The important principle in conservative treatment
is immobilization of the spine and relief of
weight bearing by rest in bed, which relieves to
some extent the extruding tension on the prolapse
and so gives the ligaments or nerve root
to adapt themselves to the pressure.
Traction on the leg by means of
a weight and adhesive strapping is sometimes
beneficial in some cases with very severe pain
is important that analgesic
drugs be administered
in adequate quantities to make the pain bearable.
an adequate trial of conservative treatment.
(ii) Recurrent attacks of pain. Operation is
usually advised at the start of a second attack if the
first episode has been severe, but the decision must
be left to the patient, who may wish to give conservative
treatment a further trial. (iii) Cauda
equina compression or severe foot drop. With
regard to sciatica the indications under (i) and
(ii) above are quite straightforward, but when
operation is contemplated for a prolapse causing
low back pain
alone, stricter criteria are necessary.