• 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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I agree. I think that having a "one size fits all" policy is unrealistic. I have two young children and relocated here for work so there is no family around. Now yes, there are great services to employees to help with a sick child but if that service is full there isn't any other option than stay home. I believe that having a "sick child" policy would be helpful; something that states if you bring your child to the ER or to urgent care and they are indeed sick, or if the Dr. tells you to stay at home to monitor your child, that you shouldn't be punished for this. My family member was severely ill to the point of hospitalization last April, I had to call in because he was too ill for sick care. This resulted in 2 occurrences, which is ridiculous. Then last week when I had a stomach bug, I just had to work overnights vomiting…great patient care in surgery, but I would lose my job if I didn't show up.

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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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Thank you for your understanding. Our PTO and sick time are all one now also so here is another valid point my husband talked to me about this weekend…if one is not home with a sick child (and only have to ever call in for themselves) then a benefit for them is that they get to use PTO for vacations instead.

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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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Technically you do since our PTO and sick time are now one in the same. Those of us that have to call in for our child(ren) use our PTO for that, you can choose to use it how you wish.

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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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😉

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Crows. Can we have a real discussion regarding the crow problems. Last week I saw someone get hit on the head and face with crow droppings, yesterday a co-worker on my floor and today I was hit twice. Please don't say it is a city issue. It is a Mayo issue as it effects your staff and visitors more than anyone else plus the city wont listen to individuals like they will a company that is Minnesota's largest employer.

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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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Treating people as individuals means others could perceive favoritism. That could lead to a lawsuit. HR's main function is to prevent Mayo being sued. Hence, blanket policies.

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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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Pretty common debt collection practice, actually. By the time someone receives that kind of offer or successfully argues for it, the debt is usually very old (years) and (in many cases) the person's credit has been damaged. Definitely would not recommend waiting on purpose.

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@jamisonodiet

Crows. Can we have a real discussion regarding the crow problems. Last week I saw someone get hit on the head and face with crow droppings, yesterday a co-worker on my floor and today I was hit twice. Please don't say it is a city issue. It is a Mayo issue as it effects your staff and visitors more than anyone else plus the city wont listen to individuals like they will a company that is Minnesota's largest employer.

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I agree. I had a patient comment a couple weeks ago on the problem, and they expressed surprise that Mayo would allow that kind of unsanitary mess so near sick people. Even if it's technically a Rochester city issue in reality our patients do see it as a reflection of Mayo.

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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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I would be curious to know the minimum balance amount/age to qualify for an offer. As someone with a high medical bill but making payments monthly, I would be intrigued to know what qualifies a patient for a discounted lump sum payment offer.

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@jamisonodiet

Crows. Can we have a real discussion regarding the crow problems. Last week I saw someone get hit on the head and face with crow droppings, yesterday a co-worker on my floor and today I was hit twice. Please don't say it is a city issue. It is a Mayo issue as it effects your staff and visitors more than anyone else plus the city wont listen to individuals like they will a company that is Minnesota's largest employer.

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The crows are cold and hungry, and they are going to go where it is warm and there is food. The warmest place around is downtown Rochester. The city spends 10's of thousands of dollars chasing them around, and that helps some, but sooner or later they are going to come back to where it is warm. Only solutions are to a) Kill them all b) built a nice heated crow sanctuary for them with plenty of food c) try to capture them, then put them on a bus and send them to Miami Beach.

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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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Hopefully, no one has to ever be in a position of losing their job because of occurrences that on an individual level could have been avoided.

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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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Mayo provided sick care works really well!

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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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However, without the rolling year just think of how many sick days would be used in December, by everyone who didn't get PTO approved…The comment section would be filled with people saying that isn't fair as well-there usually is a yin with every yang…

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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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Sounds to me like Mayo should have a "blanket policy" and offer everyone 35% discount if bills are paid in full regardless of the amount.

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@jamisonodiet

Crows. Can we have a real discussion regarding the crow problems. Last week I saw someone get hit on the head and face with crow droppings, yesterday a co-worker on my floor and today I was hit twice. Please don't say it is a city issue. It is a Mayo issue as it effects your staff and visitors more than anyone else plus the city wont listen to individuals like they will a company that is Minnesota's largest employer.

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I like option (c) – only how about a transfer to Jacksonville? They can duke it out with the resident Canada geese there.

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