Ask the Doctor: ‘My husband suffers with back pain from a herniated disc — what are his options?’

”My husband suffers with terrible back pain from a herniated disc. His father had this same problem many years ago, and had a big surgery to reduce the pain. My husband refuses to see a consultant for fear of the surgery his father had. I keep explaining that medicine has substantially changed over the past 40 years and there may be other options available to him for treatment. Please can you tell me if there are other options, I need something to show him so he might agree to be seen?”

Answer from Mr Marcus Timlin, Consultant Spinal Surgeon, Beacon Hospital.

Yes, there are other options available for treating a herniated disc that your husband can explore.

Here are some of the most common non-surgical options:

Physiotherapy: A physiotherapist can work with your husband to develop a tailored exercise programme that can help reduce his pain and improve his mobility.

Medications: Over-the-counter pain relievers like ibuprofen or paracetamol can help manage mild to moderate pain. If his pain is more severe, he may need a prescription for stronger pain relievers, muscle relaxants, or nerve pain medications.

Epidural injections: These injections deliver corticosteroids directly into the space around the spinal cord, which can help reduce inflammation and pain.

It’s important to note that surgery may be necessary in some cases, but it’s not always the first or only option. Spine surgery for a herniated disc may be recommended in cases where non-surgical treatments have failed to provide relief or when the herniation is causing significant neurological symptoms that affect the quality of life.

Most patients’ symptoms will settle down with the non-operative treatments outlined above. For the small percentage of patients that surgery is required, treatment has improved dramatically over the years.

MRI allows accurate diagnosis, enabling smaller and less invasive approaches to surgery with less pain and faster recovery than was historically possible. Magnification and microscopy allows excellent visualisation of the structures and. Fusion navigation and robotic assistance is available to allow accurate screw placement.

I would be reassuring to patients who are fearful of spine surgery that it is not as “big” an operation as it was historically. It’s important to note that spine surgery is a serious procedure and should not be taken lightly. Your husband should consult with a spine specialist to determine if surgery is the best option for him and what type of surgery would be most appropriate based on his individual case. The specialist can explain the risks and benefits of the procedure and help your husband make an informed decision about his treatment.

Have a question for the professionals you’d like answered? Get in touch with sarah.gill@image.ie with the subject headline ‘Ask The Doctor’.