Tips to Avoid Lumbar Spine Surgery

There can be several reasons for backache right from a herniated disc, facet hypertrophy, annular tear, listhesis, nerve root irritation, muscle spasm, ligament tear, and sacroiliac joints retroperitoneal abdominal organs amongst many others.

Nearly 95% of such patients can be treated without any surgical intervention.

Tips to avoid Lumbar Spine Surgery

1. Bed rest for one to five days, this will reduce the swelling of a herniated disc and nerve root, will ease pain from muscle and ligaments. Bed rest should not exceed for more than 5 days as prolonging it is not going to benefit the patient.

2. Medication: Non-steroidal anti-inflammatory drugs are the first line of treatment, they will improve the pain, mental well being and disability score. Self-medication is not advised especially in patients with history of diabetes and renal disease.

3. Walking – start small and building up the level of walking up to 60 minutes over the period of one month.

4. Exercise and physiotherapy are the most important parts of treatment. Doing gentle activities and exercise will strengthen the muscles which support the spine and reduce the pressure within the spinal canal. Any form of physical activity needs to be started in a slow and controlled pace, you can gradually step up depending on your comfort.

5. Epidural injections and Nerve Blocks – injections of short and long-acting anaesthetics and steroids into the epidural space and facet joins(epidural space is an area in the spine which contains nerves). This is an integral part of the treatment and helps avoid surgery.

6. Correct posture- sitting in the correct posture, workplace evaluation and avoid certain postures and weight lifting.

7. Lifestyle modification – weight loss, healthy well-balanced diet, quit smoking and alcohol.

8.Correction of psychosocial factors: Psychosocial factors such as stress, anxiety, depression aggravates backache.

Majority of patients doesn’t need surgery but select groups of patients with cauda equina syndrome (anaesthesia around the perineum, urinary retention and foot weakness) will need immediate surgery. Surgical intervention is also required in patients with back pain radiating to the legs, who are not responding to the conservative treatment over the period of time and are facing difficulty in walking over the period of distance and time(neurogenic claudication).