What is the point at which it’s time to seriously consider surgery to remedy a herniated disc in the low back?
“Learning to live with the pain” is the mantra heard by many people who have a herniated (bulging) disc.
This is also sometimes referred to as a pinched nerve by laypeople.
But it’s all the same deal, regardless of name: a compression of a nerve at the lumbar spinal column.
The resulting pain may be local or radiate out somewhat, sometimes extending down the leg.
Though the leg is affected in these cases, it’s not because of a muscle problem. It’s because of the nerve in the leg that originates in the spinal cord — where the site of compression is.
For a while patients will try to manage the low back (or leg) pain via conservative means, wondering for how long they can hold off on surgery before the pain becomes impossible to live with.
When Is Surgery Needed for a Herniated Disc?
For this article I consulted with Dr. P. Justin Tortolani, from MedStar Union Memorial Hospital in Baltimore. Dr. Tortolani is an orthopedic surgeon and spine specialist.
He explains: “Surgery would be indicated for lumbar herniated disc when a patient is noticing a progressive loss of strength in the leg; we term that partial paralysis.
“Another indication is when there is pain that is not retractable; when nothing tried is helping.”
This would include a failure of “steroid injection, acupuncture and just the tincture of time,” says Dr. Tortolani.
A herniated disc can cause shooting, stabbing but brief episodes of pain that can literally stop a person in their tracks.
There may be numbness and tingling. Sitting in the same position for long periods, with pressure on the hamstring (back of the upper leg) can bring on numbness and tingling.
This may often occur as a result of sitting on a toilet seat for an extended period.
Dr. Tortolani is currently the director of the MedStar Union Memorial Spine Program. His vast experience includes treating all disorders of the spine including herniated discs, spinal stenosis, and adult and adolescent scoliosis.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.