James Hawkins, MD, is a board-certified spinal surgeon on staff at Banner Estrella Medical Center.
Question: I have been having some severe pain in my back and legs and have been told it is related to a disc in my back. Does that mean surgery?
Answer: Because of the structure of the back, there are many parts of the spinal anatomy which could cause pain. If the pain radiates from your lower back into your legs, it could be due to compression or inflammation of the nerve roots extending from your spine. If the pain is mostly in your lower back and related to movement then it is often due to a structural injury to the joints or ligaments in your back. When the pain is present in the low back and not associated with movement, then the intervertebral discs can be the cause.
It is critical to determine the cause of YOUR symptoms before taking advice on how it should be treated. People often hear horror stories about the need for extensive spine surgery when that is rarely the case. Most neck, arm, back or leg pain stemming from the spine is treated without surgery. Relief could come from something as simple as learning the proper way to stand or sit, or could be to involve physical therapy or oral/injectable medication. However, if the condition does merit surgery, there are many techniques that offer minor surgery or what we consider minimally-invasive. These new minimally-invasive procedures can help alleviate pain and restore function—and have you walking out of the hospital or injection suite the same day.
One of the minimally-invasive techniques used to treat the leg pain of a herniated disc would be a microdiscectomy. A microdiscectomy involves a small (1 inch to 1 ½ inch) incision in the midline of the lower back and the removal of a small portion of bone and ligament to gain access to the nerve under compression. All joints, and most ligaments, bones and muscles are left intact making it an easy surgery to undergo with minimal rehabilitation. In fact, most often we recommend walking and eventually core strengthening exercises after a microdiscectomy to increase movement and regain your health.