Lumbar disc herniations can be difficult to treat for some patients. Persistent pain can become disabling. Most surgeons advise at least a three month trial of conservative care before considering surgery.
Nonoperative care can include physical therapy and exercise, chiropractic or osteopathic care, steroid injections, and/or acupuncture. Sometimes patients find that a combination of two or more of these treatment approaches works best.
Studies show that patients who have surgery get better faster but the final results (one year or more later) are the same as for patients who stuck it out and waited for the body to heal itself. However, any sign that pressure on the sciatic nerve is causing permanent damage requires surgical intervention.
There are a variety of ways the surgeon may treat this problem. The simplest and most common is a discectomy (removal of the disc). Microdiscectomy is becoming the standard method used for lumbar disc herniation.
The operation is done with a surgical microscope. The surgeon makes a very small incision in the low back. This surgery is minimally invasive. It is easier to perform, prevents scarring around the nerves and joints, and helps patients recover more quickly.