Herniated Disc: Nonsurgical Treatments
A herniated disc does not require surgery. You may only need to rest for a few days and take over-the-counter anti inflammatory medication. Spine specialists may be able to offer nonsurgical treatment options, such as prescription medication or physical therapy, if your symptoms persist.
Medication
A herniated disc can affect everyone differently. While one person might not notice any symptoms, another person may have severe pain and may require medication. Based on your symptoms and descriptions, doctors at NYU Langone will help you determine the right medication for you.
Nonsteroidal Anti-Inflammatory Medicines
A herniated disc can cause pain due to inflammation of the nerves and soft tissues surrounding it. An inflamed nerve can push against the disc by swelling. The swelling and pain that can result from inflammation may be reduced by nonsteroidal anti-inflammatory medication.
Ibuprofen and naproxen are the most commonly used nonsteroidal anti-inflammatory medications. You can get them all without a prescription. Your doctor will recommend the best way to use them. Doctors may recommend a stronger anti-inflammatory if a herniated disc causes severe pain that cannot be relieved with over-the-counter medication.
Muscle Relaxants
A disc that slips between the vertebrae can pinch a nerve and cause it to move off its position. This could lead to muscle spasms. Muscle relaxant medication can ease spasms, reduce pain, and allow you to move more easily. These medications may be prescribed by your doctor for a few days. Muscle spasms can often go away after this time.
Prescription Pain Relief
A herniated disc can pinch a nerve and cause severe pain. Your doctor may prescribe a short course of prescription pain relief if the over-the-counter remedies do not work. These medications should be taken for no more than a week. They are meant to make you feel better while you wait for an anti-inflammatory or muscle relaxant to kick in.
Corticosteroids
Your doctor may prescribe corticosteroids to relieve neck or back pain if other medications fail to work. The steroids work by reducing inflammation near the herniated disc, relieving pain and taking pressure off the nerve. Steroids are only available by prescription. They can be taken for up to 7-10 days. After that, your doctor will reassess your symptoms and recommend additional treatment.
Corticosteroid Injections
For herniated disc pain, corticosteroid injections can be an alternative to oral corticosteroids. An injection should only be recommended if other nonsurgical remedies have not provided relief. Steroids are powerfully anti-inflammatory and can be injected directly to the epidural space, the fluid-filled area around the spinal cord.
The injections are done under local anesthesia. NYU Langone pain specialists and radiologists use the X-ray guidance system to ensure that the medication is precisely injected. It usually takes less than 30 minutes.
Injectable steroids can provide pain relief for up to one year, or longer. Some people don’t find injections helpful. Although it is impossible to determine the effectiveness of an injection before it is administered, many people find that steroids provide long-lasting relief.
The best time to inject steroids is just before physical therapy begins. This allows for strength-building exercises without pain.
Physical Therapy
Physical therapy may be recommended by your orthopedic doctor in conjunction with a physiatrist or physical medicine doctor. Physical therapy is often used to relieve pain and prevent further damage to herniated discs.
The core is an important part in therapy for a herniated disc. It includes strengthening the muscles in the abdomen, back, stomach, and buttocks. The spine will bear more weight if these muscles are weak. This extra pressure can cause instability, or worsen a spine problem. These exercises can be taught by a physical therapist to strengthen the core muscles and improve posture.
Physical therapists may recommend other complementary methods that can improve your overall function, make you feel better, and build core muscles. A comprehensive treatment plan can include stretching, massage therapy, heat and ice therapies.
