments
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From the first link above:
?Non-Surgery Treatment
Most thoracic disc herniations put pressure on a single thoracic nerve
and those patients can be treated with non-operative measures:
restriction of activity, medications, physical therapy and injection
therapy. A thoracic disc herniation that produces symptoms from the
spinal cord is usually operated on.?
[ http://www.drdillin.com/education/definitions_thd.htm ]
In detail, it appears that the non-surgical treatment options are:
a) Restriction of activity: As herniation of a thoracic disc is caused
by pressure and motion on spinal nerves, a reduction of activity and
pressure on the spine will directly relieve pain and other symptoms.
Your wife?s doctor may recommend a general reduction of activity for a
period of weeks, and perhaps even confinement to bed.
b) Medications:
?Your doctor may prescribe pain relievers, nonsteroidal
anti-inflammatory medications (NSAIDs), and steroids. Sometimes muscle
relaxers are prescribed for muscle spasms.
-Nonsteroidal anti-inflammatory drugs (NSAIDs)?aspirin, naproxen
(Naprosyn), ibuprofen (Motrin, Nuprin, Advil), Celebrex, and Vioxx are
examples of nonsteroidal anti-inflammatory drugs used to reduce
inflammation and relieve pain.
-Analgesics, such as acetaminophen (Tylenol) can relieve pain but
don't have the anti-inflammatory effects of NSAIDs. Long-term use of
analgesics and NSAIDs may cause stomach ulcers as well as kidney and
liver problems.
-Steroids can be used to reduce the swelling and inflammation of the
nerves. They are taken orally (as a Medrol dose pack) in a tapering
dosage over a five-day period. They have the advantage of providing
pain relief within a 24-hour period.?
[ http://www.mayfieldclinic.com/pe/pe-HLDisc.htm ]
c) Physical Therapy:
?Physical therapists are skilled in treating acute back pain caused by
the disk herniation. The physical therapist can provide noninvasive
therapies, such as ultrasound or diathermy to project heat deep into
the tissues of the back or administer manual therapy, if mobility of
the spine is impaired. They may help improve posture and develop an
exercise program for recovery and long-term protection. Appropriate
exercise can help take pressure off inflamed nerve structures, while
improving overall posture and flexibility. Traction can be used to try
to decrease pressure on the disk.?
[ http://www.chclibrary.org/micromed/00051060.html#Treatment ]
d) Injection Therapy:
?Injections-
With most spinal injections, a local anesthetic called Lidocaine (also
known as Xylocaine®) is used to numb the injection site. A steroid
medication called a corticosteroid is also commonly injected along
with the anesthetic in order to reduce inflammation in the affected
areas.
Facet Joint Injection
When back pain originates from the facet joints (located in each side
of the vertebrae), a specific type of injection called a facet joint
injection may reduce inflammation and provide pain relief. Doctors use
fluoroscopy to ensure the needle is correctly placed before the
medicines are injected. Fluoroscopy is a special type of x-ray used to
project live images onto a monitor (TV screen).
Epidural Steroid Injection (ESI)
During an ESI, medications are injected into the ?epidural space?. The
epidural space is the area between the spinal sac and spinal canal,
which runs the length of the canal. As the medicine is injected into
the epidural space it coats the nerve roots and outside lining of the
facet joints.?
[ http://www.spineuniverse.com/displayarticle.php/article1477.html ]
? -Steroid injections into the area of your herniated disc may be
prescribed if your pain is severe. This procedure, performed under
fluoroscopy, involves an injection of steroids and an analgesic
numbing agent into the epidural space of the spine to reduce the
swelling and inflammation of the nerves. About 50% of patients will
notice relief after an epidural injection, although the results tend
to be temporary. This procedure is usually done in a series of three,
at 2-week intervals, to obtain the best results in the shortest time.
If the injections are helpful, the series can be done up to three
times a year.?
[ http://www.mayfieldclinic.com/pe/pe-HLDisc.htm ]
Please note: it appears that massage therapy is generally NOT used for
thoracic herniations, nor are chiropractic spinal manipulations, which
are generally only done on patients with cervical herniations. While
many patients probably have success with these methods, and you may
hear about them as options for herniated discs in general, they
probably are not viable treatment options for your wife, because of
the location of her injury.
I trust this information has shed light on your questions, but if you
require a clarification, please request one, especially before rating
this answer. Best wishes on your wife's treatment!
Regards,
-Andrewxmp
Search terms used:
"herniated disc" treatments
thoracic herniated disc treatment
Herniated thoracic Discs spinal manipulation
thoracic herniation "injection therapy" |
