Nonsurgical treatment of a herniated disc focuses on pain management through physical therapy, including various exercise routines and heat or ice treatment, as well as a pain-relief medication regimen. Surgical treatments for herniated discs include discectomy and laminectomy, according to WebMD.
Nonsurgical treatment options relieve pain in nine out 10 people with a herniated disc, reports Mayo Clinic, and they are therefore the first line of treatment. The first recommendation for those with a herniated disc is a period of rest with medication to manage pain. If pain persists after a period of rest, physical therapy is the next treatment option, reports the New York Times. Physical therapy consists of exercises aimed at strengthening muscles that support the spine as well increasing flexibility in the spine and legs. Physical therapy options also include heat or ice application, electrical stimulation and short-term bracing for the neck or lower back.
Medications used for pain management are over-the-counter medications such as ibuprofen and naproxen, muscle relaxers, and nerve pain medications such as gabapentin, pregabalin, duloxetine, and amitriptyline. If pain persists, doctors can prescribe narcotics for short-term use, explains Mayo Clinic. Inflammation-suppressing corticosteroid injections are another method of pain relief. These steroids, which inject directly into the back, reduce swelling and pain for several months.
Surgical treatment is an option only when pain interferes with daily activities or requires long-term use of narcotics, or when tests can show that the hernia is operable. A discectomy, which removes all or part of the disc, is the most effective surgical treatment option, says WebMD.