I was recently diagnosed with several herniated discs, with the l4/l5 disc having an annular tear. is using a hottub safe? i have struggled with herniated discs for several years, and frequently used a hottub to relax muscles and ease pain. ten days ago i

The : The spine is made up of bony vertebrae and disks. The disks act as shock absorbers between the vertebrae. When the disks dry out and wear out this is called degenerative disk disease. Degenerative disk disease appears as black disks, collapsed disks, bulging disks, herniated disks and annular tears on mri. Annular tear is a little tear in the outside rim of the disk called the annulus. This appears as a white dot on t2 weighted mr imaging. This may cause pain by leakage of disk chemicals and/or ingrowth of little pain nerves. Herniated disks may compress the spinal nerves and cause back and leg pain called sciatica. The leg pain is usually worse then the back pain. Black, collapse, bulging disks and annular tears may produce back pain and sometimes leg pain, but the back pain is usually much worse. Treatment of herniated disk causing sciatica (leg pain worse) is the removal of the disk from pinching the nerve. This can done by open surgery with or without microscope, or endoscopic surgery. Open surgery there is a large skin incision, retraction of paraspinal muscles and bone removal (of lamina and part of the facet joint). Endoscopic surgery is done through a tube the size of a pencil inserted into the spine through a skin incision the size of a fingernail. The muscles are not retracted and injured. They are literally pushed aside to allow this small tube to enter the spine. From there a “high-def” camera allows the surgeon to see into the spine and “un-pinch” the nerve under direct view. Painful degenerated disks and annular tears are traditionally treated by fusion surgery after failure of conservative treatment and confirmation of the painful disk by discogram (dye is injected in the disks to confirm which disk is causing pain). A newer endoscopic technique is partially disk removal with burning of the annular tear. The decision of discectomy vs fusion surgery is based on may factors and you will need to discuss it with your spine surgeon. Usually discectomy is the first treatment for severe sciatic pain which has not responded to conservative treatment (time, anti-inflammatory, physical therapy, steroid injections). The presence of an annular tear does not Prohibit the use of a hot tub.

Yes: Yes a hot tub can be “safe” to do in patients with various low back problems and can at least for the short term be helpful in helping with pain from muscle spasm and arthritis. Good question.

Back pain: In addition to the other good advice you have received. Please continue to see your doctor and look into the work of the late John Sarno, MD, who has a body-mind approach to managing organic pain. Peace and good health.