Lumbar Disc Herniation: When to Consider Surgery vs. Physical Therapy

Lower back pain is one of the most common reasons people seek medical care, and a herniated lumbar disc is often to blame. This condition occurs when one of the cushioning discs between the vertebrae in the lower spine bulges or ruptures, pressing on nearby nerves and causing pain, numbness, or weakness that can radiate down the leg.

At IGEA Brain, Spine, Pain and Orthopedics, we understand how disruptive and frustrating this pain can be. The good news is that many patients improve without surgery, but in some cases, surgical intervention may be the best path to relief. Knowing when to consider each approach is key to making an informed decision about your care.

Understanding Lumbar Disc Herniation

Each spinal disc acts as a shock absorber between the bones of the spine. When a disc becomes damaged—through aging, wear and tear, or injury—the soft inner material can push out through a crack in the tougher outer layer. If the herniation compresses a spinal nerve, it can lead to lower back pain, leg pain (sciatica), tingling, or muscle weakness.

When Physical Therapy Is the Right Choice

For many patients, lumbar disc herniation can be managed effectively with conservative, nonsurgical treatments. Physical therapy plays a central role in recovery, helping to reduce inflammation, strengthen supportive muscles, and improve mobility.

A structured therapy program may include:

• Guided stretching and strengthening exercises
• Posture and body mechanics training
• Gentle aerobic conditioning
• Techniques to relieve pressure on the affected nerves

In addition to physical therapy, medications, targeted injections, and lifestyle modifications may also help control pain and inflammation. Most people experience significant improvement within several weeks to a few months of consistent treatment.

When to Consider Surgery

While conservative care is effective for most, surgery may be recommended when:

• Pain, numbness, or weakness persists despite weeks of nonsurgical treatment
• There is significant nerve compression causing loss of function or muscle control
• Pain interferes with walking, working, or performing daily activities
• There is loss of bladder or bowel control (a rare but serious emergency)

The most common surgical option for lumbar disc herniation is microdiscectomy, a minimally invasive procedure in which the surgeon removes the portion of the disc pressing on the nerve. This approach often provides fast and lasting relief from leg pain and allows for a quicker recovery than traditional open surgery.

Making the Right Decision for Your Health

Every patient’s spine condition is unique, and the decision to proceed with surgery should always be made in consultation with an experienced specialist. At IGEA Brain, Spine, Pain and Orthopedics, our team carefully evaluates each case, using advanced imaging and thorough clinical assessments to determine the most appropriate treatment plan.

We prioritize conservative options whenever possible, reserving surgery for when it offers the clearest path to restoring comfort, mobility, and quality of life.

Take the Next Step

If you’re struggling with lower back or leg pain, don’t wait to find out what’s causing it. Early evaluation and the right treatment can prevent worsening symptoms and help you get back to living pain-free.

Schedule an appointment with IGEA Brain, Spine, Pain and Orthopedics today to discuss your symptoms and learn whether physical therapy or surgical treatment is right for you.