You will need surgery to repair your herniated disc if your case does not respond well to non-surgical approaches or has specific severe symptoms. Most herniated discs do not need an operation, but it is still important to know what to look out for.
In this article, we will help you understand when surgery might be needed for a herniated disc. We will discuss the factors that healthcare providers consider before recommending surgery. Additionally, we will explore non-surgical treatments and how they may play a role in your recovery. Understanding your options fully can help you make an informed and confident decision about your health.
When to Consider Surgery
Surgery for a herniated disc is usually considered only after non-surgical treatments—such as medication, structured physical therapy, rest, and targeted injections—have not sufficiently improved your symptoms. The decision to proceed with surgery is individualized and based on a careful assessment of your specific situation.
Here are key indications that surgery may be necessary:
Persistent, Severe Pain
If you continue to experience pain that limits your daily activities and does not respond to conservative management over several weeks or months, surgical intervention may be your best option.
Significant Weakness or Loss of Function
You might notice that your limbs are weaker or you find it more difficult to perform everyday tasks. These tasks might include things like lifting light objects, walking, or using stairs. Weakness and loss of function may be a sign that the herniated disc is pressing on your nerves, which may need surgery to address.
Nerve-Related Symptoms
Loss of sensation, ongoing tingling, or “electric shock” sensations in the limbs that worsen over time can be concerning. More urgent signs include sudden changes in bladder or bowel control. These symptoms will require immediate medical evaluation, as they can indicate a rare condition called cauda equina syndrome.
Worsening Symptoms Despite Conservative Care
Your symptoms might continue to progress, or you may develop new symptoms while following a recommended non-surgical treatment plan. If this happens, you may need surgery to prevent long-term complications.
How Doctors Determine if Surgery is Needed
Doctors use a step-by-step process to decide if surgery is the best option for someone with a herniated disc.
Step 1: Comprehensive Medical History and Symptom Review
The doctor will begin by discussing your health history, focusing on your back. You will be asked about the onset, intensity, and duration of your pain, as well as any changes in mobility, strength, or sensation. It is important to describe how symptoms impact your life, work, and sleep.
Step 2: Physical Examination
A thorough physical and neurological exam will be next. Your physician will assess the following things about your arms and legs:
- Reflexes
- Muscle strength
- Coordination
- Sensations
Step 3: Conservative Treatment Assessment
Your provider will ensure that you have tried conservative approaches first. These may include:
- Physical therapy
- Pain medication
- Anti-inflammatory drugs
- Spinal injections
If these treatments have not helped, surgery may then be an option.
Step 4: Imaging Studies
If symptoms persist or worsen, you will likely need to undergo diagnostic tests. Most providers will have you undergo an MRI test, but they might also suggest CT scans or X-rays to help rule out other problems.
Step 5: Identifying Surgical Indications
Surgery is considered when specific criteria are met, such as:
- Severe or persistent pain that does not improve with conservative management
- Progressive neurological symptoms, including worsening weakness, numbness, or loss of coordination
- Significant loss of bladder or bowel control (incontinence) or increasing difficulty walking
- Imaging confirming nerve compression that matches clinical symptoms
- Evidence that ongoing symptoms may threaten long-term nerve health or quality of life
Step 6: Shared Decision-Making
Your orthopedic surgeon will discuss the risks, benefits, and alternatives to surgery. It is important that you feel comfortable with your treatment plan and are informed about everything it entails. This approach prioritizes your health, safety, and individual goals for recovery.
Types of Herniated Disc Surgeries
Several surgical methods are available to treat herniated discs, depending on the case. Common procedures include:
Microdiscectomy
One option is called a microdiscectomy. This specific procedure carefully removes the piece of disc that is pressing on a nerve. It is often the choice for people with sciatica-like pain.
Endoscopic Discectomy
This method uses a small tool to remove the damaged part of the disc through a small cut. This method helps people heal faster, leaves less scarring, and has fewer risks than open surgery.
Laminectomy
During a laminectomy, a small part of the spine bone (called the lamina) is removed. It is often done when the spinal canal is too narrow, which can happen along with a herniated disc.
Disc Replacement
Artificial disc replacement involves taking out the damaged disc and putting in a new one. While this approach is not suitable for everyone, it preserves more spinal motion compared to some other surgeries.
Spinal Fusion
Spinal fusion is used when the spine is unstable. It connects two or more bones in the spine to make them one solid piece. This limits movement at that particular site to ease pain and improve function.
Surgery to Repair a Herniated Disc in Colorado Springs, CO
Choosing to get surgery for a herniated disc is a big step toward feeling better and getting your life back. With the right support and careful planning, many people heal well and stay pain-free long term. Even though there are risks, new techniques and tools have made this surgery safer and more successful than ever.
Do not wait to get the help you need. If you have back pain that is not disappearing, Front Range Spine and Neurosurgery is ready to support you. Contact us at (303) 790-1800 or use our online appointment request form to schedule a consultation today.
We look forward to serving you!
