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Back Pain Health Center

Understanding Spinal Disk Problems -- Diagnosis & Treatment

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What Are the Treatments for Spinal Disk Problems? continued...

Rest 

Although in the past, bed rest was universally recommended as a treatment for back pain, many doctors now recommend modified activity rather than bed rest. Bed rest for two days can be helpful for sudden, severe back pain, but prolonged bed rest may actually delay healing. People with backaches should remain active, but be careful not to perform movements that cause pain or discomfort. Your doctor may suggest a back brace or neck collar to limit movement and ease the pressure on sensitive nerves while the disk heals. 

Physical therapy and exercises to strengthen the back and abdominal muscles may be helpful in the long term.

Transcutaneous Electrical Nerve Stimulation (TENS)

One treatment option for temporary pain relief of a disk problem is transcutaneous electrical nerve stimulation (TENS), in which a device applies a small electrical current to critical points along the path of a nerve. TENS is not painful and also may be effective therapy for diabetic neuropathy. However, TENS for chronic low back pain is not effective and cannot be recommended, according to the American Academy of Neurology (AAN).

Acupuncture

Another nonsurgical treatment option is acupuncture. It's not clear how acupuncture works, but some patients get significant relief. Some spine surgeons and pain management specialists consider the use of acupuncture controversial.

Epidurals

Epidurals Steroid Injections (ESI) involve putting steroids and a local anesthetic into the space outside the sac of fluid around the spinal cord.  The local anesthetic provides short-term relief and the steroid reduces the inflammation that occurs because of the disk herniation. This treatment option is recommended when pain persists despite pain medications, modified activity, and physical therapy.

Surgery for Spinal Disk Problems

When a herniated disk causes weakness or paralysis of the nerves that control muscles of the back and limbs, or if you lose control of your bladder or bowels because of the damaged disk, your doctor will recommend surgery. 

Surgery may also be recommended for those who have persistent symptoms despite conservative treatment.  The decision for surgery for pain alone (absent any neurological findings) must be carefully considered, because although pain may improve in the short term, clinical studies do not support a long-term benefit.

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