Find out how long you should give conservative treatment a try before having surgery for your bulging (herniated) disc.
If you’ve been diagnosed with a herniated (bulging) disc, you should not rush into the decision to have surgery.
The overwhelming treatment of choice for a herniated disc is conservative — even if the pain is pretty bad.
You may want to get a second opinion if you feel that a recommendation for surgery is coming prematurely.
But the Fair Question Is…
However, how long should you try the conservative approach before it’s fair to conclude that it just won’t solve the problem?
- Cold packs
- Warm packs
- Physical therapy
- Floor stretches
- Yoga
- Acupuncture
- Over the counter pain relievers
“The timing of non-operative care depends on the individual scenario,” says Dr. P. Justin Tortolani, an orthopedic surgeon and spine specialist with University of Maryland St. Joseph Medical Center.
“If someone presents with a weakening in the leg or foot, we might watch cautiously for a few weeks.
“It means that the nerve is compressed by the disc herniation and is being damaged, and generally, means the nerve fibers in each nerve have been compromised so that they’re not transmitting signals to the muscles.
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“It can be permanent and that’s why we have a lower threshold for considering surgery in a patient who has weakness and is not improving.
“It’s also important to rule out other causes of weakness even with someone with a disc herniation, like Lou Gehrig’s disease or trauma, or syphilis.
“If they present with severe weakness and are showing improvement, they will continue to watch and continue to use non-operative treatment.
“Even with pain, if they are showing signs of strength coming back, we’ll continue to treat without surgery.”
As far as physical therapy, which may be done at home, the patient needs to faithfully stick to the entire exercise regimen in order to give it a fair chance.
Improving symptoms from a herniated or bulging disc through physical therapy can take time.
PT focuses on reducing pain, restoring mobility and strengthening muscles around the spine.
Techniques may include exercises, stretches and manual therapy.
Patience is very important, as it often takes weeks or even months to see significant improvement.
Progress varies based on the severity of the herniation, individual health and adherence to the therapy plan.
Regular follow-ups with the therapist ensure that the treatment is effective and adjusted as needed.
Dr. Tortolani’s vast experience includes treating all disorders of the spine including herniated discs, spinal stenosis, and adult and adolescent scoliosis.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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