Ten years ago, I blew a disc at L34. The doctor advised me to wait it out rather than have surgery. Eventually the pain went away and I healed up. Now I’m facing another disc herniation at L45. This time, I’ve been told to have the surgery right away. Should I be worried that something is drastically wrong?

Not necessarily, though you should bring your question and your concerns to your surgeon for clarification. What has changed in the last 10 years is our understanding of the cost-savings associated with early surgical intervention for disc herniation.

We know that the long-term outcomes are the same whether you have disc surgery or stick with conservative (nonoperative) care. But some patients don’t want to wait the full year (or longer) that it takes to reach full healing and maximum potential. Severe sciatica and low back pain from disc herniation can be extremely painful and very disabling.

If your pain is mild to moderate, then it might be better to manage it with other less invasive modalities. This could include medications, physical therapy, chiropractic care or other complementary and alternative modalities. Keep in mind that there’s a financial cost to conservative care along with the lost wages and reduced work productivity you incur while you are off work.