The treatment of a herniated disc depends on the symptoms. If the symptoms are getting better, your doctor may suggest watching and waiting to see if they go away. If they are getting steadily worse, your doctor may be more likely to suggest surgery. Many people, who initially have problems due to a herniated disc, find their symptoms completely resolve over several weeks or months.
You may not need any treatment other than watching to make sure that the problem does not progress. If the pain is bearable and symptoms from nerve or spinal cord pressure are not getting worse, your doctor may just want to watch and wait.
Depending on the severity of your pain, medications can be used to help control it. Over-the-counter pain relievers, such as ibuprofen, Tylenol(tm), and some of the newer anti-inflammatory medications, may be helpful. Make sure to follow the directions and not take too many.
If these types of medications do not control the pain, your doctor may prescribe stronger pain pills-narcotic or non-narcotic pain medications. Narcotic pain medications are very strong but also very addictive. Non-narcotic pain medications are less addictive, but are somewhat less effective than narcotics. Most physicians do not like to prescribe narcotics for more than a few days or weeks.
If the pain is more severe, it may be necessary to take a few days off from work and decrease your activities. Your doctor may also prescribe a back brace to help limit movement around the injured disc. After two days, you should begin to get moving. Start with a gentle walking program and increase the distance you walk each day.
Patients with a herniated disc are commonly prescribed physical therapy. A well-rounded rehabilitation program assists in calming pain and inflammation, improving your mobility and strength, and helping you do your daily activities with greater ease and ability.
Therapy visits are designed to help control symptoms, enabling you to resume normal activities. Exercises focus on improving strength and coordination of the low back and abdominal muscles. The emphasis of therapy is to help you learn to take care of your back through safe exercise and self-care when symptoms flare up. Therapy sessions may be scheduled two to three times each week for up to six weeks.
The goals of physical therapy are to help you
- learn ways to manage your condition and control symptoms
- resume appropriate activity levels
- learn correct posture and body movements to reduce back strain
- maximize your flexibility and strength
Epidural Steroid Injection (ESI)
The ESI is usually reserved for more severe pain from nerve root irritation due to a herniated disc. It is not usually suggested unless surgery is fast becoming an option. An ESI is only successful in reducing the pain from a herniated disc in about half the cases.
Surgical treatment for a herniated disc depends on several factors such as your specific problem and your surgeon’s experience.
- Laminotomy and Discectomy
- Endoscopic Discectomya