• By Liza Torborg

Mayo Clinic Q and A: Herniated disk symptoms often effectively treated without surgery

March 14, 2015

illustration of herniated disk and a normal disk in the spineDEAR MAYO CLINIC: What is the typical treatment and recovery time for a herniated disk? At what point should surgery be considered?

ANSWER: In many cases, pain and other symptoms caused by a herniated disk resolve with time and self-care measures. When medical treatment is required, therapy that doesn’t involve surgery often is all that’s needed to effectively treat herniated disk symptoms. However, if your symptoms significantly limit your day-to-day activities, if you have nerve damage due to a herniated disk, or if your symptoms cannot be controlled with other treatment, then spine surgery may be necessary.

Your spinal disks are the cushions between the individual bones, called vertebrae, that make up your spine. The disks have a soft center within a tougher exterior. A herniated disk happens when some of the center pushes out through a crack in the outer portion of the disk. A herniated disk may irritate or compress a nearby spinal nerve root. The result can be back pain, along with pain, numbness or weakness in an arm or leg.

For most people who develop back pain — whether it is because of a herniated disk or due to another problem — symptoms often go away within six to eight weeks. During that time, you can take steps to ease discomfort. Rest, apply heat or ice to the painful area, and take over-the-counter pain medication, such as ibuprofen or acetaminophen, if you need it. If you have muscle spasms, taking a muscle relaxant also can be useful. If pain is strong, ask your doctor about getting a short-term prescription pain medication.

There are some red flags to watch for when you have back pain. Symptoms that should prompt a call to your doctor right away include developing a fever, chills, flu-like symptoms or a rash when your back symptoms start. You should also contact your doctor if you have significant or progressive weakness. If you develop significant bowel or bladder function changes, which are often associated with pain or numbness in the area around your rectum or genitals, have those symptoms evaluated as soon as possible.

If you notice back pain and your immune system is suppressed for any reason, you have a history of cancer, you have unexplained weight loss associated with your back pain, or the beginning of the back pain was related to trauma, contact your doctor.

When symptoms lasts longer than eight weeks — or if you have any of the red flags mentioned earlier — see your doctor for an evaluation to investigate the underlying cause. Such an evaluation typically includes a magnetic resonance imaging, or MRI, exam of the spine and sometimes an electromyogram, or EMG. An EMG can show if any nerve roots have been damaged.

If tests reveal a herniated disk but no nerves are damaged and you do not have significant weakness or bladder or bowel problems, then medication, physical therapy and, in some cases, steroid injections typically are recommended. If pain and other symptoms can be adequately managed with those measures, they can be continued for as long as necessary.

Surgery for a herniated disk would be considered if there is nerve damage, if pain and other symptoms are so severe that they interfere with daily activities, or if non-surgical treatment is not effective. Surgery often can resolve herniated disk symptoms more quickly than other treatments. In general, though, when there is no nerve damage, the long-term outcome for surgical and non-surgical treatment is the same when measured two years after symptoms begin.

Fortunately, most people with a herniated disk never get to the point that they need to see a specialist or have advanced testing. Back symptoms usually go away on their own. Even for those who do need treatment, only a small minority has lingering chronic pain that does not resolve over time. James Watson, M.D., Neurology, Mayo Clinic, Rochester, Minn.

Earlier this week, I happened to ask a networking person about the mcmobile Wi-Fi network. Apparently, it was supposed to have gone away months ago, with all of us going back to using mcwpa. However, some Apple devices had issues, so they had to keep it around until they resolve that. Those of us using non-Apple devices should be moving to mcwpa as we have the chance. Many of us were using mcmobile because it was using some more advanced Wi-Fi technology that made for better hand-off of connections between access points while using it on-the-move. But, that technology was implemented in mcwpa months ago. After that was done, the plan had been to retire mcmobile, until they discovered the Apple device issue. Some of the details were probably lost in translation, but I think this info is mostly accurate.

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Although Mayo "expects staff to stay home when sick," that does not seem to be reflected in the absentee policy. As a mother with a young child in daycare and school it seems that I must save days to take when he is ill rather than when I am sick.

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@octobersunrise

Although Mayo "expects staff to stay home when sick," that does not seem to be reflected in the absentee policy. As a mother with a young child in daycare and school it seems that I must save days to take when he is ill rather than when I am sick.

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How would you propose correcting the policy so that it is fair to those of us that do not have children? Would that mean that we get an allotment of days that we can use at our discretion as well?

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I always pay my Mayo bills right away. The Q&A above stuns me that if I purposely don't pay, I can be rewarded by being offered 35 percent off the bill??

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@robertm

Earlier this week, I happened to ask a networking person about the mcmobile Wi-Fi network. Apparently, it was supposed to have gone away months ago, with all of us going back to using mcwpa. However, some Apple devices had issues, so they had to keep it around until they resolve that. Those of us using non-Apple devices should be moving to mcwpa as we have the chance. Many of us were using mcmobile because it was using some more advanced Wi-Fi technology that made for better hand-off of connections between access points while using it on-the-move. But, that technology was implemented in mcwpa months ago. After that was done, the plan had been to retire mcmobile, until they discovered the Apple device issue. Some of the details were probably lost in translation, but I think this info is mostly accurate.

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The question didn't state whether or not the person had installed airwatch on their device. I'd been told that if you don't install it (and allow Mayo access to everything on the device), you won't be able to connect to mcwpa or mcmobile.

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@octobersunrise

Although Mayo "expects staff to stay home when sick," that does not seem to be reflected in the absentee policy. As a mother with a young child in daycare and school it seems that I must save days to take when he is ill rather than when I am sick.

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I would like just not to fear being written up (or worse) if I end up using the 6-8 unexcused absences in a rolling 12 month period.

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@octobersunrise

Although Mayo "expects staff to stay home when sick," that does not seem to be reflected in the absentee policy. As a mother with a young child in daycare and school it seems that I must save days to take when he is ill rather than when I am sick.

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Having and caring for our children does not make us special in the workplace. We're supposed to be present to the patients, and we can't be present if we're not… well, present. I am in favor of reasonable expectations of absenteeism, and believe Mayo Clinic's expectations are reasonable.

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@chaddowdell

I always pay my Mayo bills right away. The Q&A above stuns me that if I purposely don't pay, I can be rewarded by being offered 35 percent off the bill??

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Don't assume that those people aren't paying their Mayo bills. I pay over $500 a month and still received the letter/offer.

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In regards to Chad's comment above. I have an outstanding Mayo bill that I pay on time every month. I would never purposely not pay it, and have received this offer more than once. I think if you purposely don't pay your bill that would warrant you to be sent to collections correct? And nowhere above does it say that it is meant for people that don't pay their bill. I think it is meant for people that have higher balances to help get them payed off quicker or easier.

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@chaddowdell

I always pay my Mayo bills right away. The Q&A above stuns me that if I purposely don't pay, I can be rewarded by being offered 35 percent off the bill??

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Some clinic bills are into the multiple thousands. Not many people could afford to pay that "right away", and just because they're not paying the entire amount does not mean that they're just not paying it. Clinic bills do go to collections and it's not a "reward" for not paying. I think that's a bit insulting to say that.

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@amysmelser

In regards to Chad's comment above. I have an outstanding Mayo bill that I pay on time every month. I would never purposely not pay it, and have received this offer more than once. I think if you purposely don't pay your bill that would warrant you to be sent to collections correct? And nowhere above does it say that it is meant for people that don't pay their bill. I think it is meant for people that have higher balances to help get them payed off quicker or easier.

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Who do we call to se if we qualify for the reduced Clinic Bill amount, if we pay it off in full?

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Will the Mayo Clinic (as an institution) be moving away from trees in the downtown area in the future? Are trees unable to be pruned back to discourage being overgrown and; if not, at what age does a tree require removal? At what age does a tree become a roosting location for birds?

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@amysmelser

In regards to Chad's comment above. I have an outstanding Mayo bill that I pay on time every month. I would never purposely not pay it, and have received this offer more than once. I think if you purposely don't pay your bill that would warrant you to be sent to collections correct? And nowhere above does it say that it is meant for people that don't pay their bill. I think it is meant for people that have higher balances to help get them payed off quicker or easier.

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As they are reviewing accounts and determine that you qualify, they send you a letter.

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@amysmelser

In regards to Chad's comment above. I have an outstanding Mayo bill that I pay on time every month. I would never purposely not pay it, and have received this offer more than once. I think if you purposely don't pay your bill that would warrant you to be sent to collections correct? And nowhere above does it say that it is meant for people that don't pay their bill. I think it is meant for people that have higher balances to help get them payed off quicker or easier.

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Don't call them, they'll call you! (In case it wasn't clear, that was meant as a joke. I'm sure that if you're experiencing significant financial hardship because of your medical bills, Mayo would like for you to contact the billing office and discuss your payment options.)

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My husband and I both have a Mayo Clinic bill. We pay both every month. He was offered the 35% off if we paid his bill in full (as we did). It saved us quite a few hundreds of dollars). I was not offered the 35% off. When I asked Mayo they said it was done randomly. Just very glad we got a good size discount on one of our bills.

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