My wife is an accountant and is advising me to have back surgery for a disc problem simply because it will save us money in the long run. She figures that way I’ll be back at my job sooner, bringing in a paycheck again. Waiting for it to heal on its own will just take too long and cost too much in lost wages. Surgery is a big decision. Is she right?

Surgery is a big decision. Many things can go right. But many things can also go wrong. Fast relief of sciatica and low back pain is the usual reason for early surgical intervention. But pain relief is not guaranteed. Just as many patients feel better as don’t.

For those who do get relief, function improves and the time to recovery and return to work is much shorter. Certainly, in dollars and cents, this makes sense! And your productivity will be greater. This is a big factor for you if you are the business owner or self-employed. Otherwise, the boon goes to the owner of your company and to society.

Studies show that in the long-run, patients with low back pain and leg pain from disc protrusion will get better. Conservative (nonoperative) care often helps but also costs money. For those who are insured, there’s a cost to the insurer and usually a smaller cost to you, the patient.

So, if you don’t want to wait or can’t cope with the pain, then surgery may be advised. If there are signs of permanent motor damage (e.g., muscle weakness, foot drop), then surgery is often considered an emergency procedure. It must be done as soon as possible.

If you really just don’t want to have surgery, then there are some other alternatives. Acupuncture, chiropractic, nonsteroidal antiinflammatory drugs (NSAIDs), and physical therapy all have some potential for improving your symptoms without surgery.