After a herniated disc is diagnosed, treatment generally starts conservatively. If the injured worker cannot work or the employer cannot accommodate work-related restrictions, then workers compensation temporary disability benefits should be paid.
The doctor may want the low back immobilized. Keeping the back still for a short time can calm inflammation and pain. This might include one or two days of bed rest. Lying on one’s back can take pressure off sore discs and nerves. However, most doctors advise against strict bed rest and prefer their patients to do ordinary activities using pain to gauge how much is too much. In rare cases in which bed rest is prescribed, it is usually used for a maximum of two days.
A back support belt is sometimes used for patients with lumbar disc herniation. The belt can help lower pressure inside the problem disc. Patients are encouraged to gradually discontinue wearing the support belt over a period of two to four days to prevent atrophy of core muscles.
Doctors prescribe certain types of medication for patients with lumbar disc herniation. At first, you may be prescribed anti-inflammatory medications such as aspirin or ibuprofen. Severe symptoms that don’t go away may be treated with narcotic drugs, such as codeine or morphine. But most doctors feel narcotics should only be used for the first few days or weeks because they are addictive when used too much or improperly. Muscle relaxants may be prescribed if the low back muscles are in spasm. Pain that spreads down the leg is sometimes relieved with oral steroids taken in tapering dosages.
Physical therapy may be prescribed. Therapy treatments focus on relieving pain, improving back movement, and fostering healthy posture. A therapist can design a program to help prevent future problems. It is important to let the physical therapist know if any job duties caused or aggravated back pain or leg pain from the disc injury.
Some patients who continue to have symptoms are given an epidural steroid injection (ESI). Steroids are powerful anti-inflammatories. In an ESI, medication is injected into the space around the lumbar spinal nerves where they branch off of the spinal cord. This area is called the epidural space. Some doctors inject only a steroid. Many doctors combine a steroid with a long-lasting numbing medication. Generally, an ESI often provides temporary relief to the injured worker with a herniated disc.
Most people with a herniated lumbar disc get better without surgery. As a result, doctors usually have their patients try nonoperative treatments for at least six weeks before considering surgery. For workers’ compensation benefits, it is important to get current off work or restrictions slips with each doctor visit.
McCormick Law Office in Milwaukee, Wisconsin.
