We are constantly asked for herniated disc tips from recently diagnosed patients who already realize that they are in for a tough time in finding effective back or neck pain relief. After all, intervertebral herniations have terrible reputations as long lasting and excruciating problems, especially when located in the neck and lower back regions.
We have provided guidance for disc pain sufferers for over a decade and have been involved in chronic pain advocacy, research and education for almost 3 decades. We have written exhaustively on the subject of herniated disc advice, but still find readers wanting a bullet pointed list of things to do and things to avoid once they know that they have one or more herniated discs in their spines.
Therefore, the focus on this dialog is to provide super simple and straight forward suggestions on the best ways to become pain-free and functionally unlimited, despite having an abnormal spinal disc condition discovered on a diagnostic imaging study. By popular demand, here are our best tips for herniated disc patients worldwide.
Here are our suggestions for patients regarding the diagnostic process for herniated discs:
Never accept a diagnosis of herniated disc without proof positive offered by advanced diagnostic imaging, such as CT scan or MRI. A physical exam can not ever diagnose an intervertebral herniation, nor can the expressed symptomology. X-rays can visualize some variety of discal space aberration, but can not usually tell the difference between desiccation or herniation, unless the disc mass has calcified into an osteochondral bar.
If a doctor or chiropractor diagnoses a herniated disc without the benefit of evidence-based testing, consider finding a new care provider, as this one assumes far too much.
If a doctor or chiropractor concludes that any herniation located on imaging is the source of pain, without careful and exhaustive clinical correlation to the entire symptom set, consider finding a new caregiver. Statistics show that the vast majority of herniations are innocent of causing the types of pain that they are mistakenly blamed for enacting. Remember, most intervertebral abnormalities are not pathological in any way and will not enact pain. Of those which are not innocent, the symptoms should correlate by location and expression. A herniated disc will not often explain the breadth of symptoms blamed upon it, even if it does create some degree of pain or neurological deficit. In essence, the disc pathology might be just part of the causative equation.
Finally, being diagnosed with a herniated disc is completely normal. Virtually all adults demonstrate intervertebral abnormalities in the neck, lumbar area, or both. Some people have lots of intervertebral abnormalities, yet experience no pain at all. Meanwhile other people have intractable pain, yet lack herniations in the affected areas of the spine. Statistics clearly show virtually all mild to moderate herniations to be innocent and coincidental to any complaint of back or neck pain. Remember the old and completely true medical saying: “Atypical structure rarely accurately explains or predicts pain”.
Here are some easy tips for patients regarding herniated disc treatment:
First and foremost, most herniated discs are not the source of pain and do not require any treatment at all. This describes virtually all the usual herniation patterns reported clinically and only excludes particularly extreme examples of pathological disc conditions where there is no doubt that symptomatic spinal canal stenosis or neuroforaminal stenosis are occurring in relation to a terribly bulging or ruptured disc.
For discs that do require treatment, be sure to understand the difference between symptomatic care practices and curative practices. Symptom-based treatment will never resolve the disc condition, forcing the patients into literal slavery to the therapy for life. Curative treatment will actually resolve the bulge or rupture, hopefully also relieving the symptoms permanently.
Treatments are incredibly diverse. Remember that old medical adage, “Diversity in therapy is a sign of diagnostic error.” If herniated discs were truly the cause of the type of pain syndromes being commonly blamed on them, then treatment would be universally effective and would only consist of a few approaches to care. Instead, since literally hundreds of treatments exist for herniated discs, and since it is abundantly clear that none of the usual modalities work very well, it is easy to see why there is so much room for competition.
Herniated disc surgery is seldom needed and even less often successful. Of all varieties of back surgery, disc-related procedures fail more often than any other type of operation. The reasons for failed disc surgery range greatly, from misdiagnosis to re-herniation, to procedural complications to mindbody factors.
Conservative care generally has no hope of resolving a herniation and is therefore almost never considered a curative modality. The exception is modern spinal decompression; although this treatment does maintain some degree of controversy as to its safety and effectiveness, especially among traditional medical providers.
The following tips are universally applicable to all patients who know that they have one or more herniated discs or fear that they may have an intervertebral pathology causing their pain:
Always get at least one second opinion on the diagnosis of a herniated disc. Always get at least one second opinion on the best approach to treatment for a verified herniated disc. We actually recommend getting several professional opinions from different types of doctors before making any decisions about the accuracy of the diagnosis, its relation to the symptoms and the best path, if any, towards treatment.
Learn the facts about herniated discs. Become educated on the topic. Do lots of research. Be mindful of the sources you are using to perform this research. Are you being sold to? Many sources are trying push a particular treatment, product or agenda. Be watchful of marketing in the guise of objective advice.
Be sure to account for all the mind and body factors that could be responsible for causing pain. Herniated discs may or may not be part of the pain problem, but there are often other physical and psychoemotional factors that must be figured into the symptomatic expression.
Do not let any single doctor intimidate you into rush decisions regarding treatment. We consistently receive letters from patients who report doctors telling them that they need immediate surgery. These doctors even warn against the time needed to get a second opinion. These types of tactics should be red flags for any diagnosed patient. In virtually all cases, including in every single one we have seen in tens of thousands of readers, these quick and frightening surgical recommendations turn out to be unnecessary and on the verge of criminally negligent activity. The obvious exceptions are those that follow massive acute trauma, such as herniations that result in paralysis or cauda equina syndrome.