For a herniated lumbar disc, which nonoperative intervention is considered an effective treatment option?

• A. Rest
• B. Warm moist heat
• C. Epidural steroid injection
• D. Transcutaneous electrical nerve stimulation

Answer: (C)

When a herniated lumbar disc causes nerve irritation, targeting the inflammatory process around the affected nerve root is a key approach. An epidural steroid injection delivers corticosteroid medication into the epidural space near the irritated nerve, directly reducing inflammation and edema surrounding the nerve root. That anti-inflammatory effect often relieves radicular leg pain and can improve function, potentially allowing progression with physical therapy or avoiding surgery in some patients. The benefit is typically temporary to intermediate in duration, but it can be substantial enough to change the treatment course.

Rest tends to be unhelpful long term because prolonged inactivity can weaken the supporting muscles and doesn’t address the inflammatory process. Warm moist heat offers only short-term symptomatic relief without targeting inflammation. Transcutaneous electrical nerve stimulation may help some patients but generally provides less consistent or durable relief for radicular pain compared with an epidural steroid injection.