09/03/2013 // Concord, CA, USA // LifeCare123 // Greg Vigna, MD, JD // (press release)
During my clinical practice it was often very difficult to tell a patient with acute back pain and leg pain, often referred as sciatica, that they have a large herniated disc that has shot out of the disc into the space outside the capsule of the disc onto the nerves and nerve roots. This type of disc herniation is called an extruded disc.
The patient’s immediate thought in this scenario is “Oh my God, I need surgery.” This is simply not the case. Studies indicate that in patients without worsening symptoms or worsening weakness that are managed conservatively for more than two months with epidural steroids, selective nerve root blocks, anti-inflammatories, and physical therapy often do not require surgery.
Several studies with advanced imaging tools involving large extruded herniated discs indicate that these herniated discs decrease in size and the body resorbs the disc. With decreasing size there is decrease in pressure and pull on the nerve root, which produces the pain and weakness present in herniated lumbar discs.
Therefore, don’t jump into surgery until waiting two months if you are not having progressive pain and weakness. Even with large extruded herniated discs recommends Greg Vigna, MD, JD.
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