Conservative treatment — mainly avoiding painful positions and following a planned exercise and pain-medication regimen — relieves symptoms in most people within a few days or weeks.
- Over-the-counter pain medications. If your pain is mild to moderate, your doctor may tell you to take an over-the-counter pain medication, such as ibuprofen (Advil, Motrin IB, others) or naproxen (Aleve, others).
- Narcotics. If your pain doesn't improve with over-the-counter medications, your doctor might prescribe narcotics, such as codeine or an oxycodone-acetaminophen combination (Percocet, OxyContin, others), for a short time. Sedation, nausea, confusion and constipation are possible side effects from these drugs.
- Anticonvulsants. Drugs originally designed to control seizures also may be helpful in the treatment of the radiating nerve pain often associated with a herniated disk.
- Muscle relaxers. Muscle relaxants may be prescribed if you have muscle spasms. Sedation and dizziness are common side effects of these medications.
- Cortisone injections. Inflammation-suppressing corticosteroids may be given by injection directly into the area around the spinal nerves. Spinal imaging can help guide the needle more safely. Occasionally a course of oral steroids may be tried to reduce swelling and inflammation.
If your pain has not resolved within a few weeks, your doctor may suggest physical therapy. Physical therapists can show you positions and exercises designed to minimize the pain of a herniated disk.
A very small number of people with herniated disks eventually need surgery. Your doctor may suggest surgery if conservative treatments fail to improve your symptoms after six weeks, especially if you continue to experience:
- Numbness or weakness
- Difficulty standing or walking
- Loss of bladder or bowel control
In many cases, surgeons can remove just the protruding portion of the disk. Rarely, however, the entire disk must be removed. In these cases, the vertebrae may need to be fused together with metal hardware to provide spinal stability. Rarely, your surgeon may suggest the implantation of an artificial disk.
Some alternative and complementary medicine treatments may help ease chronic back pain. Examples include:
- Chiropractic. Spinal manipulation has been found to be moderately effective for low back pain that has lasted for at least a month. Rarely, chiropractic treatment of the neck can cause certain types of strokes.
- Acupuncture. Although results are usually only modest, acupuncture appears to ease chronic back and neck pain fairly well.
- Massage. This hands-on therapy can provide short-term relief to people dealing with chronic low-back pain.
- Yoga. A combination of physical activity, breathing exercises and meditation, yoga can improve function and relieve chronic back pain in some people.