Herniated disc surgery, usually a microdiscectomy, removes the part of the disc that presses on a nerve. It often relieves leg pain quickly. But most herniated discs improve without an operation, and trials show results at one year are often similar with or without surgery.
What a herniated disc is
The soft centre of a spinal disc pushes through its tougher outer ring and can press on a nerve root. In the lower back this causes sciatica: pain, numbness or tingling down the leg.
Back or leg pain for more than 6 weeks? Get the free guide and a doctor review of your scan.
Surgery options
| Operation | What it involves |
|---|---|
| Microdiscectomy | Removing the disc fragment through a small incision |
| Laminectomy | Removing bone to make more room for nerves |
| Spinal fusion | Joining vertebrae together; see fusion alternatives |
| Disc replacement | Swapping the disc for an artificial one, in selected cases |
Herniated disc treatment without surgery
- Stay active and avoid long bed rest
- Physiotherapy and exercise
- Pain relief such as NSAIDs where safe
- Epidural steroid injection for severe leg pain
- PRP or stem cell injections : minimally invasive alternatives to surgery
When surgery makes sense
See when disc surgery is needed.
Back or leg pain for more than 6 weeks? Get the free guide and a doctor review of your scan.
Who is most at risk of a herniated disc
Disc herniation is most common between the ages of 30 and 50, when discs are still well hydrated but the outer ring has started to weaken. Risk rises with heavy or repetitive lifting, long hours of driving or sitting, smoking (which reduces blood flow to the disc), being overweight, and a family history of disc problems. Men are affected slightly more often than women. In older adults, back and leg pain is more often caused by spinal stenosis than by a fresh herniation.
How a herniated disc is diagnosed
A doctor first takes a history and examines your back and legs: straight-leg raising, reflexes, sensation and strength in specific muscles point to which nerve root is irritated. An MRI is the best test to see the disc and nerves, but guidelines advise against routine MRI in the first weeks unless there are red flags, because many herniations settle and MRI findings often do not change treatment early on. An MRI is usually ordered when pain persists beyond about 6 weeks, when surgery or an injection is being considered, or when there are warning signs.
Recovery after surgery versus without
| Without surgery | After microdiscectomy | |
|---|---|---|
| Leg pain | Usually eases over 6 to 12 weeks | Often eases within days |
| Return to desk work | Often within weeks while staying active | Usually 2 to 4 weeks |
| One-year outcome | Similar for many patients in trials | Similar for many patients in trials |
| Risks | Persistent pain in some | Infection, nerve injury, re-herniation |
Common questions
Can a herniated disc come back after surgery? Yes. A minority of people have a recurrent herniation at the same level, most often in the first year.
Is it safe to wait? If you have no red flags and your strength is stable, guidelines support trying active non-surgical care first. Keep a close eye on any new weakness or bladder changes.
Does a bigger herniation always need surgery? No. Size on MRI does not reliably predict symptoms, and larger fragments sometimes shrink faster.
Next step
If a surgeon has recommended an operation and you would like a second look first, send your MRI for a free doctor review.
