Treatment:

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

MEDICATIONS

People who have a sudden herniated disk caused by injury (such as a car accident or lifting a very heavy object) will get nonsteroidal anti-inflammatory medications (NSAIDs) and narcotic painkillers if they have severe pain in the back and leg.

If you have back spasms, you will usually receive muscle relaxants. Rarely, 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 how to increase flexibility in your spine and legs.

You may want to reduce your activity for the first couple of days. Then, slowly restart your usual activities. Avoid heavy lifting or twisting your back for the first 6 weeks after the pain starts. After 2 to 3 weeks, gradually start exercising again.

See: Taking care of your back at home for more about exercise and how to prevent your back pain from returning.

INJECTIONS

Steroid injections into the back in the area of the herniated disk may help control pain for several months. These injections reduce swelling around the disk and relieve many symptoms. Spinal injections are usually done in your doctor's office, using x-ray or fluoroscopy to find the area where the injection is needed.

SURGERY

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

See also: Diskectomy for more about how the surgery is done and who is most likely to benefit from it.

Ask your doctor which treatment options are best for you.

Expectations (prognosis):

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

It may take several months to a year or more to go back to all of your activities without having pain or straining your back. People who work in jobs that involve heavy lifting or back strain may need to change their job activities to avoid injuring their back again.

Complications:

• Long-term back pain
• Loss of movement or feeling 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 have severe back pain that does not go away
• You have any numbness, loss of movement, weakness, or bowel or bladder changes