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The majority of patients do not need surgery. First, it is usual to recommend cold/heat or drug treatment . In most cases, symptoms are alleviated within four to six weeks, and less than 5% of back problems require surgery.
Cold/heat treatment. During the first 24 to 48 hours, cold treatment helps to decrease the blood circulation, decreasing swelling, muscle spasms, and pain. After the first 48 hours, heat treatment can be applied. The heat increases the circulation, allowing soft tissues to heat and relax. A greater circulation also helps to draw out and remove the irritating toxins that accumulate in the tissues as a result of the muscle spasm and the disc injury. Ice or heat should never be applied directly over the skin; it is recommended to wrap the source of heat or cold in a thick towel for a maximum of 15-20 minutes.
Drugs. The medications can include an anti-inflammatory drug to reduce the inflammation, a muscle relaxant to calm the spasms, and an analgesic to alleviate acute pain of short duration. Mild to moderate pain can be treated with non-steroidal anti-inflammatory drugs (NSAIDs). These latter alleviate both the swelling and the pain. In extreme cases, an opioid analgesic may be prescribed.
Physiotherapy. Physiotherapy includes a combination of non-surgical treatments to decrease the pain, and to increase flexibility. Ice and heat treatment, a gentle massage, stretching, and neck traction, are some examples of this treatment.
Surgical treatment is considered when the conservative treatment does not alleviate the symptoms, or when compression of the spinal cord is suspected. When it is used to reduce the pressure on a nerve and the neck pain, the surgery includes the complete removal of the disc (discectomy), followed by the implanting of a spacer device, or the replacement for a prosthetic disc.
This surgery is performed via the anterior part of the neck, which is called micro-discectomy and arthrodesis, or anterior disc replacement. These procedures are very often performed using minimally invasive techniques. Minimally invasive surgery does not require large incisions, but makes small cuts and uses specialised minuscule instruments and devices during the operation, such as a microscope and an endoscope.
Published: 25 October 2019
Updated: 25 October 2019
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