Disk Herniation

WHAT YOU SHOULD KNOW:

• A lumbar disk, or intervertebral disk, is a sac filled with a gel-like material found between your vertebrae. Your vertebrae are the bones in your back that are linked together to form your spine. Your lumbar disks and vertebrae are found in your lower back. Your vertebrae and disks help your spine and body support your weight. Your spine surrounds your spinal cord that contains your nerves. Lumbar disk herniation occurs when the gel-like material bulges or leaks out from your vertebrae. A weak disk, injury, or cracked vertebrae may cause your disk to herniate. The herniated disk may press on your nerves or spinal cord. A herniated lumbar disk may be painful and decrease your movement.
  
  
• You may feel pain in your lower back, buttocks, groin, or legs. Your legs may be numb (lose feeling), or they may have a burning or tingling feeling. You may have trouble walking or moving your legs. You caregiver may check your spine and feel for areas that cause you pain. Imaging tests such as magnetic resonance imaging (MRI), a computed tomography (CT) scan, and a myelogram may be needed. Treatment may include medicines, injections, physical therapy, and surgery. Having your lumbar disk herniation treated may decrease your pain. You may be able to move and function in your daily life better. Treatment may also prevent your nerves or spinal cord from being permanently damaged.

AFTER YOU LEAVE:

Take your medicine as directed.

Call your primary healthcare provider if you think your medicine is not helping or if you have side effects. Tell him if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

• Pain medicine: Caregivers may give you medicine to take away or decrease your pain.
  
  
  • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.
    
    
  • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.
  
  
• Muscle relaxers: This medicine helps relax your muscles. It is also given to decrease pain and muscle spasms.
  
  
• Nonsteroidal anti-inflammatory (NSAID) medicine may decrease swelling and pain or fever. This medicine can be bought with or without a doctor's order. This medicine can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask your primary healthcare provider if NSAIDs are safe for you. Always read the medicine label and follow the directions on it before using this medicine.
  
  
• Steroids: Steroid medicine may be given to decrease inflammation, which is pain and swelling.

Follow-up visits:

You may need a follow-up visit so your caregiver can check your wound if you had surgery. You may need follow-up visits for steroid injections to decrease your pain. Ask your caregiver when to return for a follow-up visit. Keep all appointments. Write down any questions you may have. This way you will remember to ask these questions during your next visit.

Activity:

Try not to sit for long periods of time. Avoid heavy lifting while your back is healing. Ask your caregiver what activities you can do, and when you can go back to your usual activities.

Acupuncture:

You caregiver may suggest you try acupuncture treatments. Acupuncture may help to decrease your back pain. Ask your caregiver for more information about acupuncture.

Behavioral management:

The pain from a disk herniation may cause you to feel stressed and sad. The pain that you feel may make it hard for you to do your usual activities. Your caregiver may work with you to learn ways to cope with your feelings. Your caregiver may also help you find ways to stay relaxed and calm. Learning to cope with your pain may help you stay focused on your healing. Your caregiver may work with you on the following:

• Biofeedback training: Biofeedback is a special way to control how your body reacts to things like stress or pain. The first step in this training is to use electrodes (wires) to monitor your body responses. These electrodes are placed on different parts of your body, such as your chest. The electrodes are attached to a TV-type monitor which gives a paper tracing of your heart beating. You will learn how to control body changes, such as slowing your heart rate, when you become upset.
  
  
• Relaxation therapy: Stress may cause pain, lead to illness, and slow healing. Relaxation therapy teaches you how to feel less physical and emotional stress. Deep breathing, muscle relaxation, and music are some forms of relaxation therapy.

Exercise:

Exercises that do not stress your back muscles may help decrease your pain. Examples of low stress exercises are walking, swimming, and biking. Exercise can also help decrease your risk for blood clots if you had surgery. Talk to your caregiver before starting any new exercise program.

Ice and heat:

Putting ice or heat on your lower back may help decrease your pain. Ask your caregiver for more information about how often to apply ice or heat.

Physical therapy:

During physical therapy, you will work with a special caregiver on exercises to make your back stronger. These exercises may also help to decrease your pain. You will need to start slowly and increase your activity as you get stronger. You may also learn better ways to bend, lift, sit and stand to decrease your risk for low back pain.

Quit smoking:

It is never too late to quit smoking. Treatments for your disk herniation may work better if you do not smoke. Smoking harms the heart, lungs, and the blood. You are more likely to have a heart attack, lung disease, and cancer if you smoke. You will help yourself and those around you by not smoking. Ask your caregiver for more information about how to stop smoking if you are having trouble quitting.

For support and more information:

Contact the following:

• American Academy of Orthopaedic Surgeons
  6300 North River Road
  Rosemont , IL 60018-4262
  Phone: 1- 847 - 823-7186
  Web Address: http://www.aaos.org/
  

• American Chronic Pain Association
  PO Box 850
  Rocklin , CA 95677
  Phone: 1- 800 - 533-3231
  Web Address: http://www.theacpa.org
  

CONTACT A CAREGIVER IF:

• You have a fever.
  
  
• You have decreased feeling and numbness in one or both of your legs.
  
  
• You have pain when resting.
  
  
• You have trouble moving one or both of your legs.
  
  
• You have worsening pain at night.
  
  
• Your pain worsens even after taking your medicines.
  
  
• You have questions or concerns about your condition, treatment, or care.

SEEK CARE IMMEDIATELY IF:

• You have sudden trouble breathing.
  
  
• You begin leaking urine or stool, and it is not normal for you.
  
  
• You do not feel anything when you urinate or have a bowel movement.
  
  
• You are unable to move one or both of your legs.
  
  
• You lose feeling in your groin or buttocks.

Learn more about Disk Herniation (Discharge Care)