Torn Disc Low Back Pain Diagnosis & Treatment Options
How to Diagnose Torn Disc Low Back Pain?
For a patient suffering from low back pain, it is essential to get the most accurate and thorough diagnosis, in order to select the best treatment options for a torn disc patient. An MRI is a significant diagnostic tool that allows the physician to observe any abnormalities or changes in the spine and the disc. On an MRI, torn disc can show up as a white high intensity zone on the posterior disc. In addition to the MRI, if one or more spinal discs are suspected as the pain source, the doctor may order a provocative discogram or discography. During this sterile procedure, the suspect discs are injected with a contrast dye to make each disc visible under fluoroscopy. Provocative discography helps the doctor to see the shape and size of the intervertebral disc. The injection of the contrast dye alters the pressure within the disc and may ‘provoke’ or reproduce the patient’s pain pattern thereby helping to isolate a particular disc as a pain generator.
What are the Treatment Options for Torn Disc/Discogenic Low Back Pain?
Treatment options for a torn disc/discogenic low back pain ranges from conservative therapies to surgical intervention. The goals of treatment are to relieve pain, prevent or reduce stress on the discs or spinal nerves, and maintain normal function. It is almost always recommended that patients be prescribed nonsurgical, conservative treatment initially to help relieve symptoms.
Non-Operative Treatment
- Medications: anti-inflammatories, muscle relaxers and, on rare occasions narcotic medications
- Heat/cold therapy
- Physical therapy exercises: including stretching, massage, and strengthening
- Epidural steroid injections are used two-fold; first to relieve inflammation of the affected spinal nerve, and secondly diagnostically to confirm the correct affected level from which the pain originates.
Least Invasive Procedures
Once conservative measures have been exhausted, and the patient is still in considerable pain after 6 months, then a least invasive procedure may be recommended. The treatment options for a torn disc have shown good results in minimizing and alleviating pain altogether in some cases:
- Endoscopic Discectomy: A ¼ inch incision is made and a 7mm operating tube is placed in the disc at the site of the annular tear. An endoscope with an HD camera is inserted into the operating tube to visualize the annulus and spinal nerves. Then the tear is debrided to make sure no nucleus pulposus is stuck within the annulus and thermally heated with bipolar instrument to reduce and close the tear.
- Stem Cell Therapy: Is an excellent treatment option for a torn disc/dicogenic low back pain. If you have a torn disc you may be good candidates for regenerative stem cell therapy, a less invasive healing option. Stem cells taken from your body’s bone marrow can help seal a torn disc and reduce low back pain. After conservative efforts have failed and the patient is still in pain, this is an excellent alternative to invasive surgery.
Minimally Invasive Spine Surgery
- MIS Microdiscectomy – Usually an open procedure or using tubular retractor with an incision of 1 inch. The surgeon usually observes through a microscope or eyeglass loupes that help magnify the anatomy. Most of the pain post-operative is from the approach the surgeon made through muscle in your back. Anesthesia is necessary.
- MIS TLIF – The surgery involves removing the damaged intervertebral disc and replace it with a piece of bone or PEEK cage packed with bone to assist in union or fusion of the two vertebral bodies over time. Screws are used to hold the disc still until it fuses.
