After determining the severity of your condition, your doctor will advise you regarding forms of treatment. Conservative methods, involving activity modification, pain medication, and physical therapy, are normally pursued as a first course of treatment. The majority of disc herniations (90%) do not require surgery, and will resolve with conservative, nonoperative treatment. Features of conservative treatment typically include:
- Resting the neck area by maintaining a comfortable posture and painless activity level for period of a few days to several weeks, sometimes using a cervical collar or neck brace.
- Using non-steroidal anti-inflammatory medication (for example ibuprofen or naproxen).
- An epidural steroid injection may be performed in cases of severe pain, utilizing a spinal needle under X-ray guidance to direct the medication to the exact level of the disc herniation.
- A physical therapist may develop a course of rehabilitation based on modes of treatment known to be beneficial to herniated disc patients, including exercises, traction, ultrasound, electrical muscle stimulation, and whirlpool treatment.
Non-steroidal anti-inflammatory medications, such as ibuprofen, may be recommended to decrease swelling and relieve pain. Sometimes time-released medication is most effective. While other painkillers may be prescribed, narcotic pain medication is generally avoided.
Patients who have a severe episode of pain may benefit from a single treatment of an epidural steroid, injected directly into the affected part of the cervical spine. This form of treatment can often relieve the symptoms to such a degree that other treatment measures can then be comfortably performed.
