Symptomatic treatment for herniated discs is the working rule-of-thumb when it comes to the medical and complementary-medical management of suspected problematic intervertebral conditions. The vast majority of therapies offered to patients qualify as symptomatic care methods, rather than curative practices. Symptomatic treatment is a term used to describe any therapy modality which seeks to provide respite from the pain, and related neurological complaints, but does nothing at all to resolve the underlying reason for the symptoms to exist. In essence, these treatments do not act on the actual herniation itself.
Symptomatic care is a very controversial topic and will likely remain a debatable issue for decades to come. While it is great to enjoy pain relief, many patients really want to be cured. Since many symptomatic modalities are often offered without explaining their highly limited curative efficacy, certain ethical considerations often surface in the treatment process.
This commentary investigates the typical symptomatic care options for intervertebral herniations, as well as provides an analysis of the problems that are associated with ongoing symptom-based treatment.
Symptomatic treatment consists of virtually every nonsurgical conservative care practice that is used to treat herniated discs. There are even a few minimally invasive surgical techniques that qualify to be called symptomatic approaches to care. None of the typically prescribed treatment modalities have any real hope of resolving a herniated disc. These therapies do not, and can not, alter the spinal anatomy, so they do nothing to address the source process of pain; the intervertebral protrusion.
In essence, these symptomatic treatments for herniated discs are exclusively utilized to make the patient more comfortable, instead of curing them of the causative condition.
The most often used symptomatic care methods for herniated discs include drugs, epidural injections, chiropractic, massage, physical therapy, acupuncture and TENS. In very rare instances, chiropractic might enact a true and enduring cure, by working to fix the underlying disc problem.
Surgical nerve ablation techniques, such as neurotomy and cryoanalgesia, can be considered symptomatic care. Surgical pain management procedures, such as the implantation of a spinal cord stimulation unit, are also considered symptomatic care.
It is great that the medical professions can offer some truly effective forms of relief from chronic disc pain. We certainly have no complaint with patients wanting to enjoy some pain-free time, nor do we blame doctors for trying to provide it.
We do take issue with the fact that most caregivers do not explain the limited symptomatic nature of these care practices to their patients. Most patients are under the impression that their treatment plans are designed to cure their herniation and heal their backs. This was certainly the deceitful way it was explained to me, by literally dozens of different doctors, chiropractors and complementary therapists from various healing arts.
Not once did a care provider tell me: "This treatment will make you feel better, but will not cure you. You will still need to hope that the disc heals itself or you will eventually need find a better long-term solution for your pain."
All we ask from doctors is simple honest disclosure to their patients. Do not mislead them or lie to them about their prognosis, especially as it relates to your proposed therapy options. Do not leave out the fact that the recommended care is symptomatic in nature. Also, please do not get them addicted to pain management drugs, or keep them in treatment indefinitely, just for the sake of making even more money from their misery.
Money is an important motivating aspect of this topic. Sure, curative methods of care certainly do exist. These include many surgical techniques and noninvasive spinal decompression. However, these practices will prevent a patient from becoming an ever-returning source of income. Symptomatic care is incredibly profitable. Many patients will seek treatment for months or years, while others will acquiesce to continuing therapy for life. Think about the income this generates for doctors and therapists around the world. If all these patients were cured, imagine the economic void it would leave.
Now, it is super clear why symptom-based care has become the norm, rather than the exception.
This article is dedicated to all the patients who somehow "woke up" and realized that all those years spent in chiropractic treatment, in massage therapy or taking daily doses of pills, did nothing to heal them. All these practices may have promoted the pain as the star player in the patient’s life and perpetuated the duration of the symptomatic expression, while simultaneously depleting the patient’s financial resources. Do not let precious years of your life slip away as a slave to symptomatic treatment for herniated disc pain. Instead, work to find a cure, whenever possible. Sure, we understand that this option is not viable for all, but cures do exist for most. It is just a matter of finding the best approach to achieve successful resolution.
If you need help breaking free from symptom-based care, talk to your doctor about exploring other treatment options. If this doctor happens to be the one providing the symptomatic treatment, do not forget that they might have financial motivations for wanting to keep you in continuing care indefinitely. In this case, get a new opinion from an objective third-party physician.