Non-surgical Treatments for a Herniated Disc

A herniated disc is a relatively common condition that seldom requires surgery. It is interesting to note that although 80% of adults will experience back pain, only 1%-2% will need surgery.

If the cause of your back pain is not serious, home therapy may work and you will heal within four to six weeks. During the first 24 to 48 hours, use ice to help reduce swelling, muscle spasm, and pain. (The ice will reduce blood flow to the affected area.) Wrap an ice pack in a towel and put it on the painful area for 15 minutes. Use a heating pad after 48 hours to warm and relax sore tissues. Do not put ice or heat directly on the skin.

When medical attention is needed, most patients respond well to nonsurgical forms of treatment. During your recovery period, your doctor may recommend rest or restricted activity. You may need bed rest for a few days to take the pressure off of your nerves—but you won’t be in bed for more than a few days. Extended bed rest is no longer recommended for back pain. Mild activity is preferred for better healing, and your doctor may suggest walking, bicycling, or swimming. To help you heal, you may be asked to wear a brace for back support.

Medications may be prescribed (see box). Anti-inflammatory agents reduce swelling while relieving pain. Narcotic pain relievers may be prescribed for intense but short-lived pain (acute pain). Nonsteroidal anti-inflammatory drugs (NSAIDs) are available over-the-counter, but it is wise to discuss NSAID use with your doctor because they have a risk of stomach bleeding and other side effects.

Medications

• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Pain relievers
• Muscle relaxants
• Spinal injections (anesthetics, corticosteroids)
• Antidepressants
• Sleep aids

You may also consider going to a physical therapist, chiropractor, or acupuncturist. If needed, your doctor will refer you to a physical therapist. Physical therapy includes passive treatments such as cold or heat, deep tissue massage, electrical stimulation, and ultrasound. These treatments help prepare you for therapeutic exercise—the active part of physical therapy. Spinal manipulation by a chiropractor who uses gentle adjustments to help restore spinal function helps many patients. While acupuncture can control pain, it should be combined with other treatments, like exercise.