[KoK! Health] 4 out of 5 Patients with Herniated Disc Improve Without Surgery

Medical experts advise that 70-80% of patients with herniated discs can improve without surgery through medication and physical therapy. To prevent herniated discs, it is recommended to maintain proper posture and engage in consistent exercises that strengthen the back muscles.

Herniated Disc.
[Photo by Korea University Ansan Hospital]

According to Korea University Ansan Hospital, herniated discs (lumbar intervertebral disc herniation) were once common mainly among middle-aged and older adults, but recently, the number of young patients has been increasing. Especially for office workers who sit at desks for long hours, those who stand all day, or those who frequently use their backs at work, there is no room for complacency.

Between the vertebrae of the spine are discs that absorb shocks. When cracks develop in the annulus fibrosus surrounding the edges of the disc, and the nucleus pulposus inside the disc protrudes beyond the boundary of the vertebral bones, a disc disorder occurs.

Since herniated discs result from weakening of the annulus fibrosus, the likelihood of occurrence increases with age. However, due to genetic predisposition, habits, or trauma, the annulus fibrosus can weaken at a young age, causing disc herniation. In younger individuals, acute disc herniation caused by trauma or accidents is more common.

The main symptoms of herniated discs include sciatica extending from the buttocks to the legs, leg numbness, and radiating pain (pain originating from the affected area spreading to surrounding regions). Patients may also feel back pain and weakness in the legs.

Treatment for herniated discs can be divided into non-surgical and surgical methods. Although surgery is often the first treatment that comes to mind, 70-80% of patients experience symptom improvement within 4-6 weeks after onset without needing surgery. Non-surgical treatments include medication such as anti-inflammatory analgesics and muscle relaxants, physical therapy, and injection therapy where steroids are injected into the herniated disc area.

Professor Kim Beom-jun of the Department of Neurosurgery at Korea University Ansan Hospital explained, "If severe pain persists after 4-6 weeks from onset, surgery should be considered. If symptoms such as foot drop indicating motor nerve paralysis or urinary difficulties like weakened control over urination occur, early surgical treatment is necessary." He added, "Microscopic or endoscopic discectomy is commonly performed, and when conducted by an experienced neurosurgical spine specialist with accurate diagnosis, both surgical methods result in minimal scarring and rapid pain relief and recovery."

To prevent herniated discs, avoid slouching or sitting cross-legged on the floor for extended periods, as these postures put strain on the back. When lifting heavy objects, it is better to bend the knees and use leg strength rather than bending the back. When resting lying down, placing a pillow under the knees can help relax the back. Avoiding floor sitting and maintaining proper posture while sitting on chairs also helps.

Exercise is also important. Extension exercises, where the lower body is fixed on the floor or exercise equipment and the upper body is lifted backward, strengthen the back muscles. Abdominal exercises can also be helpful, but exercises like sit-ups that heavily involve back momentum can strain the back, so it is better to lift the upper body with knees bent.

Professor Kim advised, "Well-developed back muscles reduce the burden on the spinal joints and help prevent disc problems," but cautioned, "Avoid strenuous exercise during acute pain, and perform exercises only when there is no pain."

Professor Beomjun Kim, Department of Neurosurgery, Korea University Ansan Hospital. [Photo by Korea University Ansan Hospital]

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