15 March 2019 Autor: Álvaro Lima Degenerative disc disease should be treated after imaging diagnosis has been performed, taking into account the symptoms experienced by the patient. Lower back pain: medical and preventive measures In the early stages, lower back pain should be treated with medical and preventive measures: Change in habits: take care when undertaking physical exertion, avoid incorrect posture and do physical exercise; Physiotherapy: massage, ultrasound and specific exercise programmes; Weight control; Medication: muscle relaxants and anti-inflammatory agents. In lower back pain involving sciatic pain and numbness of the lower limbs, medical treatment or surgical treatment may be indicated. What can you do when you are suffering from cervical pain? In the event of lower back pain, the initial treatment should be medical: Rest; Medication: anti-inflammatory agents, muscle relaxants and analgesics; Physiotherapy: treatment programmes created in response to the specific characteristics of each case, which could include massage, ultrasound or specific exercise programmes. When should surgical treatment of a herniated lumbar disc be considered? Spinal herniation is one of the areas dealt with by neurosurgery and orthopaedics. Surgical treatment may be indicated when: A herniated disc is diagnosed and there is a strong correlation between the images and the patient's complaints; Conservative treatment carried out for 4 to 8 weeks has failed, depending on the patient’s degree of incapacity; A motor deficit is diagnosed, usually with regard to the movement of the feet, in which case surgical treatment needs to be performed as soon as possible in order to maximise the chances of neurological recovery. What is the surgical procedure? Surgery is carried out under general anaesthetic and with a posterior approach to the spinal canal in order to remove the displaced fragment of disc. After a small incision has been made in the skin , the muscle planes are dissected so that the back of the spine can be reached and part of the bone and yellow ligament which make up the posterior wall of the spinal canal is removed. The displaced intervertebral disc fragments are removed from inside the spinal canal and the decompression of the affected nerve root is confirmed . It is sometimes necessary to remove further fragments from the inside of the intervertebral space in order to avoid recurrence of the herniated disc . This can be done with minimally invasive techniques involving small incisions of the skin and muscle, which allows for: Faster, less painful recovery; A quick return to a normal, active life. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
