Nonsurgical Treatments for Herniated Disc

No two people experience a herniated disc in the same way. One person may hardly notice symptoms, whereas another may need medication for serious pain. Doctors at NYU Langone can assess the type of medication you need based on your diagnosis and description of what hurts.

Nonsteroidal Anti-Inflammatory Medications

Some of the pain associated with a herniated disc may be due to inflammation in the nerves and soft tissue surrounding the affected disc. When an inflamed nerve swells, it may push up against the slipped disc. By treating the inflammation with nonsteroidal anti-inflammatory medications, swelling and the resulting pain may go away.

The most common nonsteroidal anti-inflammatory medications are ibuprofen, naproxen, and aspirin. All are available without a prescription, and your doctor can recommend how best to use them. If a herniated disc causes more serious pain that is not relieved by over-the-counter medications, doctors may prescribe a more potent anti-inflammatory.

Muscle Relaxants

If a disc slips from its place between vertebrae and pinches a nerve, the electrical signals that move from the nerve to nearby muscle tissue may be disrupted, leading to painful muscle spasms. Muscle relaxant medications can calm spasms and ease pain, letting you move more easily. Your doctor may prescribe these medications for a week or two. After that, pain caused by muscle spasms often goes away on its own. 

Prescription Pain Relievers

If a herniated disc pinches a nerve, the pain can be severe. Over-the-counter medications may work to relieve pain, but if not, your doctor may recommend a brief course of prescription pain relievers. These medications are to be used for a week, at most; they are intended to help you feel better until a muscle relaxant or anti-inflammatory medication starts to work.

Corticosteroids

If other medications do not relieve your back or neck pain, your doctor may recommend corticosteroids taken by mouth. Steroids work to reduce inflammation in the area near the herniated disc, taking pressure off an affected nerve and relieving pain. Available only by prescription, steroids are typically taken for 7 to 10 days, at which time your doctor reassesses your symptoms before recommending additional treatment.

Being overweight can cause or exacerbate problems associated with the spine because excess weight, especially in the front of the body, may pull the spine’s vertebrae, joints, and discs out of alignment. If you’re overweight and have a herniated disc, this added pull on the spine may lead to nerve damage and increased pain. 

Our doctors understand that weight loss is not easy. NYU Langone’s Weight Management Program offers a variety of services that can help you make positive changes, one day at a time.

Your orthopedic doctor may work closely with a physiatrist, or physical medicine doctor, to recommend physical therapy. Often, physical therapy relieves pain and prevents further damage to a herniated disc. Our physical therapists at Rusk Rehabilitation and the Spine Center at the NYU Langone Orthopedic Center can recommend a treatment plan based on your daily routine, the location of your pain, and your overall health. 

Strengthening the core—the muscles in the back, abdomen, upper thighs, and buttocks—is an important part of therapy to treat symptoms of a herniated disc. If these muscles are weak, the spine bears more weight. This added pressure could cause instability or worsen an existing spine problem. A physical therapist can teach you a series of exercises for strengthening these core muscle groups, which can improve posture, relieve pressure on the nerves affected by a slipped disc, and alleviate pain.

A physical therapist may also recommend complementary techniques designed to improve overall function and make you feel better while you build core muscles. Stretching, massage therapy, and heat and ice therapies can all contribute to a comprehensive treatment plan.

Corticosteroid injections are an alternative to oral corticosteroids for herniated disc pain. Most of the time, an injection is recommended only after other nonsurgical treatments have failed to bring relief. Steroids have powerful anti-inflammatory properties and can be injected directly into the epidural space—the fluid-filled area surrounding the spinal cord. 

These injections are performed under local anesthesia, and NYU Langone pain management specialists and radiologists use X-ray guidance to make sure the medication is injected precisely. The procedure typically takes less than 30 minutes.

Pain relief from injected steroids may last from a week to a year or even longer. Yet some people find that injections don’t help them. There is no way to gauge the effectiveness of an injection before it is given, though for many people steroids do provide long-lasting relief. 

Steroid injections are most effective when used just before the start of physical therapy, allowing strength-building exercises to take place without pain.

Acupuncture is a therapeutic technique in which doctors insert very thin needles into various points on the surface of the body. By targeting specific points along “meridians” that correspond to the nerve pathways affected by a herniated disc, acupuncture may stimulate healing by increasing blood flow. Acupuncture may also prompt the body to release endorphins, which are natural pain relievers. 

Our licensed acupuncturists administer this therapy in a relaxed setting at NYU Langone. Acupuncture needles are left in place for 20 to 40 minutes. For optimal results, doctors may recommend several acupuncture sessions.