THE #1 Neurosurgeon Recommended Treatment For A Herniated Disc

What is the best treatment for a herniated disc?

Most people with a herniated disc will get better on their own without the need for further treatment over days to weeks. Pat had a history with the clinic, so he came to see us. But for most people the best treatment for pain from a herniated disc depends on how long you have had it.

First Six Weeks

We advised Pat to try rest, moist heat, and anti-inflammatory drugs. Rest means light activity. Tylenol is the safest anti-inflammatory drug. If Tylenol is not enough, you can try ibuprofen (2 tablets every 8 hours with food) or Alleve (one tablet every 12 hours) and Prilosec (one tablet a day). Prilosec is to prevent an ulcer caused by acid due to Alleve or ibuprofen. You can consider acupuncture or chiropractic treatment. Braces and exercise do not work well in this phase. Narcotics and muscle relaxants should be avoided.

Pat did not have any red flags. If he did, he would need to see a surgeon on an emergency basis, the same day.

Although not severe, Pat’s leg pain was associated with numbness or weakness, so he got an MRI right away; most of the time an MRI is not needed in the first six weeks. Pat’s MRI showed a giant herniated disc. For herniated discs causing severe pain without numbness or weakness epidural injection is an option. Epidural injection relieves pain temporarily, buying you time for the body to heal. In Pat’s case, he skipped the epidural injection because he had so much hip weakness that if he was left in that position his gait would be permanently altered.

After 6 Weeks

Pat was referred to surgery because he had a giant disc herniation and motor weakness. Physical therapy may be considered in this phase. If 12 weeks (about 3 months) have gone by and someone still has the pain is something structural. Hang in there.

Many patients with herniated discs will choose epidural injection in this phase of recovery. Your doctor will get an x-ray of your back and refer you to physical therapy if appropriate. If you fail to improve over three weeks and there is a lot of leg pain, then your doctor will send you for an MRI of your lower back. If the MRI shows a herniated disc as the cause of your pain, then they may refer you to a pain management doctor for epidural steroid injection.

During the injection, a needle is placed under x-ray guidance outside your spine and a cocktail of steroid and numbing medicine administered.



No matter what, if you are not improved after 12 weeks (about 3 months), then your doctor will refer you to an orthopedic spine or neurosurgeon as appropriate.

After 12 weeks (about 3 months)

If you are still having trouble 12 weeks (about 3 months) after the pain started, then it is time to have an MRI if one was not done already and see a surgeon. They will advise you on any structural problem that may be treated in your back to relieve your pain. The use of microdiscectomy surgery was established by the surgeon experience, case series, and eventually a randomized controlled trial – the NIH sponsored SPORT (Spine Patient Outcomes Research Trial). Microdiscectomy surgery is considered the standard of care by professional societies and is covered by Medicare as well as all commercial health insurance for the treatment of MRI-confirmed lumbar disc herniation with motor or sensory deficit as well as uncontrolled pain after the failure of appropriate conservative care.

[therealjoe]

Dude the pain is fucking insane. I feel bad for anyone experiencing this. It will make a grown man cry like a baby if it’s very bad.

[christinhoneycutt]

I pray right now to Jesus Christ for everyone hurting in the comments for the holy spirit to heal you I plea the blood of Jesus over you from head to toe and to your spines

[jasonlarocque]

It’s been the hardest 4 years, i got a herniated disc the summer before my senior year of high school. My life completely took a turn. I didn’t know how I was going to be able to push through. Everything got taken from me, I could no longer do the things in life that made me happy. I had a herniated disc and a bulging disc. Bye bye senior year of volleyball. I wouldn’t even be able to go into the details because it would take too long to explain. Well 4 years later, and 1 surgery later, the herniated disc is fixed, and bulging disc is herniated. So now i’m back in the same boat and have to start the process over again, It’s hard to find a job that i can work and not be in pain. It’s just so tiring, i’ve given up trying and just smoke weed to forget about it. It’s really inspiring seeing all you strong people that deal with the same bs i have to. I wish you all the best of luck on your journeys and hope you all find happiness. Peace and love✌🏻

[RUNNOFT]

Seriously, i know this sounds corny but I've suffered with major major sciatica pain due to L5S1 herniation and I honestly cannot tell you how refreshing it is to hear someone say "it's more pain than a lot of people have experienced, child birth like pain". I'm not a woman so i can't speak on birth pain, but it is biblical like pain. It has been absolute King in my life and very feared for the past 10 years. God have mercy on people that also live with this.

[tamarapThenTheresTwo]

Six years of horrible pain with 3 herniated discs and have done it all except surgery. The burning in my feet and legs makes me homebound. Going from active to not being able to even walk to my bathroom has been so depressing.However this has been the best explanation to date and I’ve researched everywhere! Thank you!

[RossMetler]

I had a severe rupture around L4-5 (>1cm extrusion). Three months of intolerable pain (from facette syndrome and sciatica) and then it started getting better all of a sudden. I am almost 60 days out from that, completely pain free and getting more mobile every day. I am super grateful I was able to avoid surgery and injections. We went through anti-inflammatories and steroid courses, all of which were completely ineffective against the pain. I worked with a great chiropractor who as able to get me some temporary relief with adjustments, but ultimately time was the only thing that made a difference.

[laurentpelissier]

I have a herniated disk 3 weeks of intense pain now. Looked all over the internet and your videos are the absolute best source of information I found so far. Thank you so much for putting these up! 🙏

[cmerighe]

Don’t rush into surgery. It almost killed my brother. He developed a nasty infection that went deep into his bones. I am treating mine with anti-inflammatory and serious physical therapy. Constant PT exercises, heating pad and massage.

[ErickaxErica]

Currently been experiencing pain since Oct 22. Now more recently numbness after 2 failed Epi injections. So now I’ll be doing surgery . Praying the relief is instant . Thank you for explaining everything in this video

[meatballsub]

This guy is awesome. I’ve had 2 microdiskects, so thankful for good surgeons.

[brassones]

Arguably the most sensible and pragmatic advice on the internet for this issue

[metalmassacre]

A velcro BACK BRACE has really helped me be more mobile on the early stages of PAIN. The one i have has some kind of firm plastic bars inside that run up and down.. Less stress on those weird “pinching” positions. Highly recommend for anyone in pain while walking etc..

[haritkumar]

The best explanation of sciatica I have ever seen. Thank you so much.

I've had to stop all my 'normal' physical activity, running, the gym, and playing squash since Nov 2021. It started in Mar 21, with a burning pain on my left foot during running and playing squash. I used otc pain medication till Jan 2022 while continuing my sports activities. I had to reduce sports from 6 days a week to 2 maybe 3 times a week during this period.

I was bedridden with pain for Feb 2022, the entire month. The pain radiating on my left leg and left arm was excruciating. My doctor recommended pain medicine and therapy.

It's Aug 2022. I have mild numbness on my the heel area of my left foot and occasional pain on my left shoulder.

Looks like the multiple herniated discs are getting better.

My big question is, when will I be able to get back to my sports and physical activity? I'm 51 years old, a navy veteran, and physical activity and sports have been a major part of my life. Without it, life feels incomplete.

[slamazu]

guys im telling you surgery and even epidural injections should really only be a last resort in my opinion. Ive been lucky enough (if you could call it lucky lol) to get my herniated discs early in life at 16, when my body is still pretty regenerative, so I can't necessarily speak for all of you older folk out there who are dealing with much worse symptoms than me. All I know is that after 2 years of pretty constant pain I'm finally starting to see the light at the end of the tunnel. What's really been working for me is a combination of PT and ATG (look up atg on youtube) exercises.

Improving your strength and mobility in basically your entire body not only has given me amazing results for reducing my herniated disc pain but it's also just a super smart thing to do because it makes your entire body more bulletproof and resistant to injury, especially for a pretty active person like myself. The last thing I had to do was probably the hardest for me which was reducing the frequency of activities that I love. I like to play basketball like as often as I can, and for 2 years I was playing through pain and then just dealing with it the next day cuz I wanted to play, but recently I've realized that no matter how much I bulletproof my body, my pain won't reduce if I'm still putting a bunch of stress on my discs constantly.

Honestly the moral of the story is that your body will tell you what's working and what's not, you really just need to learn how to listen to it. If anyone else is suffering and wants a more detailed breakdown of my routine just lemme know.

[ninastapleton]

I've never been through anything more excruciating in my 59 years. Listening to one of your videos has given me hope. It's taking entire year for my doctors to try and figure out what's going on and at this point I've diagnosed myself. Dave literally let this go on for a year giving me this drug and that drug and and it's just been a nightmare so I just wanted to say thank you thank you for your honesty and your guidance and I have hope now thank you

[salonichopra]

Thank you for the video
I have for my MRI report

Findings: The vertebral alignment is normal. The conus medullaris is appropriately positioned. No compress fractures. The last mobile intervertebal disc is being termed L5- S1 throughout this exam.

L1-2, 2-3, 3-4 are well maintained.

There is a mild circumferential disc bulge L4-5, with a slight left paracentral- right paracentral disc protrusion and annular fissure. The disc indents the anterior thecal sac and contacts the traversing L5 nerve roots bilaterally.

Superimposed on a mild-to-moderate circumferential disc. Bulge, there is a moderate to large right paracentral- left paracentral-left subarticular- left foraminal (central left subarticular) disc herniation at L5-S1, which displaces and likely compresses the traversing left S1 nerve root. The disc contacts but does not displace the traversing right S1 nerve root and mildly compresses the underlying thecal sac. There is moderate resultant narrowing of the left neural foramen and the exiting left L5 nerve root is contacted.

IMPRESSION:
Moderate to large disc herniation centered in the left subarticular zone at L5-S1, which displaces and likely compresses the traversing left S1 nerve root.


I got three spine injections. Pain is still there. I am going to Physio, chiro, massages. But I still have the sharp pain in the buttocks and the leg. I dont know what to do?

[ReportsOnChina]

Good explanation. I’ve had sciatica for about five months now, did an MRI about two months ago and confirmed I have three herniated discs. I have been trying to live with the pain now that I know the cause, and it seems to be getting slightly more bearable. Good to hear that it’s most likely just a matter of time until I’m better… thanks for the clear explanation.

[quantumhealthandnutrition]

I almost got the epidural injection until my doctor mentioned biofeedback. My sciatica and herniated disc is completely *gone* and healed! No more pain! I thank God that I was introduced to biofeedback. My family now asks me to help them out through biofeedback. Great video and details.

[sharpeye]

I think this man should do audio books. ❤️

[nathanas]

Thank you doctor ! Recently went thru the torture of herniated disc. Just wanted to share things that helped and thing that didn’t help.
1. Narcotics: only temporary relief for a few hours. I don’t recommend them.
2. Toradol: got an injection at the ER on the first day. Very helpful! ER doctor would not prescribe pills for it when I asked
3. Ibuprofen: very helpful. Caused bleeding had to stop
4. Celecoxib. Very helpful! 1 pill provided good relief for about a day.
5. Transforaminal injection: helpful for 2 weeks. Doctor discouraged second one.

6. Microdiscectomy. I was not a candidate but 2 close friends had it and found it enormously helpful because they were sciatica pain free and walking on the day of surgery!!