Most people diagnosed with a herniated disc will recover without surgery, and many people with a herniated disc do not experience any pain. However, the pain from a herniated disc can be so severe that you are unable to perform normal daily tasks. Due to the risks of surgery, the spine specialist will usually recommend surgery only after conservative treatments such as physical therapy and medications have failed, or if you experience loss of bladder or bowel control.
Background
Intervertebral discs act as shock absorbers and ensure flexibility of the spine. A disc is herniated when a fragment of its gelatinous nucleus bulges through a tear in its outer layer into the spinal canal. This can cause nerve root compression. It occurs most commonly in the lower back, and can cause pain, weakness or numbness in the back and legs. Disc herniation likely has a genetic component and can result from a single minor strain, according to the website of the American Association of Neurological Surgeons, or AANS.
Other Treatments
Rest and nonsteroidal anti-inflammatory medications followed by physical therapy typically are the first lines of treatment recommended for a herniated disc. The physical therapist will teach you proper posture and exercises to stabilize your back and improve your flexibility. Most people recover following these treatments. If these treatments fail, your doctor will likely prescribe oral steroids. Epidural steroid injections are usually the last line of nonsurgical therapy, says the AANS.
Types of Surgery
A herniated disc can be treated with a microdiscectomy, which involves the removal of the injured disc material from the spinal canal to relieve pressure on the nerve root. A microdiscectomy is a "minimally invasive" procedure, which requires a smaller incision than an "open surgery" procedure, such as a spinal fusion. Therefore, recovery is typically faster. However, if your disc reherniates, your surgeon may recommend a spinal fusion, which uses a bone graft to cause two vertebrae to unite, according to the Spine-Health website.
Post-surgical Recovery
Post surgery, your surgeon will prescribe pain medicine, instruct you on when it is safe to resume your daily activities and refer you to a physical therapist. Some surgeons believe that gentle stretching early in the recovery period can minimize scarring. Studies suggest that an early exercise program involving stretching, strengthening and low impact aerobic exercise, such as walking, can speed your recovery, although the Spine-Health site says it may take as long as three to four months for the disc to actually heal or "scar over."
Risks
As with other types of surgery, there are risks to back surgery associated with anesthesia, infection and blood clots. Damage to nerves during the surgical procedure or the failure to remove all disk fragments can cause permanent postoperative pain or weakness. In the case of a microdiscectomy, these complications are relatively uncommon. Approximately 90 percent to 95 percent of patients experience pain relief after a microdiscectomy, although in approximately 5 percent to 10 percent of patients, the disc reherniates.
