What treatment is recommended for a symptomatic thoracic disc herniation without myelopathy

Symptomatic disc herniations without myelopathy are initially treated nonoperatively. Clinical presentations vary, and symptoms are often vague. Acute disc herniations resulting in axial pain may be treated with activity modification, nonsteroidal antiinflammatory drugs, and short-term opiates. In patients with radicular complaints, oral corticosteroids, nerve blocks, and/or epidural steroid injections are considered. This approach often provides sufficient pain relief to permit initiation of physical therapy.

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