Treating A Pinched Nerve Without Surgery. Is It Possible?

A pinched nerve can occur when the tough outer layer of an intervertebral disc (the cushion between the spinal bones) becomes damaged, causing the soft inner core of the cushion to bulge out.

The human spine is made up of several vertebrae: 7 in the neck, 12 in the mid-back, 5 in the lower back, and then 5 in the pelvis and 4 in the tailbone. Between these vertebrae, except in the tailbone and pelvis, there are discs that act as cushions. Each disc has a tough outer layer (the annulus fibrosus) and a soft, gel-like center (the nucleus pulposus). The annulus is incredibly strong, designed to handle the stresses of daily life.

However, sometimes the annulus can tear. If the nucleus pulposus experiences excessive or repeated pressure, it can rupture through the tear in the annulus. This is called a herniated disc (or Herniated Nucleus Pulposus, HNP), and it can cause significant pain on the lower back. If the herniated disc material presses on a nerve, it can cause shooting pain that travels from the buttocks down the leg — this is known as sciatica. HNP is more common in younger, active people.

A pinched nerve can occur in various parts of the body. Between the vertebrae, there are joints. The joints located at the back are called facet joints. Meanwhile, the intervertebral discs are located in the front.

Triggers of HNP

Heavy weightlifting can be a trigger for a pinched nerve, especially if performed without proper preparation, incorrect posture, or without supervision from a trainer. Improper posture, incorrect movements during exercise, and lifting weights beyond the body's capacity can all contribute to the problem. Another trigger for injury during exercise is the lack of stretching and warming up before exercising. Therefore, having adequate knowledge about exercise movements and supervision from a trainer are essential for injury prevention.

HNP Symptoms

Not everyone with HNP will experience the same symptoms, condition and severity of HNP can be definitively diagnosed through an MRI scan. Here are some of the common symptoms people may experience:

• Lower back pain, neck pain, shoulder and upper back pain
• If HNP occurs in the lumbar region, pain can radiate from the buttocks to the legs, varying in intensity from mild to severe. Symptoms may also include weakness in both legs. In certain cases, it can be accompanied by urinary and bowel dysfunction
• If HNP occurs in the cervical spine (neck), the most intense pain is typically felt in the shoulder and arm, along with numbness or tingling in the fingers.

Therefore, potential symptoms can include sensory disturbances (numbness, tingling, or pins and needles), muscle weakness or loss of strength, difficulty with urination and bowel movements, and in some cases, even problems with coordination and balance.

Diagnosing HNP

When visiting RS Pondok Indah with symptoms of HNP, patients will undergo a series of examinations, including:

1. A medical interview to gather information about patients medical history, daily activities, and any exercise routines that might trigger HNP
2. A thorough physical examination and review of patients medical history
3. Diagnostic tests to confirm the diagnosis, such as CT Scan atau MRI to visualize the spine or electromyography (EMG) to measure the electrical activity of muscles during contraction

HNP Treatment

The treatment for HNP varies depending on the symptoms and the severity of the disc herniation. It can range from conservative approaches to surgical intervention. In mild cases of HNP, rest, avoiding bending movements, and taking pain relievers and anti-inflammatory medications may suffice. For minimal HNP cases where pain persists despite conservative treatment, pain management with injections directly into the affected area may be considered.

However, if the pain in your lower back, neck, or back doesn't subside, radiates to your legs, or causes tingling and muscle weakness in your legs, to the point of interfering with your daily activities, more aggressive treatment options should be considered.

Conventional surgery or minimally invasive surgery with the help of scope can be used to relieve pressure on the irritated nerve. In cases where the vertebrae have shifted, more extensive surgery may be necessary to stabilize the spine.

To help prevent spinal problems, regular exercise focusing on strengthening your core muscles like your abs and back is essential. It's also crucial to maintain good posture, whether you're sitting at your desk or exercising. When lifting heavy objects, use proper form and avoid lifting beyond your capabilities. For high-intensity workouts, start gradually, tailor the excercise to your fitness level, and consider working with a trainer. Most importantly, maintain an ideal body weight, avoid smoking, and limit alcohol consumption.