Herniated Disc (Disc Herniation of the Spine)

  • Medical Author:
    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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What is the treatment for a herniated disc?

Occasionally, disc herniation is incidentally detected when a test such as an MRI is performed for other reasons. If no symptoms are present, no particular treatment is necessary.

Depending on the severity of symptoms, treatments for a herniated disc include physical therapy, muscle-relaxant medications, pain medications, anti-inflammation medications, local injection of cortisone (epidural injections), and surgical operations. In any case, all people with a disc herniation should rest and avoid reinjuring the disc. Sometimes, even people with relatively severe pain early on can respond to conservative measures, including physical therapy with an exercise regimen, epidural cortisone injection, and/or oral cortisone medication (such as methylprednisolone or prednisone), without the need for surgical intervention.

There are now a variety of surgical approaches to treat disc herniation. Each type of operation is customized to the individual situation and depends a great deal on the condition of the spine around the disc affected. Surgical options include microdiscectomy using small surgical instruments and open surgical repair (either from a posterior or anterior approach). Urgent operation can be necessary when cauda equina syndrome is present (reviewed above).

What are home remedies for a herniated disc?

Home remedies for disc herniation can be very effective in relieving the pain. These include over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen sodium (Aleve), as well as the application of heat and ice. Alternating heat and ice is very effective for pain relief for many people. Activity modification is also important, which includes avoidance of activities that aggravate pain and may worsen the nerve impingement. Bed rest and complete inactivity are unnecessary; they hinder recovery and are not advised.

What exercises and stretches can be done for a herniated disc?

Exercising is not advised for new symptoms of a herniated disc. On the other hand, building and maintaining strength in the back muscles and abdominal muscles is very important to prevent and treat chronic back problems. Exercises such as walking, physical therapy, and yoga have been proven to be very beneficial for those with chronic back pain.

Simple stretching can be very beneficial for symptoms of a herniated disc. Stretching should be started slowly and carefully. Stretching generally involves stretching the back in a backward bending position, called extension.

What kind of health-care professionals treat herniated discs?

Many different health-care providers treat herniated discs. Usually patients will see their primary-care provider initially, who may be a general practitioner or specialist in internal medicine or family practice. Other physicians who frequently see patients with herniated discs include emergency-medicine physicians, pain-management specialists, orthopedists, neurosurgeons, rheumatologists, and neurologists.

What is the prognosis (outlook) for a herniated disc?

The outlook for herniated disc depends on the severity and accompanying symptoms. While it is often possible to have full recovery with conservative treatment measures, sometimes surgical intervention is necessary because of persistent symptoms.

Is it possible to prevent a herniated disc?

A herniated disc can only be prevented by avoiding injury to the spine.

Medically reviewed by Aimee V. HachigianGould, MD; American Board of Orthopaedic Surgery

REFERENCE:

Kasper, D., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Professional, 2015.

Medically Reviewed by a Doctor on 2/22/2016

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