Treatment:

The first treatment for a herniated disk is a short period of rest with pain and anti-inflammatory medications, followed by physical therapy. Most people who follow these treatments will recover and return to their normal activities. A small number of people need to have further treatment, which may include steroid injections or surgery.

MEDICATIONS

Nonsteroidal anti-inflammatory medications (NSAIDs) and narcotic painkillers will be given to people with a sudden herniated disk caused by some sort of injury (such as a car accident or lifting a very heavy object) that is immediately followed by severe pain in the back and leg.

If you have back spasms, you will usually receive muscle relaxants. On rare occasions, steroids may be given either by pill or directly into the blood through an IV.

NSAIDs are used for long-term pain control, but narcotics may be given if the pain does not respond to anti-inflammatory drugs.

LIFESTYLE CHANGES

Diet and exercise are crucial to improving back pain in overweight patients.

Physical therapy is important for nearly everyone with disk disease. Therapists will tell you how to properly lift, dress, walk, and perform other activities. They will work on strengthening the muscles that help support the spine. You will also learn flexibility of the spine and legs.

INJECTIONS

Steroid injections into the back in the area of the herniated disk may help control pain for several months. Such injections reduce swelling around the disk and relieve many symptoms. Spinal injections are usually done on an outpatient basis, using x-ray or fluoroscopy to identify the area where the injection is needed.

SURGERY

Surgery may be an option for the few patients whose symptoms do not go away despite other treatments and time.

See also: Diskectomy

Ask your doctor which treatment options are best for you.

Expectations (prognosis):

Most people will improve with conservative treatment. A small percentage may continue to have chronic back pain even after treatment.

It may take several months to a year or more to resume all activities without pain or strain to the back. People with certain occupations that involve heavy lifting or back strain may need to change job activities to avoid recurrent back injury.

Complications:

• Long-term back pain
• Loss of movement or sensation in the legs or feet
• Loss of bowel and bladder function
• Permanent spinal cord injury (very rare)

Calling your health care provider:

Call your health care provider if:

• You develop persistent, severe back pain develops
• You have any numbness, loss of movement, weakness, or bowel or bladder changes