What Are the Treatments for a Herniated Disk?

Medically Reviewed by Jabeen Begum, MD on May 21, 2024
Written by Shawna Seed
7 min read

A vertebral disk is a rubbery structure between the vertebrae in your back. It cushions the bones in your spine. When a disk herniates, some of the cushioning material slips out of the casing that holds it. This is also called a ruptured disk or or slipped disk.

A herniated disk can press on the nerves in your spine and cause pain, weakness, and numbness in your neck, back, arms, and legs. Sometimes these symptoms can be severe enough to disrupt your life.

Most of the time, though, the problems from your herniated disk should start to improve on their own within a few weeks. In the meantime, try one or more of these treatments to help you feel better.

Medicine can help ease the symptoms of a herniated disk. 

Over-the-counter pain relievers

If your pain is moderate or mild, take an over-the-counter pain medicine such as acetaminophen, ibuprofen, or naproxen. These medicines can help relieve your pain and bring down swelling.

Don't use these OTC drugs for more than 10 days without talking to your doctor. When you take large amounts or for a long time, nonsteroidal anti-inflammatory drugs (NSAIDs) can increase your risk for heart problems or bleeding.

Prescription narcotics

Your doctor may be reluctant to prescribe opioid pain medication because of the risk of side effects and addiction. But if other drugs aren't controlling your pain, you doctor may have you take codeine or an oxycodone-acetaminophen combination for a very limited time.

Muscle relaxants for herniated disk

Your doctor might prescribe muscle relaxants to ease muscle spasms in your back. In the U.S., doctors most often prescribe a type of drug called non-benzodiazepine antispasmodics. Drugs in this class include: 

  • Carisoprodol (Rela, Soma)
  • Cyclobenzaprine (Amrix, Flexeril)
  • Metaxalone (Skelaxin)
  • Methocarbamol (Robaxin)
  • Orphenadrine (Disipal, Norflex)
  • Tizanidine (Zanaflex)

However, a 2021 review and analysis of several studies found that muscle relaxers had limited effectiveness in treating lower back pain.

Nerve pain medication for herniated disk

These drugs act on nerve impulses to reduce pain. Drugs in this class include: 

  • Duloxetine (Cymbalta)
  • Gabapentin (Horizant, Neurontin)
  • Pregabalin (Lyrica)
  • Venlafaxine (Effexor XR)

Some exercises can help improve the symptoms of a herniated disk. A physical therapist can teach you which ones strengthen the muscles that support your back. Physical therapy programs also include:

  • Stretching exercises to keep your muscles flexible
  • Aerobic exercises such as walking or riding a stationary bicycle
  • Massage
  • Ice and heat
  • Ultrasound therapy
  • Electrical muscle stimulation

Herniated disk exercises

Your physical therapist or other health care provider will let you know which exercises are right for you. When you start exercising, your back may hurt. If your pain level stays the same or pain moves more toward your back and away from your butt and leg, that's OK. If exercise causes pain in your leg or butt, or if your pain level goes up dramatically, stop exercising and consult your health care provider. Here are some exercises to try: 

Resting on your belly. If you start to feel new pain in your leg or pain increases in your leg, stop the exercise. 

  1. Lie on your belly facedown or with your face turned toward the side. You can fold your arms and rest your head on them if that's more comfortable. 
  2. Relax your lower back muscles.
  3. Remain on your belly for 2 minutes.

Press-up back extension. If you feel new or worsening pain in your leg, stop the exercise. 

  1. Lie on your stomach with your elbows close to your sides. 
  2. Using your arms, raise your upper back from the floor. Your forearms should be flat on the floor. Relax your stomach and back muscles as you arch up. 
  3. Hold the position for 2 minutes. Repeat 2-4 times. 

Full press-up back extension. Don't do this exercise if it causes new or worsening pain down your leg. 

  1. Lie on your belly with your elbows at your sides. 
  2. Straightening your arms, push your upper back off the floor. Allow your lower back to sag. 
  3. Hold for 6 seconds. Repeat this exercise 8 to 12 times. 

Backward bend. If you can't do the full press-up back extension, try this exercise instead. If it causes new or worsening pain down your leg, stop.

  1. Stand with your feet hip-width apart. Don't lock your knees. Your toes should point forward. 
  2. Put your hands on the small of your back. 
  3. Bend backward as far as you can while keeping your knees straight. Hold for a few seconds, then relax. 
  4. Repeat this exercise 2-4 times, trying to bend a little further on each repetition.

If rest, pain relievers, and physical therapy don't help with your pain, your doctor can inject a steroid medicine into the space around your spinal nerve. This is called an epidural injection. The steroid can help bring down the swelling, help you move more easily, and ease pain from a herniated disk.

Your doctor will use an X-ray or CT scan to find the right spot to inject the medicine. You might need more than one steroid shot to relieve your pain.

Most people with a herniated disk don't need surgery. Rest and other treatments should start to improve your symptoms within 4 to 6 weeks. But if your pain doesn’t improve, surgery might be an option.

When to you need surgery for a herniated disk?

Talk to your doctor about surgery if:

  • You’re not getting relief from pain relievers, injections, and physical therapy.
  • Your symptoms keep getting worse.
  • You have trouble standing or walking.
  • You can't control your bowels or bladder.

Most of the time, the surgeon can just remove the part of the disk that's protruding. You probably won't need the entire disk removed.

Diskectomy

During this procedure, your surgeon removes your damaged disk to relieve pressure on your nerves. They can perform the surgery in a couple of ways:

  • Your surgeon performs open discectomy via a cut in your back or neck.
  • Microdiscektomy is done through a much smaller incision. Your surgeon inserts a thin tube with a camera on one end to see and remove the damaged disk.

Lumbar laminotomy

Sometimes your surgeon will also need to remove a small piece of bone called the lamina from the vertebra. The lamina forms a protective cover over your spinal cord. Removing part or all of it helps the surgeon access your herniated disk. It also can relieve pressure on your nerves and eliminate leg pain and sciatica.

The lamina can be removed during the discektomy. Or you might have it taken out in a separate surgery.

Spinal fusion

After a discektomy or laminotomy, your surgeon may fuse together the two vertebrae on either side of the disk to stabilize your spine. This is called spinal fusion. Fusing the two disks will stop the bones from moving and prevent pain.

Artificial disk surgery

Very few people are good candidates for artificial disk surgery because it only works on certain disks in your lower back. But if your doctor thinks this is an option, they will replace your damaged disk with one made of plastic or metal. The new disk will help keep your spine stable and let you move more easily.

Taking it easy for a few days may ease your symptoms.

Rest can relieve swelling and give your back time to heal. While your back hurts, avoid exercise and other activities where you have to bend or lift.

Your doctor might suggest that you rest in bed. Bed rest is fine for a short period of time, but don't stay off your feet for longer than 1 or 2 days. You need to keep moving so your joints and muscles don't stiffen up.

You can also use ice and heat to help relieve your pain. Just place an ice pack or warm wet towel on the area of your back that is sore. You can alternate hot and cold, or use whichever feels best.

Most herniated disks get better on their own or with treatment. They can happen again, but you can take steps to prevent that. 

Use good posture

To protect your spine and prevent another herniated disk, you should always sit and stand up straight. If you have to stand for a long period of time, rest one foot on a stool or box to take pressure off your back.

Be careful with heavy lifting

When you lift anything heavy, make sure you protect your back. Squat from your knees to pick it up. Don't bend from the waist. It puts too much pressure on your back.

Stay at a healthy weight

Extra pounds put more strain on your back. Maintain a healthy weight.

Don't smoke

Smoking can cause hardening of the arteries, which can damage the disks in your spine.

A herniated disk can cause pain in your back, in your butt, or down your leg. The pain may go away over time with conservative treatment such as rest, OTC pain relievers, and gentle exercise. If your pain continues, your doctor may prescribe medicine to relax muscles or target nerves in your back. If none of those things work to ease your symptoms, you may need surgery. 

What is the fastest way to heal a herniated disk?

Alter your activities for a few days to avoid movement that causes pain. Take OTC pain relievers to ease symptoms. For most people, this will relieve your symptoms within a few days to a few weeks. 

Can a herniated disk heal on its own?

The pain often goes away on its own or gets better with rest and medicine. But a herniated disk can get worse, especially if you keep repeating the movements that damaged it in the first place. 

What is the most common treatment for herniated disks?

Most people don't need surgery. Prescription medication and physical therapy can help if rest and OTC pain relievers don't work. Your doctor also might try an steroid injection in your back to relieve pain. Surgery is an option only after more conservative treatment doesn't work. 

What are three signs and symptoms of a herniated disk?

The symptoms vary based on which disk you've herniated. If the problem is in your lower back (lumbar disk), you may have: 

  • Back pain
  • Numb spots or tingling in your legs or feet
  • Weakness 

If the problem is in your neck (cervical disk), you may have: 

  • Pain in your shoulder blades or between them 
  • Pain that goes to your shoulder, down your arm, or into your hands or fingers
  • Numbness or tingling in your hands 
  • Pain at the back of your neck or the sides
  • Pain that gets worse when you turn your neck