What are the Treatments for a Herniated Disk?

A herniated disk can press on the nerves in your spine and cause pain, weakness, and numbness in your neck, back, arms, and legs. Sometimes these symptoms can be severe enough to disrupt your life.

Most of the time, though, the problems from your herniated disk should start to improve on their own within a few weeks. In the meantime, try one or more of these treatments to help you feel better.

Rest

Take it easy for a few days. Rest can relieve swelling and give your back time to heal. While your back hurts, avoid exercise and other activities where you have to bend or lift.

Your doctor might suggest that you rest in bed. Bed rest is fine for a short period of time, but don't stay off your feet for longer than 1 or 2 days. You need to keep moving so your joints and muscles don't stiffen up.

You can also use ice and heat to help relieve your pain. Just place an ice pack or warm wet towel on the area of your back that is sore. You can alternate hot and cold, or use whichever feels best.

Medications

Take an over-the-counter pain medicines like ibuprofen (Motrin, Advil) or naproxen (Aleve, Naprosyn). These medicines can help relieve your pain and bring down swelling.

Just don't use these for more than 10 days without talking to your doctor. When used in large amounts or for a long time, nonsteroidal anti-inflammatory drugs (NSAIDs) can increase your risk for heart problems or bleeding.

Narcotics such as codeine or oxycodone-acetaminophen (Percocet) are also short-term options that your doctor may prescribe if over-the-counter meds don’t work.

Your doctor might also prescribe muscle relaxants to ease muscle spasms in your back. And nerve pain medicines, such as amitriptyline (Elavil, Vanatrip), duloxetine (Cymbalta), gabapentin (Neurontin), pregabalin (Lyrica), and tramadol (Ultram) are options to ease nerve-damage pain.

Physical Therapy

Some exercises can help improve the symptoms of a herniated disc. A physical therapist can teach you which ones strengthen the muscles that support your back. Physical therapy programs also include:

  • Stretching exercises to keep your muscles flexible
  • Aerobic exercises -- such as walking or riding a stationary bicycle
  • Massage
  • Ice and heat
  • Ultrasound therapy
  • Electrical muscle stimulation

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Injections

If rest, pain relievers, and physical therapy don't help with your pain, your doctor can inject a steroid medicine into the space around your spinal nerve. This is called an epidural injection. The steroid can help bring down the swelling, help you move more easily, and ease pain from a herniated disk.

Your doctor will use an X-ray or CT scan to find the right spot to inject the medicine. You might need more than one steroid shot to relieve your pain.

Surgery

Most people with a herniated disk don't need surgery. Rest and other treatments should start to improve your symptoms within 4 to 6 weeks. But if your pain doesn’t improve, surgery might be an option.

Talk to your doctor about surgery if:

  • You’re not getting relief from pain relievers, injections, and physical therapy.
  • Your symptoms keep getting worse.
  • You have trouble standing or walking.
  • You can't control your bowels or bladder.

Diskectomy. During this procedure, your surgeon removes your damaged disk to relieve pressure on your nerves. He can perform the surgery in a couple of ways:

  • Your surgeons performs open diskectomy is via a cut in your back or neck.
  • Microdiscectomy is done through a much smaller incision. Your surgeon inserts a thin tube with a camera on one end to see and remove the damaged disk.

Lumbar laminotomy. Sometimes your surgeon will also need to remove a small piece of bone called the lamina from the vertebra. The lamina forms a protective cover over your spinal cord. Removing part or all of it helps the surgeon access your herniated disk. It also can relieve pressure on your nerves and eliminate leg pain and sciatica.

The lamina can be removed during the diskectomy. Or, you might have it taken out in a separate surgery.

Spinal fusion. After a diskectomy or laminotomy, your surgeon may fuse together the two vertebrae on either side of the disk to stabilize your spine. This is called spinal fusion. Fusing the two disks will stop the bones from moving and prevent you from having any more pain.

Artificial disk surgery. Only a few people are good candidates for artificial disk surgery because it only works on certain disks in your lower back. But if your doctor thinks this is an option, he will replace your damaged disk with one made of plastic or metal. The new disk will help keep your spine stable and let you move more easily.

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Protect Your Spine

Most herniated disks get better on their own or with treatment. But they can happen again.

To protect your spine and prevent another herniated disk, you should always sit and stand up straight. If you have to stand for a long period of time, rest one foot on a stool or box to take pressure off your back.

Be careful when you lift anything heavy. Squat from your knees to pick it up. Don't bend from the waist. It puts too much pressure on your back.

Stay at a good weight for you. Extra pounds put more strain on your back.

Don't smoke. It can cause hardening of the arteries, which can damage the disks in your spine.

WebMD Medical Reference Reviewed by Laura J. Martin, MD on October 09, 2016

Sources

SOURCES:

American Academy of Family Physicians: "Herniated Disk."

American Academy of Orthopaedic Surgery: "Herniated Disk in the Lower Back."

American Association of Neurological Surgeons: "Herniated Disk."

Cleveland Clinic: "Herniated Disk." "Non-Steroidal Anti-Inflammatory Medicines (NSAIDs)."

Mayo Clinic. “Herniated Disk.”

North American Spine Society: "Lumbar (Open) Microscopic Diskectomy."

NYU Langone Medical Center: "Surgery for Herniated Disk."

Radiological Society of North America, Inc.: "Epidural Injections."

Temple University Health System: "Herniated Disk Surgery."

University of Michigan: "Lumbar Herniated Disk: Should I Have Surgery?"

Weill Cornell Brain and Spine Center: "Herniated Disk."

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