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Unless there are neurological deficits, muscular weakness, difficulty in walking, or horse-tail syndrome, the first treatment option is conservative care with the aim of alleviating the pain.
The common non-surgical measures include:
Rest. As a general measure, one or two days of rest calm severe pain; however, the rest should not last too long. The patient should have some rest periods during the day but avoid sitting down for long periods of time.
Controlling all movements and carrying them out slowly. The patient should change daily activities in order to avoid movements that cause more pain, especially bending forwards and lifting heavy objects.
Anti-inflammatory drugs. Drugs like ibuprofen or naproxen can reduce the pain.
Physical therapy. Some specific exercises can strengthen the lower back and the abdominal muscles.
Epidural steroid injection. In this procedure, steroids are injected into the back to reduce the local inflammation. Studies demonstrate that epidural injections can be successful in between 42% to 56% of patients that have not had relief with another six-weeks or longer non-surgical treatment.
A small percentage of patients suffering from a lumbar disc herniation require surgery. Spinal surgery is only recommended after a non-surgical treatment that has not alleviated the symptoms.
The most common surgical procedure for a lumbar disc herniation is a lumbar microdiscectomy. A small part of the bone located over the nerve root and/or the disc material is extracted. This extraction is performed below the nerve root in order to alleviate the pinched nerved and to provide more space for the nerve to recover.
Published: 29 October 2019
Updated: 29 October 2019
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