Patient: I have been diagnosed with a protruding disk but advised not to have surgery. The worst pain is at night in bed and getting up in the morning – for about an hour afterwards, it hurts. Panadeine forte doesn’t relieve the pain. Is there anything I can do to alleviate this?
Doctor: The back pain caused by a herniated disk is due to a nerve compression that can produce an inflammatory process affectin g nerve roots (neuritis). The bulging of the content of the disk is more common in the lumbar region than in the cervical region. The bulging may or may not be clinically significant. Some patients with bulges are symptomatic and have a lot of pain, while others remain totally asymptomatic.The treatment strategy would be as follows: try to keep a proper posture, avoiding repetitive cervical and lumbosacral stress (example weight lifting), adhering to a healthy lifestyle and proper nutrition, physical activity, losing excess of weight, smoking cessation, seeking medical advice in a timely manner when indicated. During the pain crisis a physical therapy program should be followed and aimed to reduce pain and inflammation. For patients that show poor response to these measures the surgical option may be considered.