Our Health Library information does not replace the advice of a doctor. Please be advised that this information is made available to assist our patients to learn more about their health. Our providers may not see and/or treat all topics found herein. You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them. Get the Compare Your Your Quiz Your Summary This decision aid is for you if your herniated disc is in your low back and your symptoms have lasted a few weeks. It does not cover information about a herniated disc in the neck area of the spine (cervical disc herniation). The bones that form the spine—your vertebrae—are cushioned by small, spongy discs. When these discs are healthy, they act as shock absorbers for the spine and keep the spine flexible. But when a disc is damaged, it may bulge or break open. This is called a herniated disc. It may also be called a slipped or ruptured disc. A herniated disc doesn't always cause symptoms. But when it presses on nerve roots, it can cause pain, numbness, and weakness in the area of the body where the nerve travels. A herniated disc in the lower back is a common cause of back and leg pain. Sometimes it can cause pain and numbness in the buttock and down the leg. This is called sciatica (say "sy-AT-ih-kuh"). For most people, symptoms get better over time, with or without treatment. The goal of the procedures is to take the pressure off the nerve roots. This is usually done by removing disc material. This is called a discectomy. There are different ways to remove disc material. They are: Studies haven't shown noticeable differences in how well each of these procedures works. So you and your doctor will think about several things in deciding which treatment may be right for you. These include your particular body structure, your symptoms, which disc is herniated, what you prefer, and your doctor's expertise and experience.footnote 1 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 physical therapy 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 one of these things doesn't work, you can try something else or combine some of them. If you are getting better after at least 6 weeks of nonsurgical treatment, that's a good sign that your symptoms may keep getting better 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 nonsurgical treatment. But, overall, most people felt better with or without surgery.footnote 4 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 nonsurgical group) was assigned to try nonsurgical treatments for 6 months, followed by surgery if their symptoms didn't improve. Both groups were asked about their recovery 2 months after surgery or the start of nonsurgical treatment. People in the surgery group felt better (closer to complete recovery) than people in the nonsurgical group. But after 1 year, both treatment groups rated their recovery about the same.footnote 2 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. Your doctor might recommend surgery as an option for your herniated disc if: Compare What is usually involved? What are the benefits? What are the risks and side effects? 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. Dean, age 39 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. Mai-Li, age 57 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. Jane, age 46 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 symptoms get better. 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. Javier, age 43 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. Reasons to have surgery for a herniated disc now Reasons not to have surgery now 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 physical therapist 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. I am in a lot of pain. I don't see how I can stand it much longer. My pain isn't bad enough that I need to have surgery right now. 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. If I get better slowly using exercises and/or medicine, that's okay with me. I'm not worried about how much this surgery will cost. I don't have insurance and don't see how I can afford this surgery. My other important reasons: My other important reasons: 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. Having surgery for herniated disc now NOT having surgery now Check the facts Decide what's next Certainty 1. How sure do you feel right now about your decision? Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision. This decision aid is for you if your herniated disc is in your low back and your symptoms have lasted a few weeks. It does not cover information about a herniated disc in the neck area of the spine (cervical disc herniation). The bones that form the spine—your vertebrae—are cushioned by small, spongy discs. When these discs are healthy, they act as shock absorbers for the spine and keep the spine flexible. But when a disc is damaged, it may bulge or break open. This is called a herniated disc. It may also be called a slipped or ruptured disc. A herniated disc doesn't always cause symptoms. But when it presses on nerve roots, it can cause pain, numbness, and weakness in the area of the body where the nerve travels. A herniated disc in the lower back is a common cause of back and leg pain. Sometimes it can cause pain and numbness in the buttock and down the leg. This is called sciatica (say "sy-AT-ih-kuh"). For most people, symptoms get better over time, with or without treatment. The goal of the procedures is to take the pressure off the nerve roots. This is usually done by removing disc material. This is called a discectomy. There are different ways to remove disc material. They are: Studies haven't shown noticeable differences in how well each of these procedures works. So you and your doctor will think about several things in deciding which treatment may be right for you. These include your particular body structure, your symptoms, which disc is herniated, what you prefer, and your doctor's expertise and experience.1 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 physical therapy 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 one of these things doesn't work, you can try something else or combine some of them. If you are getting better after at least 6 weeks of nonsurgical treatment, that's a good sign that your symptoms may keep getting better 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 nonsurgical treatment. But, overall, most people felt better with or without surgery.4 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 nonsurgical group) was assigned to try nonsurgical treatments for 6 months, followed by surgery if their symptoms didn't improve. Both groups were asked about their recovery 2 months after surgery or the start of nonsurgical treatment. People in the surgery group felt better (closer to complete recovery) than people in the nonsurgical group. But after 1 year, both treatment groups rated their recovery about the same.2 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. Your doctor might recommend surgery as an option for your herniated disc if: 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." — Dean, age 39 "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." — Mai-Li, age 57 "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." — Jane, age 46 "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 symptoms get better. 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." — Javier, age 43 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. Reasons to have surgery for a herniated disc now Reasons not to have surgery now 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 physical therapist 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. I am in a lot of pain. I don't see how I can stand it much longer. My pain isn't bad enough that I need to have surgery right now. 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. If I get better slowly using exercises and/or medicine, that's okay with me. I'm not worried about how much this surgery will cost. I don't have insurance and don't see how I can afford this surgery. My other important reasons: My other important reasons: 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. Having surgery for herniated disc now NOT having surgery now 1.
If I have pain because of a herniated disc, I probably need surgery. 2.
If my symptoms haven't gotten better, surgery might help me get better faster. 3.
Years from now, I will probably feel just as good without surgery as I would if I have surgery. 1.
Do you understand the options available to you? 2.
Are you clear about which benefits and side effects matter most to you? 3.
Do you have enough support and advice from others to make a choice? 1.
How sure do you feel right now about your decision? 2.
Check what you need to do before you make this decision. Current as of: July 17, 2023 Author: Ignite Healthwise, LLC Staff Clinical Review BoardLumbar Herniated Disc: Should I Have Surgery?
Lumbar Herniated Disc: Should I Have Surgery?
1
Facts2
Options3
Feelings4
Decision5
Yourself6
Get the facts
Your options
Key points to remember
What is a herniated disc?
What kinds of procedures are done for a herniated disc?
What nonsurgical treatments are used for a herniated disc?
How well does herniated disc surgery work?
What are the risks of surgery?
Why might your doctor recommend herniated disc surgery?
Compare your options
Personal stories about herniated disc surgery
What matters most to you?
Where are you leaning now?
What else do you need to make your decision?
Your Summary
Your decision
Next steps
Which way you're leaning
How sure you are
Your comments
Your knowledge of the facts
Key concepts that you understood
Key concepts that may need review
Getting ready to act
Patient choices
Credits and References
Author Ignite Healthwise, LLC Staff Clinical Review Board Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.Lumbar Herniated Disc: Should I Have Surgery?
1. Get the Facts
Your options
Key points to remember
What is a herniated disc?
What kinds of procedures are done for a herniated disc?
What nonsurgical treatments are used for a herniated disc?
How well does herniated disc surgery work?
What are the risks of surgery?
Why might your doctor recommend herniated disc surgery?
2. Compare your options
Have herniated disc surgery now Don't have surgery now. Use nonsurgical treatments instead. What is usually involved? What are the benefits? What are the risks and side effects? Personal stories
Personal stories about herniated disc surgery
3. What matters most to you?
4. Where are you leaning now?
5. What else do you need to make your decision?
Check the facts
Decide what's next
Certainty
By Ignite Healthwise, LLC Staff Clinical Review Board Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.
Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.
FAQs
Have herniated disc surgery now Have herniated disc surgery now
Don't have surgery now. Use nonsurgical treatments instead. Don't have surgery now. Use nonsurgical treatments instead.
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Undecided
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Credits
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Citations
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.
Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
FAQs
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Equally important
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That's right. For most people, symptoms get better over time, with or without treatment. And many people are able to manage their symptoms with things like changes in the way they do their activities, medicines to manage pain, exercise, physical therapy, or steroid injections.
That's right. Surgery may relieve your pain faster than nonsurgical 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.
That's right. Over the long term, surgery and nonsurgical treatments work about the same to reduce pain and other symptoms.
Not sure at all
Somewhat sure
Very sure
Credits
References
Citations