Treat conservatively for at least a month. If the patient has severe neurological deficit, severe leg weakness or muscle wasting, more aggressive measures may be needed. Initial treatment for low back pain consists of 2-3 days of bedrest with early ambulation, along with patient reassurance. Back surgery is rarely necessary. Herniated discs do not cause most of the pain, and even the pain with herniated disc usually resolves with conservative treatment.
Conservative therapy includes treatment with anti-inflammatory drugs and muscle relaxants.
Patients need to be reassured. Don't tell someone he has a herniated disc until it is confirmed. Use the term bulging or extruded disc instead of ruptured disc - less frightening. Let patients know that most people do get better spontaneously with proper care. Reoccurrence of back pain and sciatica should be expected.