An accurate diagnosis of the underlying cause of pain and other symptoms is crucial, since the diagnosis dictates effective treatment options.
For example, treating a lumbar herniated disc will not do much good if a muscle strain or other soft tissue injury is the actual cause of pain. This point is especially important if surgery is being considered for treatment.
Nonsurgical Treatments for Herniated Disc Pain
Nonsurgical treatment is always the first course of action for back pain, including pain from a herniated disc or degenerative disc.
Options for nonsurgical treatments typically include a combination of:
- Spine-Specialized physical therapy typically includes a combination of stretching, strengthening, and aerobic exercise to provide better stability and support for the spine.
- Massage therapy can help reduce muscle tension and muscle spasms, which may add to back or neck pain. Muscle tension is especially common around an unstable spinal segment where a disc is unable to provide necessary support.
- Epidural steroid injections consist of steroid pain medication injected into the area surrounding the spine. This treatment tends to be more effective for nerve root pain than for neck or back pain.
In most cases, nonsurgical treatment is able to sufficiently relieve pain from a herniated disc and surgery is not needed.
Surgical Treatments for Disc Pain
Surgery is only considered when nonsurgical treatments have not provided adequate pain relief.
Spine surgery can only alleviate pain if the herniated disc or degenerative disc seen on an MRI is confirmed as the pain source. The following spinal surgeries may be considered to alleviate disc pain:
- Microdiscectomyfor a herniated disc, a minimally-invasive procedure in which the herniated portion of the disc is removed.
- Artificial disc replacement for degenerative disc disease and herniated discs is a minimally invasive procedure that replaces a damaged disc with a specialized implant that mimics the normal function of the disc, maintaining mobility.
- Spinal fusion fusion for degenerative disc disease, in which the disc space is fused together to remove motion at the spinal segment. Spinal fusion involves setting up a bone graft, as well as possible implanted instruments, to facilitate bone growth across the facet joints. Fusion occurs after the surgery.
Spinal surgery is typically paired with a physical therapy rehabilitation program to restore range of motion and maximize functioning after surgery. Recovery from surgery depends on the severity of the condition, and the individual’s natural healing process.
Surgery is never appropriate when the exact pain source cannot be identified.