Conservative Treatments for a Lumbar Herniated Disk

By: Peter F. Ullrich, Jr, MD

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Within the first six weeks it is probably reasonable to try different medications, modalities and therapies to try to alleviate the pain from the lumbar herniated disc and to give the disk herniation time to heal. With time the body can reabsorb the disk herniation, and if the symptoms start to abate within the six-week period, continued conservative treatment for the herniated disk is warranted.

At the very least, at the onset of pain from a herniated disk it is usually considered reasonable to start with a couple of days of bed rest followed by slow mobilization.

In This Article:

Chiropractic and Exercise for a Herniated Disk

If the pain is severe and/or if symptoms persist for 2 to 4 weeks, a trial of either chiropractic or osteopathic treatments, and/or exercise and physical therapy is warranted. The goals of chiropractic/osteopathic manipulation and physical therapy are to reduce pain and to allow the patient to return to a normal level of functioning. For more information, see the following resources:

Medications for a Herniated Disk

Medications may also help reduce the pain from a herniated disk, and non-steroidal anti-inflammatory drugs (NSAIDs) can reduce the inflammation caused by the disk herniation.

See also NSAIDs.

Epidural Steroid Injections for a Herniated Disk

Either oral steroid medication or an epidural injection may achieve a stronger anti-inflammatory effect, although their use is a little riskier, and neither has been clearly shown to change the natural history of whether or not a patient will need surgery. Approximately 50% of the time, an epidural steroid injection will provide pain relief that may last from one week up to one year. Up to three epidural injections may be done in a one-year time frame (at least two weeks apart). For more information, see the following resources: