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How is a herniated disc treated?

Conservative treatment for a slipped disc includes rest, avoidance of heavy lifting and physical therapy. Avoid lifting heavy objects, bending, twisting and sitting and standing for long periods of time. Some physicians might recommend weight loss if weight issues have caused the slipped disc. Extreme cases might necessitate surgery.

This answer provided for NATA by the University of Tampa Athletic Training Education Program.

Dr. Stephen Parker, MD
Physical Medicine & Rehabilitation Specialist

Most herniated disks will resolve spontaneously if left untreated. When necessary, treatment regimens including therapies can be considered, along with medicines to control the pain. While there are exercises that may be helpful in minor to moderately severe cases, surgery is sometimes warranted in more severe cases, such as those in which bladder and/or bowel function have been lost or impaired. In an attempt to reduce the inflammation that is brought on by herniations, injections involving steroids can be introduced into the low back in an attempt to curtail the symptoms. 

Modified activity is another modality that can be implemented in the setting of a herniated disk. The most common mechanisms contributing to herniated disk are bending and twisting while lifting, and so avoiding those particular movements is certainly important. It is recommended that the patient stay away from improper reaching, bending, lifting, prolonged sitting or standing.

In therapies, back stabilization exercises are implemented. It is very, very important to have a strong “core” both in the abdominal musculature as well as the lower back to prevent herniated disks in the future. When one has a strong core, one is less prone to developing herniated disk disease. In the therapies, various modalities can be used such as heat and ultrasound. There is typically spasm to the side that the disk is herniated on, and for this heat and/or electrical stimulation in various forms can be beneficial.

Certainly, not last to be considered are pain medications, usually starting with nonsteroidals such as Motrin, and/or anti-spasmodics, such as Flexeril. Narcotics may be used sparingly in severe cases, and in some cases nerve stabilizers such as Neurontin or Lyrica may be indicated. In 10 percent of cases, surgical management, such as microdiskectomy which involves removing a small portion of the disc or other surgical procedures may be considered.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.