You’ve been diagnosed with a lumbar disc herniation - now what?

Not all disc herniations are the same: some are bigger, some are smaller, and they occur in various locations. Nonetheless, I have seen even large ones resorb over TIME (several weeks).

The occasions I recommend surgery right away is if a patient is weak or has neurological deficits. For example, some people have a foot drop or can’t stand on their heels. If the only symptoms are pain, then how to proceed is totally up to you. The recommended treatment is threefold:

1. Medications - Tylenol, anti-inflammatories or NSAIDs (advil/alleve/ibuprofen), nerve pills (Gabapentin or Lyrica), medrol dose pack (steroids), muscle relaxants (Robaxin, Flexeril, etc.)

2.  Physical therapy with TRACTION. Stretch the vertebral bodies apart, opening up the spine, giving the nerves more room.

3. Injections, such as epidural steroid injections, targeted at the level of the herniation.

You do not NEED any of these interventions if it is just pain. But if you’re hurting, you probably WANT to do all of this. If these non-operative measures all fail over several weeks, surgery is an option (minimally invasive discectomy). The surgery to remove this disc herniation is simple (no rods or screws), fast (~1-1.5 hours), safe, and patients generally go home same day with a quarter-sized incision closed with glue on the skin.