Do I need surgery for a herniated disc?
Usually not. Most sciatica from a herniated disc improves within weeks with activity, physical therapy, medication and sometimes an epidural injection. Surgery is considered when leg pain stays severe after about six to eight weeks of non-surgical care, when weakness is getting worse, or right away for loss of bladder or bowel control, which is an emergency.
Get emergency care right away if you have
- Loss of bladder or bowel control, or numbness in the groin or inner thighs
- Weakness in a leg or foot that is getting worse
- Back pain with fever, or after a serious fall or crash
Call 911 or go to an emergency room. Our offices, including urgent care, are not emergency rooms.
What usually happens without surgery
See also herniated disc treatment and sciatica. Most sciatica from a herniated disc gets better on its own. In research, about half of people improve within about 10 days and about three in four within four weeks. Some people still have symptoms a year later, so it's worth getting care if pain isn't easing.
Treatment without surgery
- Staying active within what you can manage, rather than bed rest
- Physical therapy to calm nerve pain and strengthen your back and core
- Medication for pain and inflammation, as your physician advises
- Epidural steroid injections when leg pain is severe or slow to improve
- Chiropractic care for some people, as part of a wider plan
When surgery makes sense
Surgery to remove the part of the disc pressing on the nerve (a microdiscectomy) may help when leg pain stays severe after about six to eight weeks of good non-surgical care, when weakness is getting worse, or in an emergency such as loss of bladder or bowel control. In a large trial, people who had surgery often felt better sooner, but by two years both groups had improved substantially. The choice is yours, and our spine physicians will explain the trade-offs.
Common questions
How long does a herniated disc take to heal?
Many people improve within a few weeks, and most within a few months. Pain that isn't improving after about six weeks, or that keeps returning, should be checked.
Do I need an MRI?
Not always. An MRI is usually ordered when symptoms last more than about six weeks, when surgery or an injection is being considered, or right away if there are warning signs.
Can a herniated disc heal on its own?
Often, yes. The disc material pressing on the nerve can shrink over time, which is why many people get better without surgery.
