Should i have surgery for herniated disc

In some cases, a small piece of bone from the affected vertebra may be removed. This small piece is called the lamina.

It's the thin part of the vertebrae that forms a protective arch over the spinal cord. A procedure called a laminotomy removes some of the lamina. A laminectomy removes most of or all of the lamina. It also may remove thickened tissue that is narrowing the spinal canal. Either of these procedures may be done at the same time as a discectomy, or separately. Your doctor may recommend a rehabilitation program after the procedure.

This program may include physiotherapy and home exercises. Treatments other than surgery can often help you feel better, be more active, and avoid surgery. Many people are able to manage their symptoms with things like:. If you are getting better after at least 6 weeks of non-surgical treatment, that's a good sign that your body will keep healing without surgery. Often the body reabsorbs the material from the disc, which helps the pain go away.

This process is called resorption. Surgery for a lumbar low back herniated disc works well for many people, but not for everyone. For some people, it can get rid of all or most of their symptoms.

In a study of people who had sciatica caused by a herniated disc, the chances of having no symptoms or almost no symptoms 3 months to 2 years later was a little higher with surgery than with non-surgical treatment. But overall most people felt better with or without surgery. In a study of people who had 6 to 12 weeks of severe sciatica related to a herniated disc, one group was assigned to have surgery soon the surgery group.

The other group the non-surgical group was assigned to try non-surgical treatments for 6 months, followed by surgery if their symptoms didn't improve. When asked about their recovery 2 months after surgery or the start of non-surgical treatment, people in the surgery group felt better closer to complete recovery than people in the non-surgical group. But after 1 year, both treatment groups rated their recovery about the same.

If you don't choose surgery now, you can change your mind later if your symptoms haven't gotten better or have gotten worse even with other treatments. Surgery seems to work just as well if it's done within 6 months after your symptoms started. Most people have no problems with back surgery for a herniated disc. But as for most surgeries, there are some risks:. The numbers in this section are for discectomy standard discectomy and microdiscectomy , the most common surgery for herniated disc.

There is no high-quality evidence showing that surgery is more helpful than non-surgical treatment for a lumbar herniated disc. In a study of people who had sciatica caused by a herniated disc , the chances of having no symptoms or almost no symptoms 3 months to 2 years later was a little higher with surgery than with non-surgical treatment.

But overall, most people felt better with or without surgery. In a study of people who had 6 to 12 weeks of severe sciatica related to a herniated disc , one group was assigned to have surgery soon the surgery group. Take a group of people who have back surgery. The more serious risks include:. Wound problems, including infection and hematoma bad bruise : Less than 1 to 2 out of people who had surgery had an infection or some other wound problem. This means that 98 to more than 99 did not.

Nerve damage: About 1 to 3 out of people who had surgery had nerve root injury or new or worsening nerve-related problems, such as weakness, numbness, or tingling. This means that 97 to 99 did not have these problems. Having symptoms that don't get better, or having new symptoms in the future: About 4 to 10 out of people who had surgery went on to have another surgery for a herniated disc. This means that 90 to 96 did not.

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions. I injured my back working in the garden a few weeks ago. Based on the symptoms I'm having, my doctor says it's pretty likely that I have a herniated disc.

From what I understand, the pain and leg symptoms will probably go away over time, but I can't wait that long. My doctor says that the surgery will probably help me recover faster, even though over the long term it might not make any difference. The short term is what's important to me right now. I can accept the potential risks, so I'm going ahead with tests and moving forward with the surgery.

Surgery has always made me nervous, even though I've never had a bad experience with it myself. I just prefer not to have surgery if I have any other option available. The pain and other symptoms from my herniated disc are getting better, even if it's happening slowly. My doctor said that it is reasonable for me to just keep doing home treatment and take better care of my back.

The pain from my herniated disc is the worst pain I have ever felt. My leg feels like it is on fire. I know that isn't true for everyone who has a herniated disc, but it sure is in my case. I'm willing to try a month or so of conservative treatment. But if there isn't a dramatic improvement, my doctor has agreed to go ahead with plans for surgery.

I'm lucky, because my company has allowed me to take a job in another department where I don't have to lift and where I can move around if I need to during the day. If I wasn't able to do that, or if the pain was really bad, I would definitely have had surgery. But this way I can keep working while my back heals on its own. The pain is definitely still there, but it's manageable.

I expect that over time I will be able to return to most of my normal work and recreational activities. Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements. I understand that surgery has risks.

But I am comfortable with the idea of having back surgery, because there is a chance that it might help. I don't like the idea of surgery at all, because of the risks and the chance that it might not help. I've tried exercises, medicines, and working with a physiotherapist for a few months, and I don't think they have helped me. I think the exercises I've been doing or the medicines I'm taking are starting to help.

It's very important that I get my pain under control so that I can go back to work as soon as possible. Time is not a problem for me. Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision.

Show which way you are leaning right now. How sure do you feel right now about your decision? Use the following space to list questions, concerns, and next steps. Here's a record of your answers.

You can use it to talk with your doctor or loved ones about your decision. I am in a lot of pain. I don't see how I can stand it much longer.

If I have pain because of a herniated disc, I probably need surgery. If my symptoms haven't gotten better, surgery might help me get better faster. Years from now, I will probably feel just as good without surgery as I would if I have surgery. Are you clear about which benefits and side effects matter most to you? Do you have enough support and advice from others to make a choice? Author: Healthwise Staff. Medical Review: William H.

Blahd Jr. Keller MD - Orthopedics. This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use and Privacy Policy. Learn how we develop our content. Low back pain. In: Kelley and Firestein's Textbook of Rheumatology. Philadelphia, Pa. Accessed Sept. Winn HR, ed.

Nonsurgical and postsurgical management of low back pain. Chou R. Subacute and chronic low back pain: Surgical treatment. Spine surgery. Rochester, Minn. Knight CL, et al. Treatment of acute back pain. Azar FM, et al. Degenerative disorders of the thoracic and lumbar spine. In: Campbell's Operative Orthopaedics. See also Acupuncture Acupuncture for back pain? Exercise and chronic disease Functional electrical stimulation for spinal cord injury Inversion therapy: Can it relieve back pain?

Office ergonomics Prolotherapy: Back pain solution? Mayo Clinic Press Check out these best-sellers and special offers on books and newsletters from Mayo Clinic.

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Show which way you are leaning right now. How sure do you feel right now about your decision? Use the following space to list questions, concerns, and next steps. Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

I am in a lot of pain. I don't see how I can stand it much longer. If I have pain because of a herniated disc, I probably need surgery. If my symptoms haven't gotten better, surgery might help me get better faster. Years from now, I will probably feel just as good without surgery as I would if I have surgery. Are you clear about which benefits and side effects matter most to you?

Do you have enough support and advice from others to make a choice? Author: Healthwise Staff. Medical Review: William H. Blahd Jr. Keller MD - Orthopedics. This information does not replace the advice of a doctor. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. Learn how we develop our content. To learn more about Healthwise, visit Healthwise.

Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. It looks like your browser does not have JavaScript enabled. Please turn on JavaScript and try again. Important Phone Numbers. Get the facts. Your options Have surgery for your herniated disc now.

Don't have surgery now. Try things like a change in the way you do your activities, medicines to manage pain, exercise, physiotherapy, or steroid injections instead. Key points to remember A herniated disc in the lower back is a common cause of back and leg pain.

Many people are able to manage their symptoms with things like changes in the way they do their activities, medicines to manage pain, exercise, physiotherapy, or steroid injections.

If one of these things doesn't work, you can try something else or combine some of them. Surgery may relieve your pain faster than non-surgical treatments. For symptoms that have lasted at least 6 weeks and that make it hard to do your normal activities, surgery is an option when other treatments haven't helped. Over the long term, surgery and non-surgical treatments work about the same to reduce pain and other symptoms.

Back surgery has some risks, including infection, nerve damage, and the chance that the surgery won't relieve your symptoms. And even if you get better with surgery, there is a chance that you may get new symptoms in the future. What is a herniated disc? What kinds of procedures are done for a herniated disc? There are different ways to remove disc material.

They are: Open discectomy. This is done through a large cut, called an incision, in your back. This is done through a smaller incision. It causes less damage to surrounding tissue. Minimally invasive procedures. These are done through one or more tiny incisions in your back. Your doctor can put special tools through the incisions, such as cutting or heating devices or lasers. These tools can cut or destroy part of the disc.

What non-surgical treatments are used for a herniated disc? Many people are able to manage their symptoms with things like: Changing the way they do their activities. This means trying other ways of doing your activities that don't cause pain or make other symptoms worse. For example, if sitting makes symptoms worse, try standing up to do your tasks.

Or you can switch between sitting and standing. Taking medicines to manage pain. Acetaminophen such as Tylenol and non-steroidal anti-inflammatory drugs like ibuprofen such as Advil or Motrin and naproxen such as Aleve may help your pain. Be safe with medicines. Read and follow all instructions on the label. Aerobic exercise can help your symptoms. Take a short walk 10 to 20 minutes on a level surface try to avoid slopes, hills, or stairs every 2 to 3 hours.

Walk only distances you can manage without pain, especially leg pain. It helps you learn stretching and strength exercises that may reduce pain and other symptoms. The goal of this treatment is to make your daily tasks and activities easier. Steroid injections. These are shots that might be recommended for some people if other non-surgical treatments haven't worked. The shots may ease leg pain by reducing inflammation in the nerve root.

These shots may work for some people, but not for everyone. And when they work, they only help relieve symptoms for a short time. How well does herniated disc surgery work? What are the risks of surgery? But as for most surgeries, there are some risks: There is a slight risk of damaging nerves or the spine during surgery. Some people form a lot of scar tissue in the area of the surgery. That tissue can press against nerves and cause pain.

There is some risk of infection, which may cause more damage. An infection may require antibiotics and another surgery. Serious side effects of anesthesia aren't common but can include trouble breathing, heart attack, stroke, and even death.

There is a chance that the surgery won't relieve your symptoms. And even if you get better with surgery, there is a chance you may get new symptoms in the future. What do numbers tell us about the benefits and risks of back surgery?

Symptom improvement with and without back surgery footnote 2? With surgery With non-surgical treatment Symptom-free or almost symptom-free within 3 months 66 out of people 62 out of people Symptom-free or almost symptom-free within 1 year 76 out of people 67 out of people Symptom-free or almost symptom-free within 2 years 76 out of people 69 out of people How people rated their recovery on a 7-point scale, where "1" is complete recovery and "7" is worse symptoms footnote 3?

People assigned to have surgery soon People assigned to try non-surgical treatments for 6 months followed by surgery if their symptoms didn't improve At 2 months On average, people rated their recovery as 2. On average, people rated their recovery as 3. At 1 year On average, people rated their recovery as 1.

On average, people rated their recovery as 2. Examples of serious risks of surgery for herniated disc footnote 4 Serious risks? Wound problems, including infection and hematoma bad bruise Less than 1 to 2 out of people who had surgery had an infection or some other wound problem. Nerve damage About 1 to 3 out of people who had surgery had nerve root injury or new or worsening nerve-related problems, such as weakness, numbness, or tingling.

Surgery doesn't relieve symptoms, or new symptoms occur About 4 to 10 out of people who had surgery went on to have another surgery for a herniated disc. Benefits There is no high-quality evidence showing that surgery is more helpful than non-surgical treatment for a lumbar herniated disc. This means that 34 still had some symptoms. This means that 38 still had some symptoms. Within 1 year: 76 people out of who had surgery had no symptoms or almost no symptoms.

This means that 24 still had some symptoms. This means that 33 still had some symptoms.