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Frequently Asked Questions

What is the treatment for herniated discs?: Dr. Donald D Dietze Jr.
Covington, LA

Truthfully, symptoms resolve without specific treatment in 85% of people over 6 months. There should be some evidence of resolution by 6 weeks. Medical treatment initially involves reassurance and comfort measures. Additional treatment modalities can include physical therapy, lumbar traction and spinal injections. Surgery is reserved for failure of resolution, failure to control pain or progressive development of weakness or urinary problems.; Dr. Jeffrey Goldstein
New York, NY

Initial treatment of a herniated disc is rest, ice, and medications (nonsteroidal antiinflammatories, steroid tapers, muscle relaxants, and/or pain killers). Other modalities may also be added. These modalities include physical therapy, chiropractic care, acupuncture, or osteopathic care may be tried. Sometimes steroid injections can be performed. Following failure of nonoperative treatment surgical intervention, such as discectomy or fusion, may be a consideration.; Dr. Mark Rosenthal
Baltimore, MD

If it is a small herniation, an injection and Physical Therapy may be all that is needed. If the herniation is large, or there is significant loss of function, surgery may be the best option. If surgery is indicated, the best results are seen when the surgery is done in the first 6 months or so.; Dr. Andrew Glass
Someras Pt., NJ

Some patients with herniated discs can be successfully treated with bed rest, restricted physical activities, physically therapy and/or medications. Other patients may require some form of surgery to fix the problem. Variables that influence the choice of treatment include intensity of pain, degree of loss of function, extent of structural damage to the spine and disc, response to other forms of treatment, degree of neurological problem (loss of strength, sensation and/or bowel/bladder function) and health of the patient. Ultimately, the choice of treatment or treatments is a cooperative decision between the patient and his or her specialist. This requires extensive discussion and decision-making.; Dr. Thomas Zdeblick
Madison, WI

Most herniated discs can be treated without surgery. Often time, physical therapy, anti-inflammatory medications, and occasionally an epidural steroid injection are all helpful for disc herniations. Approximately 75% of people will improve on these treatments. For those patients that do not improve with these treatments over a two-month period, surgery may be indicated. Other indications for surgery include weakness, unremitting pain, or changes in bladder control.; Dr. Andrew Glass
Someras Pt., NJ

Some patients with herniated discs can be successfully treated with bed rest, restricted physical activities, physically therapy and/or medications. Other patients may require some form of surgery to fix the problem. Variables that influence the choice of treatment include intensity of pain, degree of loss of function, extent of structural damage to the spine and disc, response to other forms of treatment, degree of neurological problem (loss of strength, sensation and/or bowel/bladder function) and health of the patient. Ultimately, the choice of treatment or treatments is a cooperative decision between the patient and his or her specialist. This requires extensive discussion and decision-making.; Dr. George Frey
Englewood, CO

Most herniated discs, 80% in fact, simply get better on their own. This can take about three months to occur. If, however, the disc herniation continues to cause sciatica or leg pain, then oftentimes treatment is necessary. This initially includes physical therapy to strengthen muscles, as well as the use of the soft tissue treatment, such as massage and stretching. Cortisone injections, called epidural steroid injections, around the pinched nerve may also be of benefit. If all of these measures fail, surgery may be necessary. The standard surgical procedure for disc, to free up the nerve. More advanced techniques include the endoscopic removal of the disc material through a minimally invasive technique.; Dr. W. Christopher Urban
Glen Burnie, MD

There are several treatment options for a herniated disc. A non-operative approach is successful in treating many small disc herniations. This approach includes a short period of rest followed by a physical fitness program to improve muscle strength and aerobic conditioning. A variety of modalities are available to relieve the acute pain associated with a disc herniation. These include anti-inflammatory medications, muscle relaxants, narcotics, and oral steroids. Steroid injections may also be used to decrease the inflammation caused by the herniation. If conservative therapy fails, surgical excision of the herniated disc is very effective at relieving the pressure on the nerve root and decreasing the inflammatory response to the disc material. This procedure can be performed using microsurgical techniques, which are less invasive and lead to quicker recovery.; Dr. Eung-Jun Cha
Bedford, IN

Lumbar epidural, physical therapy or for extreme--surgery.; Dr. Kenneth A Pettine
Loveland, CO

The American Academy of Orthopedic Surgery strongly recommends six weeks of non-operative treatment for a herniated disc since 90% of herniated discs get better in this time frame. A patient who continues to have symptoms of intense leg pain after six weeks of onset carries a poorer prognosis. Non-operative treatments include chiropractic, physical therapy, massage therapy, rolfing, acupuncture, nonsteroidal anti-inflammatory medications, steroids, pain medications, and muscle relaxers.; Dr. Rick Sasso
Indianapolis, IN

Usually activity modification (rest), non-steroidal anti-inflammatory medications, and physical therapy are initiated.; Dr. Paul J Slosar
Daly City, CA

The usual treatment for a disc herniation is 2-3 days of bedrest followed by increasing activity as tolerated. Some patients may need medications for a period of time. Physical therapy is frequently utilized if patients are feeling better. A number of patients may benefit from an epidural cortisone injection to reduce the swelling and inflammation surrounding the nerves. A few patients will need surgery. Most spine surgeons use minimally invasive microscopic surgery to treat these disc herniations.; Dr. Dennis G Crandall
Mesa, AZ

The majority of people with disk herniations get well without intervention. Physical therapy, medications for pain and inflammation, epidural steroid injections, and the passage of time can all be helpful. When the pain continues, a 1 hour surgical procedure called microdiskectomy is 95% effective at significantly improving pain.; Dr. Paul J Slosar
Daly City, CA

The usual treatment for a disc herniation is 2-3 days of bedrest followed by increasing activity as tolerated. Some patients may need medications for a period of time. Physical therapy is frequently utilized if patients are feeling better. A number of patients may benefit from an epidural cortisone injection to reduce the swelling and inflammation surrounding the nerves. A few patients will need surgery. Most spine surgeons use minimally invasive microscopic surgery to treat these disc herniations.; Dr. Sebastian Lattuga
Rockville Centre, NY

The majority of patients that have herniated discs can be made better with many non-surgical remedies such as physical therapy ,exercise, chiropractic, acupuncture, massage, all have been found to be effective in alleviating the symptoms of herniated discs. Other treatments include directed cortisone injections into area of the herniated discs called epidural injections.; Dr. Kambiz Hannani
Los Angeles, CA

Most disc herniations become painless within the first two to four weeks. If the pain does not disappear within a few weeks, physical therapy and epidural steroid injections are usually attempted. If the pain continues or is causing significant weakness or problems with bowel and bladder function, surgical removal of the disc is an option. Depending on the type of disc herniation, the surgery can be up to 90 percent successful in stopping pain. Furthermore, surgery is usually minimally invasive, allowing patients to return to sedentary work within a few days.; Dr. Ezriel E Kornel
White Plains, NY

The most common treatment is a couple of days of bed rest followed by the use of anti-inflammatory medications, possibly pain medications and then a progressive increase in physical activities such as walking. Often physical therapy or chiropractic management are valuable treatment modalities that get people feeling better more quickly. When that regimen does not work, then epidural steroid injection may be tried and may also be beneficial. If all these treatments fail, then surgery is indicated and depending on the size of the disc herniation and the location of the herniation and the experience of the surgeon, the techniques may vary. The most common technique for a single herniated lumbar disc is an operation called a microdiscectomy but now becoming more and more prevalent as well is a minimally invasive microdiscectomy or endoscopic assisted microdiscectomy.; Dr. Jorge E Isaza
Baton Rouge, LA

The majority of herniated discs can be treated conservatively. About 95% of the patients with acute disc herniations get better with time, physical therapy, anti-inflammatory medications, and muscle relaxants. Some disc herniations require further treatment, such as epidural steroid injections and surgery. Surgery is indicated for the patient with intractable pain or that do not improve with conservative treatment after six weeks. The same holds true for a patient with progressive neurological deficit or bladder or bowel dysfunction.; Dr. Jeffrey C Wang
Los Angeles, CA

Most herniated discs are responsive to conservative treatment, which would include physical therapy, rest, anti-inflammatory medications, as well as the possible use of steroids and physical therapy. If this conservative treatment fails to alleviate the symptoms, patients will often have a good response to an epidural steroid injection, which is given specifically at the level of the disc. When all of these treatments fail and the patient remains symptomatic, we then perform a microdiscectomy. This microdiscectomy is done under a microscope where a tiny incision is made over the disc, and using minimally invasive techniques, the disc can be shaved to alleviate the pressure on the nerve.; Dr. Sylvain Palmer
Mission Viejo, CA

Initial treatment of a herniated disc is rest, ice, and medications (nonsteroidal antiinflammatories, muscle relaxants, pain killers). Once the initial pain has subsided physical therapy can be added. Other modalities such as chiropractice care, acupuncture, or osteopathic care can be tried. When this is not sufficient sometimes steroid injections can be performed. Ultimately surgical interventions can be considered such as discectomy or fusion.; Dr. Sean Salehi
Chicago, IL

Initially, conservative treatments - such as bed rest, aspirin or Motrin®, and physical therapy - should be utilized to treat a herniated disc.; Dr. Thomas Kleeman
Bedford, NH

When a disc herniates, the initial symptoms of pain, numbness, and weakness may be quite severe. As time allows for healing to occur, the symptoms will often subside. The pain will usually subside within a few weeks. The numbness and weakness may take longer. The initial treatment is directed towards relieving the inflammatory pain with non-narcotic anti-inflammatory medication such as NSAIDs or a short course of steroids. Occasionally a brief treatment of narcotic pain medication may be necessary. As the pain subsides, a course of physical therapy will aid in the healing process and help prevent deconditioning. The use of resistive exercise will help re-strengthen the weakened muscles. If the pain fails to respond to conservative measures or the numbness and weakness are progressive, then surgical decompression may be indicated.; Dr. John S Shiau
Staten Island, NY

In our practice we try not to operate. So if a patient comes to us with a herniated disc, we try to treat it conservatively with physical therapy, pain management, anti-inflammatory, and ninety percent of people with a herniated disc get better within six weeks. I would never, unless it was an emergency, advise a patient to have surgery if it is less than that. If conservative treatment does not work, or after about a month, the patient is not feeling any better, then we may try an epidural injection with steroids injections. If that does not work, then we may recommend surgery to keep that herniated disc away from the nerves so it is not irritated anymore. Of course it is all individualized for each patient, depending on the severity of the symptoms. But in a normal patient who is not in too much distress, those are the little steps we take before we decide on surgery.; Dr. Kenneth A Pettine
Loveland, CO

The American Academy of Orthopedic Surgery strongly recommends six weeks of non-operative treatment for a herniated disc since 90% of herniated discs get better in this time frame. A patient who continues to have symptoms of intense leg pain after six weeks of onset carries a poorer prognosis. Non-operative treatments include chiropractic, physical therapy, massage therapy, rolfing, acupuncture, nonsteroidal anti-inflammatory medications, steroids, pain medications, and muscle relaxers.; Dr. Mark Rosenthal
Baltimore, MD

If it is a small herniation, an injection and Physical Therapy may be all that is needed. If the herniation is large, or there is significant loss of function, surgery may be the best option. If surgery is indicated, the best results are seen when the surgery is done in the first 6 months or so.; Dr. Randy Davis
Glen Burnie, MD

The most important initial treatment of herniated discs is the natural history. Again, 80% of people will get better without surgery within six to eight weeks. Once they improve, it is important for the patient to enter into a program of back stabilization exercises and avoid stress on what is clearly an abnormal disc.; Dr. George Frey
Englewood, CO

Most herniated discs, 80% in fact, simply get better on their own. This can take about three months to occur. If, however, the disc herniation continues to cause sciatica or leg pain, then oftentimes treatment is necessary. This initially includes physical therapy to strengthen muscles, as well as the use of the soft tissue treatment, such as massage and stretching. Cortisone injections, called epidural steroid injections, around the pinched nerve may also be of benefit. If all of these measures fail, surgery may be necessary. The standard surgical procedure for disc, to free up the nerve. More advanced techniques include the endoscopic removal of the disc material through a minimally invasive technique.; Dr. Thomas Zdeblick
Madison, WI

Most herniated discs can be treated without surgery. Often time, physical therapy, anti-inflammatory medications, and occasionally an epidural steroid injection are all helpful for disc herniations. Approximately 75% of people will improve on these treatments. For those patients that do not improve with these treatments over a two-month period, surgery may be indicated. Other indications for surgery include weakness, unremitting pain, or changes in bladder control.; Dr. Donald D Dietze Jr.
Covington, LA

Truthfully, symptoms resolve without specific treatment in 85% of people over 6 months. There should be some evidence of resolution by 6 weeks. Medical treatment initially involves reassurance and comfort measures. Additional treatment modalities can include physical therapy, lumbar traction and spinal injections. Surgery is reserved for failure of resolution, failure to control pain or progressive development of weakness or urinary problems.; Dr. Eung-Jun Cha
Bedford, IN

Lumbar epidural, physical therapy or for extreme--surgery.; Dr. Robert S Pashman
Los Angeles, CA

A herniated disc is treated with conservative therapy unless there is a spinal deformity or neurologic deficit. Conservative therapy can include physical therapy, chiropractic care, acupuncture, Pilates, ultrasound, pain medication, muscle relaxants and a short course of steroids. If these do not work, the next steps include a steroid epidural injections or a facet joint block. Surgical intervention is the last resort, but if it becomes necessary, a microdiscectomy is a commonly performed procedure.; Dr. Sylvain Palmer
Mission Viejo, CA

Initial treatment of a herniated disc is rest, ice, and medications (nonsteroidal antiinflammatories, muscle relaxants, pain killers). Once the initial pain has subsided physical therapy can be added. Other modalities such as chiropractice care, acupuncture, or osteopathic care can be tried. When this is not sufficient sometimes steroid injections can be performed. Ultimately surgical interventions can be considered such as discectomy or fusion.; Dr. Reginald Knight
Seattle, WA

Moderate rest, exercise, non-steroidal anti-inflammatory medications (NSAIDS), altering your activities.; Dr. Theodore A Belanger
Charlotte, NC

Most patients will recover without surgery. Symptoms can be controlled with medication, injections, and physical therapy. If symptoms are not adequately controlled with these treatments, loss of bladder control occurs, or if recovery is inadequate after 2-3 months of conservative treatment, then surgery for removal of the herniated disc fragment can be considered.; Dr. Theodore A Belanger
Charlotte, NC

Most patients will recover without surgery. Symptoms can be controlled with medication, injections, and physical therapy. If symptoms are not adequately controlled with these treatments, loss of bladder control occurs, or if recovery is inadequate after 2-3 months of conservative treatment, then surgery for removal of the herniated disc fragment can be considered.; Dr. Rick Sasso
Indianapolis, IN

Usually activity modification (rest), non-steroidal anti-inflammatory medications, and physical therapy are initiated.; Dr. Ezriel E Kornel
White Plains, NY

The most common treatment is a couple of days of bed rest followed by the use of anti-inflammatory medications, possibly pain medications and then a progressive increase in physical activities such as walking. Often physical therapy or chiropractic management are valuable treatment modalities that get people feeling better more quickly. When that regimen does not work, then epidural steroid injection may be tried and may also be beneficial. If all these treatments fail, then surgery is indicated and depending on the size of the disc herniation and the location of the herniation and the experience of the surgeon, the techniques may vary. The most common technique for a single herniated lumbar disc is an operation called a microdiscectomy but now becoming more and more prevalent as well is a minimally invasive microdiscectomy or endoscopic assisted microdiscectomy.; Dr. Jeffrey C Wang
Los Angeles, CA

Most herniated discs are responsive to conservative treatment, which would include physical therapy, rest, anti-inflammatory medications, as well as the possible use of steroids and physical therapy. If this conservative treatment fails to alleviate the symptoms, patients will often have a good response to an epidural steroid injection, which is given specifically at the level of the disc. When all of these treatments fail and the patient remains symptomatic, we then perform a microdiscectomy. This microdiscectomy is done under a microscope where a tiny incision is made over the disc, and using minimally invasive techniques, the disc can be shaved to alleviate the pressure on the nerve.

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The commentary above recounts the experiences of these physicians. Medtronic invited them to share their stories candidly. Keep in mind that results vary; not every patient's response is the same. Talk with your doctor to learn more about any products that are mentioned above.

It is important that you discuss the potential risks, complications and benefits of spinal surgery with your doctor prior to receiving treatment, and that you rely on your doctor's judgment. Only your doctor can determine whether you are a suitable candidate for this treatment.

Published: September 26, 2007
Updated: September 26, 2007