The spine is the body’s main support structure. It serves as a foundation and protects the body from injury and stress. The spinal column consists of 26 individual vertebrae connected by intervertebral discs. These discs allow the spine to move and provide shock absorption, softening the load. Each disc consists of a tough outer fibrous ring (annulus fibrosus) and a soft inner pulpy core (nucleus pulposus).
The spine ages just like all other organs in the body. Age, excess weight, previous injuries, and harmful habits all negatively affect it. As a result, the fibrous ring often tears, and a small portion of the pulpy nucleus protrudes outward, compressing nerve endings of the spinal cord. This condition is called an intervertebral disc hernia. The nucleus pulposus substance acts as a chemical irritant to nerve tissue, causing local inflammation, swelling, and microcirculatory disturbances. This leads to local irritation of sensory receptors and muscle spasms, resulting in pain and limited mobility in the affected area.
When treating intervertebral hernias, it is important to not miss the window for conservative treatment to avoid surgery and its possible complications. Timely consultation with a specialist allows for an early diagnosis, halts progression, and prevents complications.
When acute pain, weakness, or numbness arise, doctors often prescribe nonsteroidal anti-inflammatory drugs (NSAIDs) such as diclofenac, indomethacin, piroxicam, and others. These drugs work by reducing inflammation in the compressed nerve root and often effectively relieve pain. While they do not cure the hernia itself, these medications can significantly ease the patient’s condition during treatment, providing relief from pain and pain-related insomnia. NSAIDs are considered first-line treatment — usually the starting point in therapy.
Muscle relaxants help relax skeletal muscles, relieve painful muscle spasms, and improve blood circulation to some degree. This sometimes reduces pain slightly. However, muscle relaxants relax all muscles, meaning that while they relieve spasms, they also eliminate the beneficial protective muscle tension. Therefore, their use can sometimes worsen the patient’s condition.
In addition to medication, treatment of disc hernias includes manual and physical therapy, as well as therapeutic exercises aimed at strengthening muscles that stabilize the vertebrae. However, if pain persists despite conservative treatment, a more effective minimally invasive method — percutaneous nucleoplasty — is used. This method does not disrupt the anatomical structure of the spine and allows patients to recover quickly and return to normal life.
Percutaneous nucleoplasty consists of two stages:
- Injection of Discogel into the intervertebral disc without opening the spinal canal. Discogel acts on the nucleus of the disc in such a way that the protrusion retracts. Due to ethanol’s absorption of water from the nucleus pulposus, immediate decompression occurs, relieving internal pressure on the spinal nerve roots and eliminating pain.
- Injection of corticosteroid drugs into the affected area helps reduce inflammation between the vertebrae and relieve spasms.
Additionally, therapy may be supplemented by neuromuscular stimulation procedures, which help eliminate pain syndrome and address problems related to a sedentary lifestyle (muscle weakness and atrophy).
Often, for several weeks after the procedure, doctors recommend wearing orthopedic insoles for sensory balance, and elderly or nervous patients may be prescribed Bach Flower® homeopathic remedies to relieve stress and promote nervous system recovery.
TREATMENT OF HERNIATED DISCS
Nucleoplasty is a minimally invasive procedure developed to treat disc herniation. Based on symptoms and MRI data, the doctor determines which disc(s) are causing pain. Percutaneous nucleoplasty can be applied to any segment of the spine, and it is possible to treat multiple hernias in a single procedure.
Under visual control using an angiograph that provides millimeter accuracy, and under local anesthesia, a puncture needle is inserted into the center of the herniated intervertebral disc. Through this needle, Discogel is slowly injected using a special syringe.
Discogel has a pronounced therapeutic effect. Its mechanism of action is based on a physicochemical process: necrosis and dehydration of the nucleus pulposus. Discogel works through the hygroscopic effect of ethanol, which osmotically acts on the water contained in the nucleus pulposus. By absorbing water from the nucleus pulposus, ethanol causes immediate decompression and pain relief. After the injection, Discogel remains in the disc, thereby preventing any type of destabilization. The patient’s condition is monitored using ECG, blood pressure monitors, and oxygen level measurement devices.
Corticosteroid injections into the epidural space and tissue near the compressed nerve relieve pain, reduce inflammation, and reduce swelling of the soft tissues around the nerve and the compressed nerve root itself.
At the end of the procedure, the needle is withdrawn from the intervertebral disc, the puncture site is treated and covered with a dressing. No scars or wounds form on the skin or spinal canal. Since no other invasive interventions are performed during the procedure—such as muscle or bone incisions—the recovery is very fast, and the patient can quickly return to normal life.
Discogel contains tungsten nanoparticles—a contrast agent that allows visualization of the gel’s spread within the disc under radiological control and later monitoring of the healing process of the damaged discs.
NEUROMUSCULAR STIMULATION
Neuromuscular stimulation is a fundamental procedure in the treatment of intervertebral hernias, as well as in the rehabilitation and strengthening of the back’s muscular corset after the procedure. The use of a neuromuscular stimulation device allows targeted effects on the patient’s back muscles through low-frequency electrical currents. The stimulation is delivered via special electrodes that the doctor places on the affected area of the back. Under the influence of neuromuscular stimulation, nerve conductivity increases, and the recovery of damaged nerves accelerates.
As a result of the treatment, the synthesis of biologically active substances in the tissues increases, metabolic waste products, toxins, and slags are removed, swelling is reduced, and normal functioning is restored. Blood supply and metabolism improve in the back muscles surrounding the spine. The back muscles become stronger and more efficient. Neuromuscular stimulation causes active muscle contractions, which have a pronounced training effect and restore the proper structure of the muscular corset, which may have been disrupted due to prolonged poor posture caused by pain.
Pain caused by hernias may also have psychological causes. The patient’s emotional state—feelings of anxiety, tension, and fear of the procedure—can contribute to additional pain sensations. For this reason, doctors recommend the use of Bach Flower essences, which have been produced since 1975 and are recommended by the WHO for use in cases of emotional stress to help relieve nervous tension.
PARAVERTEBRAL LIPOSUCTION
There are areas on the back where some people accumulate excess fat deposits. Excess weight puts additional strain on the discs in the lower back. Sometimes it is impossible to get rid of back pain without normalizing weight. In such cases, liposuction is recommended. This is a minimally traumatic and relatively simple procedure that does not require hospitalization. Using a special device, fat is suctioned out through small incisions.
