Generally, during the first two to three weeks the acute symptoms subside. Some patients may be referred to physical therapy or a supervised work-conditioning program. If the symptoms of DDD and low back pain persist despite non-operative treatment, further diagnostic tests may be necessary. These tests may include an MRI, CT Scan, Myelogram, or possibly Discography. Although most DDD patients with herniation respond well to non-operative treatments, a small percentage do not.
Disc herniation is the most common indication for spinal surgery.
Red Flags Lumbar herniation causing loss of bowel or bladder control, or major lower extremity deficit, requires immediate surgery. Cauda Equina Syndrome is a serious disorder that may be caused by a large central herniation. The cauda equina begins at the end of the spinal cord. The cauda sac is filled with nerves resembling the tail of a horse. When these symptoms present, surgery is required immediately.