In many treatment cases, patients with a herniated lumbar disc will slowly start to see improvements after several days or weeks. Many patients are likely to be free of symptoms by 3 to 4 months. However, there are a percentage of patients that will still experience pain while recovering.
When it comes to disc herniation, conservative or non-surgical care is still the first line of defense – unless there are signs of neurological deficits such as muscle weakness, difficulty in walking, or cauda equine syndrome. Conservative care that focuses on providing pain relief may include:
- Bed rest – Patients are advised to undergo one to two days of bed rest to calm severe back pain. It is not advisable to stay off the feet longer than that though. Patients are advised to take rest breaks throughout the day, but still avoid sitting for long periods of time. Slow and controlled movements are highly recommended, as well as changing up a patient’s daily activity in order to avoid movements that can cause further pain. This includes avoiding lifting and bending forward.
- Medications – Anti-inflammatory medications such as ibuprofen or naproxen may be prescribed in order to relieve pain.
- Physical therapy – Patients are advised to do specific exercises as part of a therapy program in order to strengthen lower back and abdominal muscles.
- Epidural steroid injection – steroids are injected in the patient’s back during the procedure to reduce local inflammation.
Epidural injections are the only proven effective method when it comes to reducing symptoms, with 42-56% chances of success for patients who have not been helped by non-surgical care. When it comes to surgical treatment, spine surgery is recommended only if non-surgical treatment failed to relieve any of the painful symptoms of disc herniation. The surgical approach includes:
- Microdiskectomy – This is the most common procedure for disc herniation. Microdiskectomy removes the herniated part of the disc, as well as any fragments that cause pressure on a patient’s spinal nerve.
- Rehabilitation – Rehabilitation may be prescribed by the surgeon after the patient’s incision has healed. A simple 30-minute walk everyday and flexibility exercises that target the back and legs may be advised.