Lumbar (Intervertebral) Disk Disorders Follow-up

Updated: Feb 18, 2016
  • Author: Jere F Baldwin, MD; Chief Editor: Trevor John Mills, MD, MPH  more...
  • Print
Follow-up

Further Outpatient Care

Patients should lie in a position in which they are most comfortable.

Bed rest is not recommended most of the time. The exception is for patients whose pain is so severe that they cannot ambulate. Prolonged immobilization may worsen pain and extend recovery time. Strict bed rest should never exceed 2 days. Patients should be encouraged to begin limited activity as soon as possible.

Whether spinal manipulation (ie, chiropractic care) improves the rate of recovery in patients with disk disease is controversial.

Multiple surgical techniques have been used in patients with disk herniation who have not responded to 6 weeks of conservative therapy. These techniques include diskectomy, spinal fusion, and injection of chymopapain. Newer techniques continue to be developed. [12, 13, 14, 15]

The Spine Patient Outcomes Research Trial (SPORT) in 2006 failed to find any statistical superiority of surgical treatment versus conservative treatment for lumbar disk herniation. [16, 17] This occurred because the study design allowed crossover of treatment based on the patients' preference. These findings suggest that, in most cases, there is no clear reason to advocate for surgery apart. Patient choice appears to be the most important predictive factor.

Next:

Further Inpatient Care

Inpatient care generally is not required, except for those rare cases of intractable pain or in cases in which the social situation does not allow adequate home care. Further inpatient care mostly consists of continued analgesics, physical therapy, and possible consultation with a spine specialist.

Previous
Next:

Deterrence/Prevention

Prevention includes the following:

  • Smoking cessation
  • Weight reduction
  • Improve general physical condition
  • Avoid aggravating factors
Previous
Next:

Complications

Complications include the following:

Previous
Next:

Prognosis

Most patients can resume normal activities.

Previous
Next:

Patient Education

For excellent patient education resources, see eMedicineHealth's patient education article Low Back Pain.

Previous