Non-Surgical Treatments
The initial treatment for a herniated disc is usually conservative and nonsurgical. A doctor may advise the patient to maintain a low, painless activity level for a few days to several weeks. This helps the spinal nerve inflammation to decrease. Bedrest is not recommended.
A herniated disc is frequently treated with nonsteroidal anti-inflammatory medication, if the pain is only mild to moderate. An epidural steroid injection may be performed utilizing a spinal needle under X-ray guidance to direct the medication to the exact level of the disc herniation.
The doctor may recommend physical therapy. The therapist will perform an in-depth evaluation, which, combined with the doctor's diagnosis, dictates a treatment specifically designed for patients with herniated discs. Therapy may include pelvic traction, gentle massage, ice and heat therapy, ultrasound, electrical muscle stimulation and stretching exercises. Pain medication and muscle relaxants may also be beneficial in conjunction with physical therapy.
Symptoms from a herniated disc usually get better in a few weeks or months. To help you recover:
- Rest if you have severe pain. Otherwise, stay active. Staying in bed for more than 1 or 2 days can weaken your muscles and make the problem worse. Walking and other light activity may help.
- Try to use hot cold therapy. Use heating pad or hot gel pack for about 15 to 20 minutes every 2 or 3 hours. Try a warm shower in place of one session with the heating pad. You can also try an ice pack for 10 to 15 minutes every 2 to 3 hours.
- Do the exercises that your doctor or physical therapist suggests. These will help keep your back muscles strong and prevent another injury.
- Ask your doctor about medicine to treat your symptoms. Medicine won't cure a herniated disc, but it may help with pain and swelling.
Usually, a herniated disc will heal on its own over time. Be patient, and keep following your treatment plan. If your symptoms don't get better in a few months, you may want to talk to your doctor about surgery.
Surgery
A doctor may recommend surgery if conservative treatment options, such as physical therapy and medications, do not reduce or end the pain altogether. Doctors discuss surgical options with patients to determine the proper procedure. As with any surgery, a patient's age, overall health and other issues are taken into consideration.
The benefits of surgery should be weighed carefully against its risks. Although a large percentage of patients with herniated discs report significant pain relief after surgery, there is no guarantee that surgery will help.
A patient may be considered a candidate for spinal surgery if:
- Radicular pain limits normal activity or impairs quality of life
- Progressive neurological deficits develop, such as leg weakness and/or numbness
- Loss of normal bowel and bladder functions
- Difficulty standing or walking
- Medication and physical therapy are ineffective
- The patient is in reasonably good health
Post-operative precautions
Patients need strict bed rest after surgery, and the bed should preferably be made of a hardboard bed, and the bed rest time is about 4-5 weeks. The duration of bed rest is about 4-5 weeks. It may depend on the patient's age, physical condition, and the extent of resected tissue.
Early turning after surgery should be assisted by nursing staff and should not be turned strongly by oneself to ensure good healing of the lumbar fascia, muscles, and ligaments.
After sufficient bed rest, the patient can be protected by a suitable lumbar girth. If there is a bone graft in the surgery, it is advisable to fix it with a plaster undershirt for 3-4 months and wait for the bone graft to heal completely before moving to the ground.
During the recovery period, patients should gradually strengthen the exercise of low back muscle strength and pay attention to the correction of poor posture and self-protection of low back activities to prevent recurrence of the disease.
After surgery, brain workers should gradually resume work after 2-3 months, and manual workers should start working only after 3-4 months. Work should be light to heavy, working time from short to long, and avoid doing strong bending into weight-bearing activities.
Conservative therapy requires patience, but sticking with your treatment plan can reduce back pain and minimize the chance of worsening pain or damage to the disk. Conservative measures and surgery can both take time to be effective.