For most of the herniated disc injured workers with McCormick Law Office attorney representation, surgery is not the first treatment option. Unless a herniated disc is causing significant immediate problems, most doctors believe it best to begin with nonsurgical treatment.
Occasionally, short-term bed rest is used to can calm inflammation and pain. However, most doctors advise against strict bed rest and prefer their patients to do ordinary activities using pain to gauge how much is too much.
A back support belt or brace is sometimes used for patients with lumbar disc herniation. The belt can help lower pressure inside the problem disc. Some doctors use a back brace to gauge whether certain surgeries may help. Back supports are not long-term solutions.
Doctors prescribe different pain medications for patients with lumbar or cervical disc herniations. At first, over the counter mild analgesics or prescribed anti-inflammatory medications such as aspirin or ibuprofen may be used. More severe symptoms may be treated with narcotic drugs, such as codeine or morphine or tricyclic antidepressants, such as amitriptyline or doxepin. Narcotics or opioids should be used carefully given their addictive qualities. Muscle relaxants may be prescribed if the low back or neck muscles are in spasm. Pain that spreads down the leg or arm is sometimes relieved with oral steroids taken in tapering dosages.
Physical therapy is often tried for pain relief through improving back movement, better posture and stronger muscles.
Some patients who continue to have symptoms are given an epidural steroid injection (ESI). Steroids are powerful anti-inflammatories. In an ESI, medication is injected into the space around the lumbar spinal nerves where they branch off of the spinal cord. This area is called the epidural space. Some doctors inject only a steroid. Most doctors, however, combine a steroid with a long-lasting numbing medication. Generally, an ESI is given only when other treatments aren't working. But ESIs are not always successful in relieving pain. If they do work, they often provide only temporary relief.
Most people with a herniated disc in the lumbar or cervical spine get better without surgery. As a result, doctors usually have their patients try nonoperative treatments for at least six weeks before considering surgery. But when patients simply aren't getting better, or if the problem is becoming more severe, surgery may be suggested.