A ruptured disc in the lower spine causes increased pressure on the nerves coming from the spinal cord, which can lead to severe pain, according to "Understanding Medical Surgical Nursing" by Linda Williams and Paula Hopper. When a protrusion of a disc occurs in the lower spine, shooting pain down the leg may be present. Many options are available to treat this common diagnosis.
Medications
Pain medications, also called analgesics, can decrease the sensation of pain caused by a ruptured disc. The three most common types of pain medications used for acute and chronic pain are opioids, nonopioids and adjuvants. Nonopioids, such as anti-inflammatory medications, can decrease inflammation and are effective at reducing the irritation of nerve roots in the spine. Narcotic medications, also called opioids, are prescribed to patients with severe pain. Adjuvant drugs relieve pain but are for a different medical purpose, note Williams and Hopper. Physicians determine the medications given for pain and the length of time they are prescribed.
Physical Therapy
Physical therapy is a conservative treatment measure most physicians prescribe as a first line of treatment for pain relief. The spine is stabilized by several muscles, and the physical therapist focuses on strengthening those particular muscles to help decrease pain. A therapist will design an individual treatment plan based on each patient's ability level. Most treatment plans require a patient to attend physical therapy two or three times per week.
Epidural Injections
The goal of epidural steroid injections is to decrease pain caused by the ruptured disc. The injections have a combination of medications in them and can only be placed into the spinal area by a specially trained physician. The medications given during the injection include steroids, long-acting pain relievers and long-acting anesthetics, report Williams and Hopper. The long-acting anesthetic numbs the nerve that the ruptured disc has irritated, allowing instant relief, while the steroid works to reduce the swelling around the nerve for a long-term effect. Epidurals are generally completed in a series of three injections for low back pain relief, states Dr. Anthony Freeman of Great Seal Pain Management.
Back Surgery
Several different surgeries can treat a ruptured disc, according to Williams and Hopper. A laminectomie procedure removes a section of bone from the spinal column in order to decrease pressure or to allow access to the ruptured disc. Physicians can also remove a ruptured disc during a procedure called a diskectomy if the disc can not be repaired. Another common back surgery performed to relieve pain is a percutaneous diskectomy, which requires a needle insertion into the faulty disc to remove part of the ruptured disc. Laser disc surgery can break up ruptured tissue and is routinely performed, reports the California Orthopedic Medical Clinic.
References
- Pain Management Center in Paducah Kentucky
- The Mayo Clinic: Back Pain
- California Orthopedic Medical Clinic, INC.
- Dr. Anthony Freeman, D.O.; Great Seal Pain Management; Chillicothe, Ohio
- "Understanding Medical Surgical Nursing"; Linda Williams and Paula Hopper; 2003
Member Comments