Living with a herniated disc can be painfully challenging, but you may find relief with rest, a planned exercise program, and time. However, when your pain is persistent, limits your mobility, or otherwise diminishes your quality of life, surgery may be your best option.
Board-certified neurosurgeon Dr. Patrick Doherty and our Yale Neurosurgery New London team are experts at diagnosing and treating painful spine disorders, including herniated discs.
While conservative therapies are often exactly what your back needs to heal, here’s why our team agrees that some people may require surgical intervention for a herniated disc.
Understanding herniated discs
The spine includes vertically stacked vertebrae separated by intervertebral discs that act as cushions and shock absorbers. A herniated disc occurs when the outer layer of the disc, called the annulus fibrosus, weakens or tears.
This provides an opening for the inner gel-like disc material, known as the nucleus pulposus, to protrude (herniate) or leak out. Depending on the direction of herniation, the disc material may encroach on nearby nerves, ligaments, and other spinal structures.
This can lead to pain, numbness, weakness, and other symptoms that may spread into areas (dermatomes) served by nerves. For instance, a herniated disc in the lumbar (lower) spine that irritates the sciatic nerve can cause pain traveling into the hips, legs, and feet.
Conservative treatments for herniated discs
In many cases, nonsurgical treatments are the first defense against herniated discs. These may include physical therapy, medicine, lifestyle changes or epidural injections:
Targeted exercises and stretches can help improve flexibility, strengthen the core, and alleviate pressure on the affected disc.
Dr. Doherty may prescribe pain relievers, muscle relaxants, and anti-inflammatory drugs to manage pain and reduce inflammation.
Changes in daily activities, such as maintaining good posture, using proper lifting techniques, and incorporating ergonomic adjustments, can contribute to symptom relief.
Epidural steroid injections
These injections deliver anti-inflammatory medication directly to the affected area, relieving pain and inflammation.
When do you consider surgery for a herniated disc?
While many people experience significant improvement with conservative treatments, Dr. Doherty may recommend surgery for certain situations, including these:
Persistent or severe symptoms
Dr. Doherty may consider surgery if conservative treatments fail to provide relief and the pain, numbness, or weakness persists or worsens.
You may also benefit from surgery when a herniated disc significantly impairs your ability to perform daily activities at home or work.
Surgery may become a priority to prevent permanent damage when nerve compression leads to neurological deficits, such as difficulty with bowel or bladder control.
What types of surgeries are available for herniated discs?
Several surgical procedures can address herniated discs. Dr. Doherty bases his recommendations on factors such as the location and severity of the herniation.
Common surgical options include discectomy, laminectomy, and spinal fusion:
This procedure involves removing the portion of the disc that is pressing on a nerve, relieving nerve compression.
During laminectomy, Dr. Doherty removes a portion of the vertebral bone (lamina) to create more space and alleviate nerve pressure.
If the disc damage causes significant instability, Dr. Doherty may suggest spinal fusion to join two or more vertebrae together. This helps stabilize the spine and relieves pain.
Dr. Doherty recommends the least invasive and most beneficial procedure for your disc problem and discusses your options in detail before scheduling the surgery.
Schedule an evaluation at Yale Neurosurgery New London today for more information about herniated disc treatment and other services we offer.