Patient Education
Conservative Care vs. Surgery for a Herniated Disc
A plain-language overview of non-surgical and surgical options, and the questions worth asking your physician or surgeon before you decide.
Get emergency care right away if you have:
- New loss of bladder or bowel control
- Numbness in the groin, buttocks or inner thighs
- Leg weakness that is getting worse quickly
These can be signs of severe nerve compression, including cauda equina syndrome. Call 911 or go to the nearest emergency room.
Side-by-Side Comparison
Understanding a Herniated Disc
The discs between the vertebrae act as cushions. A disc herniates when some of its softer inner material pushes through the tougher outer layer. If that material presses on or irritates a nearby nerve, it can cause pain, numbness, tingling or weakness that travels into an arm or a leg, which in the lower back is often called sciatica.
Symptoms from a herniated disc often ease over time. Imaging, such as an MRI, may be recommended depending on your symptoms and examination. For more background, read herniated disc vs. bulging disc.
Conservative Care
Conservative care means non-surgical treatment. Depending on the person, it can include chiropractic care, non-surgical spinal decompression and traction, therapeutic exercise, changes to daily activity, and medication managed by your physician. The goals are to ease pain, calm the irritated nerve and restore movement.
Good conservative care also includes knowing when to step back. If your symptoms change, get worse, or do not improve as expected, a medical evaluation or a surgical opinion should be part of the conversation.
Surgery
When non-surgical care does not relieve symptoms, or when nerve compression is severe, a spine surgeon may recommend an operation. The most common procedure for a herniated disc is a discectomy, often performed as a microdiscectomy, which removes the portion of the disc pressing on the nerve.
Like any surgery, spine surgery carries risks, including infection, bleeding, nerve injury and the chance that symptoms persist or return. For the right patient, it can be the appropriate choice. A spine surgeon is the right person to explain whether surgery makes sense for you, what recovery involves, and what the alternatives are.
Questions to Ask Your Physician or Surgeon
Whatever you decide, the decision is yours to make with your physician or surgeon. These questions can help you get the information you need.
- What is causing my symptoms, and what does my imaging show?
- Are there any signs that make surgery urgent in my case?
- What is likely to happen if I continue with non-surgical care for now?
- What are the risks and the expected recovery for the procedure you recommend?
- What rehabilitation will I need afterward, and when can I return to work and activity?
Conservative Options With Dr. Casey
Dr. Kowin Casey is a chiropractic physician who offers non-surgical care for spine and disc-related pain. If you are weighing your options, an examination can help you understand where you stand.
Non-Surgical Spinal Decompression & Traction
Non-surgical cervical, thoracic and lumbar decompression, with manual and mechanical traction.
Learn more ›Chiropractic & Spinal Corrective Care
Examination and chiropractic care for the spine, with guidance you can use at home.
Learn more ›Physiotherapy & Rehabilitation
Rehabilitation-focused care and therapeutic exercise to help you move and recover.
Learn more ›Frequently Asked Questions
Do most herniated discs need surgery?
No. Many people with a herniated disc improve without surgery, and non-surgical care is often tried first when there are no red-flag symptoms. Surgery is generally considered when symptoms are severe or getting worse, when there are signs of significant nerve compression, or when conservative care has not given enough relief. Your physician or surgeon can tell you which applies to you.
How long should I try conservative care before considering surgery?
There is no single timeline that fits everyone. It depends on your symptoms, your examination, your imaging and how you respond to care. Talk with your physician or a spine surgeon about when a surgical opinion makes sense for you, and seek care right away if your symptoms get worse.
Can chiropractic care or spinal decompression help a herniated disc?
Chiropractic care, non-surgical decompression and traction are conservative options that some people with disc-related pain choose to try. Results vary from person to person, and they are not right for everyone. An examination helps determine whether they are appropriate for you.
Can I get care after back surgery?
Follow your surgeon's instructions and rehabilitation plan first. Once your surgeon has cleared you, ask whether additional rehabilitation care is appropriate, and share your surgical history with any provider you see.
When is a herniated disc an emergency?
Loss of bladder or bowel control, numbness in the groin, buttocks or inner thighs, or leg weakness that is getting worse quickly can signal severe nerve compression, including cauda equina syndrome. Call 911 or go to the nearest emergency room.
This page is general health information, not a diagnosis or a substitute for an examination. Decisions about surgery should be made with your physician or surgeon.
Talk With Dr. Casey About Non-Surgical Care
If you have been diagnosed with a herniated disc and want to understand your non-surgical options, schedule a visit. KC Wellness and Physiotherapy is at 1815 Grand Blvd., Kansas City, MO 64108.
New patient? Download the intake forms or contact our office.