What's the treatment for herniated discs?
In most cases, a herniated disk will heal on its own with around two days of bed rest, over-the-counter pain relievers to help with the discomfort, and anti-inflammatory medications. After about 2 weeks, many people recover without any treatment. Applying cold (such as ice packs) or heat (such as a heating pad) or using over-the-counter analgesics may help relieve the
pain. Sometimes surgery to remove part or all the disk and part of a vertebra is necessary. In 10 to 20% of people who undergo surgery for sciatica due to a herniated disk, another disk ruptures.
In most cases, a herniated disk (with or without sciatica) will respond to conservative treatment. This may include limited bed rest (generally no more than a day or two) warm baths, heating pads and medications, such as aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) or muscle relaxants. When these more conservative measures don't work, epidural steroid injections may be helpful. Epidural steroid injections have been used to decrease pain by injecting an antiinflammatory drug, usually a corticosteroid, around the nerve root to reduce inflammation and edema (swelling). This involves the careful injection of a long acting steroid and an anesthetic into the space near the spinal cord and compressed nerves. This partly relieves the pressure on the nerve root as well as resolves the inflammation.
Because prolonged inactivity can promote deconditioning, physical therapists may suggest that you start an exercise regimen early. Physical therapists are skilled in treating acute back pain caused by the disk herniation. The physical therapist can provide noninvasive therapies, such as ultrasound or diathermy to project heat deep into the tissues of the back or administer manual therapy, if mobility of the spine is impaired. They may help improve posture and develop an exercise program for recovery and long-term protection. Appropriate exercise can help take pressure off inflamed nerve structures, while improving overall posture and flexibility. Traction can be used to try to decrease pressure on the disk. A lumbar support can be helpful for a herniated disk at this level as a temporary measure to reduce pain and improve posture.
If the disk has fragmented, your doctor may recommend surgery to remove the pieces of the disk that are compressing the nerve. There are many types of surgical techniques for repairing a herniated disk. With a laminectomy, the surgeon removes any fragments of the disk that are pressing on the nerve, as well as a part of the vertebra called the lamina. Microsurgical techniques require smaller incisions and only a local anesthetic. Some types of herniated disk surgeries can be performed on an outpatient basis. The extent of your injury, as well as your age and overall health, will help determine the type of surgery that is best for you. Surgery is followed by physical therapy to strengthen the back and help you resume normal activities. Surgery is performed in only a small number (less than 10%) of people who have herniated discs. Surgery may be considered for people who have progressive nerve damage or severe weakness or numbness or for those whose pain has not been relieved by other methods. |
