Medications

Although medicine doesn't cure a herniated disc, it may reduce inflammation and pain and allow you to begin an exercise program that can strengthen your stomach and back muscles.

Medication choices

• Pain relievers, such as acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs).
• Muscle relaxants.
• Corticosteroids.
• Opioids.
• Antidepressants.

Enzyme injection into the damaged disc (chemonucleolysis) can be done to try to dissolve a bulging disc. (An enzyme is a chemical or protein that is able to speed up a specific chemical reaction.) This procedure is rarely done.¹

Surgery

Surgery is considered if the following conditions are present:

• You have leg pain that hasn't improved with at least 4 weeks of nonsurgical treatment, and your symptoms are bad enough to interfere with normal activities and work and to require strong pain medicine.
• You have weakness, loss of motion, or abnormal sensitivity.
• Tests show that your herniated disc can be treated surgically.

People who have surgery may feel better faster. But in the long run, people treated with surgery and people treated without surgery have similar abilities to work and to be active.³ Some people require additional disc surgery after their first surgery.

Herniated Disc: Should I Have Surgery?

Many people are able to gradually resume work and daily activities soon after surgery. In some cases, your doctor may recommend a rehabilitation program after surgery, which might include physical therapy and home exercises.

Disc surgery isn't considered effective treatment for low back pain that is not caused by a herniated disc. Disc surgery is also not done if back pain is the only symptom the herniated disc causes.

Surgery choices

• Discectomy. This may be the most effective type of surgery for people who have tried nonsurgical treatment without success and who have severe, disabling pain.
• Percutaneous discectomy is considered less effective than open discectomy.
• Laminotomy and laminectomy. Either procedure may be done at the same time as a discectomy, or separately.

Experimental procedures

A number of technologies using small incisions or injections for destroying the disc are used by some surgeons. Examples are endoscopic discectomy and electrothermal disc decompression. These techniques are experimental and unproven. If your doctor recommends one of them to treat your herniated disc, make sure to get as much information as possible about the procedure. Consider getting a second opinion.

Laser discectomy uses a focused beam of light to dissolve a herniated disc. Although this technology has been used by some surgeons for several years, it is considered experimental because of the lack of studies on its effectiveness and safety.² It appears to be less effective than standard discectomy.⁴

Other treatments that have been tried include removing the center of the disc, and removing all or part of the disc by using suction. These treatments are not considered to be effective.