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Decision Aid for Herniated Disc in the Lower Back
WHAT YOU NEED TO KNOW:
What do I need to know about making treatment decisions for my herniated disc?
You can work with your healthcare provider to choose a treatment plan that works best for you. Your treatment choices include nonsurgical options and surgery. Your healthcare provider may recommend nonsurgical treatments first. Learn about the benefits and risks of nonsurgical treatment and surgery so you can make an informed choice.
What do I need to know about a herniated disc?
Aging increases your risk for a herniated (bulging) disc because your discs weaken and shrink as you get older. Discs are natural, spongy cushions between the vertebrae (bones) in your spine. The bulging disc may press on your nerves or spinal cord. This pressure causes pain in your lower back, buttocks, groin, or legs. It can also cause numbness or weakness in one leg.
How is a herniated disc treated, and what are the benefits?
- Nonsurgical treatment helps many people feel better within 6 weeks. Over a period of a year, it has been found to work as well as surgery in improving symptoms.
- Physical therapy exercises can help strengthen your lower back and abdominal muscles.
- Medicines , such as NSAIDs, help decrease swelling and pain. An example of an NSAID is ibuprofen. Muscle relaxers decrease pain and muscle spasms.
- Epidural steroid injections help reduce swelling and pain for about 2 to 4 weeks. They may be recommended if you have no pain relief after 6 weeks of physical therapy and NSAIDs.
- Surgery can be done to fix your herniated disc if other treatments have failed. Surgery can be done to remove the herniated disc that is putting pressure on your spinal nerve. Surgery usually provides faster pain relief than nonsurgical treatment for most people.
What are the risks of treatment?
Even with treatment and recovery, there is a chance that your symptoms may return or that you may develop another herniated disc.
- Nonsurgical treatment takes more time to provide pain relief than surgery. Medicines must be taken in limited doses. NSAIDs can cause stomach bleeding or kidney problems in certain people. Steroid injections are usually limited to about 4 each year. This is because the medicine can weaken the bones in your spine and your muscles. Steroids can also increase your risk for other infections, cause changes in your mood, and increase blood sugar levels.
- Surgery increases your risk for infection at the incision site and deep in the disc space. The protective layer of your spinal cord may tear or leak. This causes cerebrospinal fluid (CSF) to leak. You may have to lie flat for up to 7 days while the tear or leak heals. You may need disc surgery again. You may need surgery to remove your discs and fuse your vertebrae together. This surgery would limit movement in your back.
What questions should I ask my healthcare provider to help me make a treatment decision?
- Am I a good candidate for steroid injections?
- How will I know if signs and symptoms are becoming severe enough to need surgery?
- Am I a good candidate for surgery?
- How long is recovery from surgery?
Care AgreementYou have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.
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