Large percentages (80-90%) of people, with a recent or new herniated disc, improve without surgery. Initially, doctors will address the pain with non-surgical treatment options if it prevents the patient from living his normal lifestyle.

The main goal of treating a herniated disc is to decrease pain and other symptoms and not to correct the anatomy of the spine. In most cases, the symptoms subside by themselves or after using non-surgical treatments.
If these treatments are not effective after 6 weeks, other long-term methods will be considered and even surgery if necessary.

Initial control for the pain


The first approach in treating herniated discs can be administered in the home. Treatments such as ice application, muscle relaxants, heat therapy, and pain medication are usually prescribed.

• Pain medications. The doctor will usually prescribe non-prescription medication NSAIDs such as Naproxen and ibuprofen to treat inflammation and pain.


• Ice application. Cold packs and application of ice may help muscle spasms and inflammation, which come with a herniated disc, within the first 48 hours after the start of the back pain. An ice massage may also be helpful.


• Muscle relaxants. These may be prescribed to ease the painful muscle spasms that accompany the herniated disc.


• Heat therapy. This can relieve the pain of muscle spasms within the first 48 hours. Heating pads, hot compress and heat wraps can be effective. A hot bath and other moist heat are often preferred.


• Heat and ice. Alternating cold and hot packs often bring maximum pain relief.

Exercise


Taking a proactive approach to recovery from a herniated disc using physical exercise could reduce the pain and ensure the long-term health of your back.

A herniated disc may require a couple of days rest but the temptation to stay in bed for days at a time will not provide the conditioning the muscles need to help the recovery process. Also, not exercising will prevent your body from responding well to further treatment.

Exercising is a good way to stabilize and strengthen your lower back muscles and will prevent additional pain and injury. When the muscles are strong they support bones and body weight taking unnecessary pressure off the spine.

Even with strong muscles to support the back, it is important to lose weight to truly support the spine. Extra body weight will strain the back and losing weight will reduce pain and promote the restoration of a healthy back.

Physical therapy


Physical therapy may play a major role in a herniated disc recovery. Physical therapy gives immediate pain relief and can teach a patient how to condition his body to prevent future pain and injury. Several physical therapy techniques can be used. Passive treatments will relax the body and include a deep tissue massage; there are also electrical stimulation, hydrotherapy, and hot and cold therapy.

The physical therapy approach begins with passive fitness. Then after the body heals active treatments are started to strengthen the body and prevent further pain.

Simple aerobic exercises and stretching will help control herniated disc pain. Pilates and yoga will improve flexibility and strength and provide pain relief to the lower back and leg. Moderate aerobic exercise such as biking, swimming, and walking will also help relieve pain.

Acupuncture


Acupuncture is an ancient Chinese practice in which the practitioner inserts several needles through the skin. They are left there for about 20 to 40 minutes. This process releases endorphins into the bloodstream.

As endorphins are the body’s natural pain relievers, this practice decreases pain sensation from the herniated disc. The US Food and Drug Administration has approved this process as a treatment for back pain.

Injections near the spine


Often epidural steroid injections can be used to help relieve pain from the herniated disc. They may be administered as steroids combined with anesthetic medication, or saline, or pure steroids, or as purely aesthetic.

These injections may be given in the back, lower back/buttocks region, or in the neck. When the steroids are injected in the epidural space they disperse into the nerve endings and the tissues. This spreads their anti-inflammatory effect throughout the pain transmitting areas.

Resources:


https://www.ncbi.nlm.nih.gov/books/NBK279469/

https://www.webmd.com/pain-management/treatments-for-herniated-disk#1

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