Optional Back Pain Therapies
Introduction
The purpose of this work is not to obsessively evaluate
the merits of all the available therapies with exhaustive
statistics and intricate details; however, it would not
be complete unless I gave some direction to those who's
back pain is not alleviated by The O'Connor Technique
(tm) and are forced to seek other relief from disc herniation
pain.
TENS (Transcutaneous
Electrucal Nerve Stimulation)
This methodology relies upon a small pulsating current
of electricity to basically confuse the nerve impulses going
up the spinal cord to the brain. It is possibly functioning
on the same level as acupuncture, the effect of which is
poorly understood and explained; however, in some people
it works.
Ice and Heat
The Gateing Theory of Pain also probably explains why
ice and heat both seem to reduce pain.
Acupuncture
Not one to immediately dispel the possibility that acupuncture
helps pain, I feel that it is highly unlikely that sticking
a little needle in a distant part of the body will have
any effect upon the physical nature of herniated disc pain.
Trigger
Point Point Injections
These rank very close to acupuncture in my view as a
therapy. If someone thinks they can permanently affect pain
caused by a mechanical impingement upon nerves by injecting
an anesthetic at some distant point, they are only masking
the pain if it helps at all.
Epidural Steroid
/ Aneshetic Injections
I rank this therapy within the realm of last resorts
and believe it is treating only the symptoms, not the source
of the pain.
Chemonucleolysis
This is a technique in which a protein digesting enzyme
(chymopapain) is injected into the central disc space and
allowed to actually digest the disc material.
Surgery
Everyone with severe back pain is confronted by the
inevitable concern--Will I need surgery? Too often, the
decision is not well-thought out, made in desperation, or
undertaken with unreasonable expectations.
Percutaneous
Diskectomy
Of all the available therapies for degenerative disc
disease the most promising and least traumatic involves
the use of a large needle-like device that enters the disc
space and removes the painful disc material in a piecemeal
fashion with a cutting device on the tip (or a laser which
vaporizes the offending disc material) allowing it to be
vacuumed out.
Microdiskectomy
Often, adequate decompression of the spinal cord or
nerve root can be achieved by microdiskectomy. In this procedure,
a hemilaminotomy (partial removal of the disc) is done through
a tiny skin incision, and herniated disk material is removed
with the aid of an operating microscope.
Laminectomy
One of the alternatives to diskectomy include laminectomy
(or more properly termed a laminotomy) in which a portion
of the vertebral bone directly posterior to the site of
herniation called the lamina is removed.
Artificial
Discs
A new option that is currently undergoing clinical trials
involves replacing the problem disc with an artificial prosthetic
disc. It is currently too early to tell if these will be
successful; but they apparently hold promise.
Fusion
The more disc material that is removed or the more simple
discectomy surgery that is done increases the instability
of the spine, often necessitating fusion surgery later as
the disc continues to degenerate.
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