Manejo da hérnia lombar – uma revisão de literatura

Lumbar disc herniation represents a significant public health issue and is a leading cause of pain radiating into the lower limbs. It most frequently affects economically active adults between the ages of 30 and 50, with a slightly higher prevalence among men. The complexity of managing a lumbar disc herniation lies in the need to balance immediate pain relief with the scientific reality that, in most cases, the condition has a favorable prognosis. This review aims to present scientific evidence regarding various treatment approaches for lumbar disc herniation. It is a narrative literature review based on a search of the National Library of Medicine (PubMed), Scientific Electronic Library Online (SciELO), and Google Scholar databases, covering the period from 2020 to 2026. A synthesis of the literature indicates that conservative treatment is the first-line approach for most patients with a lumbar disc herniation. Surgery is indicated when conservative treatment fails to yield satisfactory results, when pain becomes unmanageable, or in the presence of motor deficits or cauda equina syndrome. While surgery offers immediate pain relief, it carries risks inherent to any invasive procedure, such as epidural fibrosis and potential wound-healing complications. Clarifying the balance between immediate clinical benefits and long-term risks is essential, as it takes into account patient expectations and the social impact of the condition on daily life and work.