What are the treatment options?

Generally, medical management is recommended before surgery is considered. Medical management includes one or more of the following: active physical therapy, simple analgesics (pain-relieving medications), muscle relaxants, non-steroidal anti-inflammatory medication, epidural blocks ("nerve blocks"), a short course of steroids, and possibly very short-term bed rest.

When major neurological changes are present upon the clinical examination, an urgent surgical consultation may be suggested. This situation is rare and usually includes loss of bowel and bladder control.

Otherwise, surgery is reserved for patients who have not shown adequate improvement with non-surgical care in 6 to 12 weeks.

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