Treatments for Back Pain

Explanation by Dr. Ali Nemati Treatment of lumbar disc herniation depends on symptom severity, pain level, and functional impairment. The type and extent of disc herniation determine the appropriate therapy: ________________________________________ 1. Mild Disc Herniation • Pain may occur after daily activities. • Short-term rest (1–2 weeks) and reduced pressure on the back can relieve pain and prevent worsening. • Light exercises, such as walking in a pool up to chest level, are very effective. ________________________________________ 2. Moderate Disc Herniation • Requires more rest and careful monitoring than mild cases. • Pain medications can help, but using medication alone without rest and proper movement may worsen disc herniation. • If pain persists, minimally invasive procedures are recommended: o RF (laser) for painful joints and removal of pain-causing nerves o Intra-spinal injections to relieve shooting pain o Discogel injection to reduce disc pressure on the spinal cord, reducing pain up to 70% All procedures are performed under CT scan guidance to ensure precision and safety. ________________________________________ 3. Severe Disc Herniation • The only effective treatment is open surgery. • Surgery can rapidly relieve leg pain and reduce back pain. • Delaying surgery in severe cases with muscle weakness is dangerous and reduces the chance of recovery of motor function (e.g., foot drop or urinary/fecal incontinence). • If disc herniation is accompanied by vertebral slippage, spinal fixation with screws may be required. ________________________________________ Summary • Mild: rest, light activity, gentle exercises • Moderate: rest, pain medication, minimally invasive procedures • Severe: immediate open surgery, fixation if necessary Goal: Reduce pain, maintain daily function, and prevent permanent nerve and muscle damage.