My Spine - Lumbar
There are always four options :
How is it treated ?
�o treatment – This is acceptable if there is no serious nerve compression – therefore in the absence of spinal claudication or radicular symptoms . There are always people who choose this option for a variety of personal reasons . This is also the option that is chosen in people who have serious medical conditions that does not allow them to have a general anaesthetic . It is rare for this condition to become better without surgery and it usually follows a progressive course whereby the range and severity of symptoms increase .
Treatment that does not require intervention – Courses of painkillers and anti-inflammatory drugs can be combined with treatment from therapists to control symptoms . This is appropriate in patients with limited spinal claudication and radicular symptoms as well as in those patients who are medically unfit to undergo more invasive treatment .
Limited intervention – This include procedures such as caudal or sacral block , radiofrequency rhizotomy and Nucleoplasty . These treatments may be highly effective , have very few side-effects or complications and are performed as day procedures .
Intervention ( surgery ) – The indications for surgery are :
1 . Failed conservative management . This is when painkillers , anti-inflammatory medication and manual therapy such as physiotherapy and chiropractic treatment have been utilised for at least six weeks without improvement . 2 . Pain that does not respond to any other treatment modality and is sufficiently severe to the extent that it limits your daily activities and quality of life . This includes local lower back pain , referred pain and radicular pain . 3 . Muscle weakness due to nerve compression ( radicular weakness ). 4 . Cauda Equina syndrome and Conus Medullaris syndrome ( see the chapter Lumbar Slipped Disc ).
39