Usually a herniated disc heals on its own. If treatment is needed, a non-surgical approach is typically used first including:
- Home care, such as resting if you have severe pain, taking short walks and using heat or ice for pain.
- Doing exercises that your doctor or physical therapist prescribes. These may include core exercises, which can help you strengthen the muscles of your trunk to protect your back.
- Taking medicines to treat your symptoms, such as NSAIDs (ibuprofen, naproxen). If NSAIDS are not effective, then stronger pain medicines, muscle relaxers, and/or antidepressants may be used. Corticosteroid shots in the back are also sometimes used.
- Not smoking will be beneficial. Nicotine can harm the discs in your back because it negatively impacts how well the discs can absorb the nutrients they need to stay healthy. In addition, nicotine may cause them to become dry and brittle.
- Complementary medicine is sometimes used in conjunction with standard or conventional care to treat pain caused by certain herniated discs. Complementary therapies may include acupuncture, manipulation of the spine, massage, or chiropractor.
Symptoms usually improve over time. If the herniated disc is squeezing your spinal cord or nerves and/or you are having on-going weakness, constant pain or decreased control of your bladder or bowels, surgery will be considered.
Common surgical treatment
Surgery can be a good choice for those who have nerve damage that is getting worse or disabling pain after several weeks of non-surgical treatment.
Lumbar discectomy
The most common surgery for herniated disc is lumbar discectomy. In this procedure, the herniated disc material that is pressing on a nerve root or on the spinal cord is removed. Both a traditional approach and a minimally invasive approach to a discectomy are offered by Parkview Neurosciences. As a new patient, you will be evaluated on an individual basis to determine the best approach for you. If the minimally invasive discectomy approach is taken, a small incision is made in the skin and only the bone that is pinching the nerve is removed.
Following surgery, your doctor may recommend physical therapy and home exercises to help you recover. Recovery time is typically brief after discectomy and individuals may return to work and daily activities soon after surgery.
Lumbar laminotomy or laminectomy
This procedure is sometimes performed prior to a discectomy to allow the surgeon to better see the herniated disc. A small piece of bone (the lamina) is removed from the affected vertebra before the disc material is removed. In addition, this process reduces pressure on the spinal cord or spinal cord nerve roots.
These procedures are performed in a hospital operating room or in an outpatient surgery center. As with any surgery, there are some risks for surgical treatment of a herniated disc. Talk with your physician to help determine if surgery is the best option for you.