Prolapsed disc

Find out how a slipped disc is treated. Exercise, physiotherapy and painkilling medication are usually recommended. Surgery is needed in about 1 in 10 cases.

In most cases, a slipped (prolapsed) disc will slowly improve with rest, gentle exercise and medication. Recovery can take between one and three months.

Keeping active

It's very important to keep active.

Initially, it may be difficult to move around. If you're in severe pain, you may need to rest at first, but try to keep this to a minimum because keeping moving is important in helping you recover faster.

Doing exercise is likely to help your back. It doesn’t matter what type of exercise you choose, the important thing is to keep moving and gradually increase your activity level.

You may find your pain increases at first when you start moving around.

This is normal and doesn't mean you're causing more damage. Remember: hurt doesn’t equal harm. The pain should settle down quite quickly, allowing you to gradually increase the amount of exercise you're doing.

Physiotherapy

You may be referred to a physiotherapist as part of your treatment programme.

Physiotherapists are qualified healthcare professionals who use a range of techniques, including massage and manipulation, to restore movement and function.

A physiotherapist will be able to draw up an individually tailored exercise plan for you. This will keep you active, minimise pain and help prevent any further damage to your back.

Read more about physiotherapy.

Osteopathy and chiropractic

Some people choose to try osteopathy or see a chiropractor. Both types of therapy are used to treat back pain.

Osteopathy and chiropractic aren't widely available on the NHS, and you'll usually have to pay for treatment privately.

Medication

You may be prescribed a number of different medicines to help ease any painful symptoms of a slipped disc.

Over-the-counter painkillers

Non-steroidal anti-inflammatory drug (NSAID) tablets, such as ibuprofen, may help if you have any back pain. Many types are available to buy from pharmacies or supermarkets without a prescription.

But NSAIDs aren't suitable for everyone, so check the box or leaflet to see whether you can take the medicine first. Speak to a pharmacist if you're not sure.

If you can't take NSAIDs, alternative medicines such as codeine (with or without paracetamol) may help for pain that has started recently. But this should only be used for a few days, as it can cause addiction if used for longer.

Paracetamol on its own isn't recommended for back pain.

Speak to your GP if over-the-counter medicines aren't helping.

Medication for nerve pain

If you have pain in your leg, hip or buttocks (sciatica), your doctor may prescribe a stronger painkiller.

These include:

  • some types of antidepressant, such as amitriptyline and duloxetine – these medications were originally designed to treat depression, but they have since been found to help relieve nerve pain
  • anticonvulsants, such as gabapentin and pregabalin – these medications were originally designed to treat epilepsy, but they can also be useful for treating nerve pain

These medications aren't suitable for everyone, particularly when used in the long term, so it's important to discuss all available options with your GP. Some of these medications can also cause significant side effects in some people.

Epidural injections

Corticosteroids, often known as steroids, are an anti-inflammatory medicine.

They may be injected into your lower back (an epidural injection) to help reduce inflammation and pain if you have severe pain due to sciatica.

These injections may help relieve pain in the short term, but their effect tends to wear off over time.

Muscle relaxants

You may be prescribed a muscle relaxant, such as diazepam, to take for a few days if your back or leg muscles are very tense.

Surgery

Surgery isn’t usually needed, but it may be considered if:

  • your symptoms haven't improved using other treatments
  • you have very severe symptoms, such as progressive muscle weakness, altered bladder or bowel function, or numbness around the genitals or anus

The aim of surgery is to cut away the piece of the disc that bulges out to release the pressure on your spinal nerves. This is known as a discectomy and can be carried out in several ways.

Some of these procedures are explained in more detail below.

Open discectomy

An open discectomy is a procedure to remove part of the disc that is pressing on a nerve. It's carried out under general anaesthetic, which means you'll be unconscious during the operation.

The surgeon will make a cut (incision) over the affected area of your spine down to the lamina, the bony arch of your vertebra. 

They'll gently pull the nerve away to expose the prolapsed or bulging disc, and remove just enough to prevent pressure on the nerves.

To complete the operation, the surgeon will close the incision with stitches or surgical staples.

Microdiscectomy

A microdiscectomy, also known as a minimally invasive discectomy, is where a discectomy is carried out through a smaller incision.

The surgeon uses a special microscope and small surgical instruments inserted through the incision to move the nerve away from the affected disc and remove a small piece of the disc.

This procedure is generally as effective as an open discectomy in the long-term, although the initial recovery phase may be quicker.

Recovery

For most people, back surgery helps ease the pain in their leg, but it may not have any effect on back pain.

Depending on the procedure you've had and the type of work you do, you'll be able to return to work after two to eight weeks.

Possible complications resulting from surgery may include:

  • infection
  • nerve injury and paralysis
  • severe bleeding (haemorrhage)
  • temporary impaired sense (dysaesthesia) – for example, losing the sense of touch
  • loss of bladder or bowel control

Before deciding to have surgery, ask your surgeon about their experience doing the surgery, and their success and complication rates.

They'll tell you whether you're at risk of developing complications and how long it will take to recover. You may be given a rehabilitation programme to follow.

Read more about the risks of lumbar decompression surgery and recovering from lumbar decompression surgery.


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