Spinal disks are soft, rubbery disks that cushion the vertebrae or back bones. They serve as "shock absorbers" for the spine. Disks have a hard exterior "shell" that protects a gel-like center. When something damages a disk, the soft interior material may bulge or leak through a crack in the exterior. Many people seek herniated disk treatment for the back pain caused by this condition.
A herniated disk is sometimes known as a slipped disk or ruptured disk. Spinal disk damage can irritate the nerves and cause pain or numbness in the back, arms and legs. Some people, however, live with the damage without experiencing any symptoms.
Several treatments exist to help people with back problems due to a herniated disk. Doctors typically prescribe conservative treatments before suggesting spinal surgery. Home remedies, medications and physical therapy are the preferred treatment methods. Most people do not need surgery to correct a herniated disk.
Home remedies are a starting point for treating a herniated disk. Non-prescription medications like acetaminophen, ibuprofen and naproxen may relieve the associated pain. Cold packs help reduce inflammation, and gentle heat may also provide comfort.
Bed rest is important to start the healing process, but too much rest can cause stiff joints and muscles. Short rest periods followed by short walks can improve recovery. Avoiding activities that may worsen the pain can speed the healing process.
Prescription medications are the most common herniated disk treatment. If over-the-counter medications do not relieve the pain, doctors may prescribe narcotics for a short period of time. Codeine or a combination of hydrocodone and acetaminophen are the most common narcotic prescriptions.
Doctors often prescribe drugs to reduce nerve damage caused by a herniated disk. Amitriptyline, duloxetine, gabapentin, pregabalin and tramadol are commonly-prescribed nerve pain medications. Since they are milder than narcotics, more doctors are prescribing them as first-line medications.
Muscle relaxers such as cyclobenzaprine and diazepam are often prescribed for muscle spasms in the back, arms and legs. Corticosteroid injections may suppress inflammation in the area around the spinal nerves.
Physical therapy provides exercises to strengthen the back and minimize herniated disk pain. As the pain diminishes and the condition improves, physical therapists may move patients to a rehabilitation program. Physical therapy may also include hot and cold therapy, traction, ultrasound, electrotherapy and back or neck braces.
Very few people with ruptured disks need back surgery. Doctors always recommend conservative treatments before suggesting surgical correction. However, for some people, surgery may be necessary to repair damage and relieve pain.
Doctors generally recommend surgery if conservative treatments are ineffective, if patients cannot perform everyday activities without pain or discomfort. Surgery is also recommended for disk fragments that press on spinal nerves and cause progressive back weakness. Surgeons may remove all or part of a ruptured disk. For some people, bone fusion or an artificial disk may be necessary.
Nine out of ten people with herniated disks obtain symptom relief through pain medications, back exercises and careful movements. Most symptoms improve within a month or two of conservative treatments. According to imaging studies, the damaged part of a spinal disk shrinks over time, which results in pain relief and other symptom improvement.
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