Pharmacological Intervention and Pain Management
The primary goal of treatment of each patient suffering from disc herniation is to help relieve pain and other symptoms. If your pain is mild to moderate, your doctor may recommend over-the-counter drugs such as aspirin, ibuprofen, acetaminophen, and naproxen. However, if your pain is long-term or severe, narcotic pain relief may be necessary for a short period until your symptoms are managed. Muscle relaxants may also be prescribed for muscle spasms.
Exercise caution in taking any prescribed medication, and take medication only as prescribed. Remember, taking more medication than necessary will not resolve the structural damage of your herniated disc. In addition, it could also have undesirable side effects and lead to drug dependence.
Ask your prescribing physician or pharmacist for more information about your medication, its therapeutic use and its side effects. Be sure to inform them of any allergies and current prescribed or over-the-counter medications. In addition, continue to take your medication for as long as prescribed. Do not stop taking your medicine unless your doctor tells you to do so.
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
These are medications with analgesic (pain reducing) and fever reducing properties. They are useful for patients with disc herniation, as they help reduce inflammation and swelling and thereby reduce pain.
However, chronic use of over-the-counter and prescribed NSAIDs should be closely monitored by your doctor. Long-term use increases your risk of potential problems such as internal bleeding and/or stomach upset. In addition, some NSAIDs such as naproxen, ibuprofen and aspirin are not suitable for patients who have a history of ulcers and cardiac problems.
Oral and Epidural Corticosteroids
Corticosteroids are drugs that have effective anti-inflammatory properties. They may be given orally, injected into the spinal canal (epidural), or introduced adjacent to the nerve to treat herniated disc symptoms. Epidural and spinal nerve corticosteroids can be used by patients who have symptoms of nerve root compression/inflammation, and whose symptoms have not improved after several weeks of non-surgical treatment.
In some cases, oral and epidural corticosteroids may delay or eliminate the need for surgery. However, long-term or repeated use of these drugs may cause serious side effects such as headaches, dizziness, increased leg and back pain, infectious or non-infectious inflammation of the spinal tissues and damage to nerve roots after multiple injections. These treatments should be administered by a trained professional as a part of a comprehensive treatment regimen.
Trigger Point Injection
A trigger point injection is a procedure performed to relieve or reduce the vertebral pain caused by trigger points, or knots of muscle that form when muscles remain contracted. Local anesthesia (usually combined with corticosteroids) is introduced directly into the muscle or soft tissue along the affected herniated disk. This is an outpatient procedure that does not require hospital admission. However, as with other pain medications, trigger point injections do not provide a permanent structural cure for herniated discs.