• 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.

@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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You are responsible for your children, not your employer, or anyone else for that matter. If you do not want to be written up then I would suggest making/finding alternative arrangements.

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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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Yeah, it's great to just say that parents need to deal with it like everyone else. When the choice comes between calling in sick because you may be contagious and getting put into corrective action, or going to work sick and exposing everyone around you, what are you going to choose? The only reason that this also gets brought up by parents with young children so often is that we also have to take unexpected PTO to deal with sick children, and there really isn't a whole lot we can do about that. So you can go ahead and just take the attitude that the employees with sick children need to deal with it like everyone else, but you should also be prepared for those parents to come to work sick because they don't want to jeopardize their careers.

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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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In response to the young ladies discussion about time off for sick children. My boys are grown now but that nightmare of trying to find someone to care for your sick child is not something you ever forget. Especially when the child just wants Mommy to be there. And I don't think anyone at home with a sick child feels like it is a vacation day. Most of the time you would just as soon be at work. So,I would really like to ask for everyone to instead of looking at this as a need for "fairness", to maybe consider this a chance instead to step into someone else's shoes. Being a young working mother can be a terribly hard exhausting time. How do we problem solve to make it better?

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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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To be clear, I never made any comments about what others are doing. I never said anybody else is not paying their bill. Basically I was asking if it was beneficial of me to let my bill build up a bit, and then only pay it off in smaller amounts each month, and then I might get an offer of 35% off? I had never known this happened. Though from reading the comments, it's obvious that it is somewhat randomly offered.

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@davidkveene

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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When the trees were being removed from the North Side of Harwick on 2nd street, I asked the people removing them the reason for the removal. They told me that the side walk was not wide enough for a wheelchair and the trees were on the way of the expansion of the side walk.

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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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Real simple…..don't treat everyone the same with a blanket policy. It's life that some people miss work more than others for a variety of reasons, not just having children. Is life a bit easier with children, maybe. Is life easier when you never get sick, most likely. Is life easier if you never have rough stretches in life which cause you to miss work, yes. However, that is not always the case. We all hope we never have to miss work in relation to an illness or injury, but when it happens it can be unfortunate. Treat everyone as individuals and leave it up the supervisors/managers to follow up with their employees to see if corrective action needs to be taken. Do we treat our patients as one or on an individual basis? Same should go for employees.

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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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They don't offer the 35%. I'm surprised to hear of this offer also! if you're not paying your bill, they request full payment, and have you fill out a financial assistance application, then send you to collections in the meantime!

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@davidkveene

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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Most of the trees in the downtown location are variations of Ash. With the invasive EAB almost guaranteeing to wipe out all Ash trees in the Midwest in the near future, there will inevitably be few trees left unless they replace with other species.

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@judywittenberger

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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From a business perspective it makes good sense. Better to have less money in hand, now, than possible more money in the future – but slowly, and with bookkeeping expenses. Present value versus future value.

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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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Are you replying to my comment? I don't believe I said 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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Patient Account Services (PAS) 6-5670.

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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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Should there also be a correction to the funeral leave policy if a parent, sibling, or child passes away, because it's inherently unfair to those employees who don't have parents, siblings, or children?

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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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That sounds to me like the recipe for an HR disaster.

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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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At first glance the occurrence policy looks very reasonable, however, it's the flaw in the rolling calendar year. The rolling calendar year is a joke. It only takes one bad patch or bad luck period in someone's life to get them to corrective action and than that person has to wait an entire year hoping nothing else comes along in order for those occurrences to start dropping off. For any absent policy that is in place, there will be people who try to abuse or try to use the system. For that, it goes back to the supervisor/manager's responsibility to police those individuals. It's like we have blanket policy in place to take away responsibility and leave in the hands of what is written on paper. If I had to do my job only by what I see on paper, I wouldn't be very good at it. I have to examine and assess my patients to provide excellent care, not just look at what is black and white.

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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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Good point, Patrick. If anyone should have a good idea if the employee is mistreating the system or has actual problems/illness that requires more time off in a year than 5 occurrences (everyone says 10, but if you don't want to get written up and have a blemish on your record, it's 5) it should be the supervisor.

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