Surgery for a herniated disc

Is surgery right for a herniated disc?

Hearing the word surgery can feel scary, especially when you are dealing with sharp leg or arm pain, numbness, or weakness. The good news is that most people with a herniated disc improve without surgery, often over weeks to a few months, with time, staying active, and guided rehabilitation. ¹ ²

Surgery may be considered when symptoms strongly suggest a nerve is being irritated or compressed and:

• Pain stays severe and disabling even after a solid trial of conservative care.
• You have weakness that is worsening, or a serious loss of strength that makes walking, lifting the foot, gripping, or using the arm difficult. ¹ ³
• You have an emergency condition like cauda equina syndrome, which can include new bladder or bowel control problems, numbness in the saddle area (around the genitals or inner thighs), or rapidly worsening weakness in both legs. This needs urgent evaluation and often urgent surgery. ¹

A helpful way to think about surgery is this: for many people, surgery can speed up relief, but it does not guarantee a perfect outcome, and it is not the right choice for everyone. Shared decision-making matters here. You and your clinician weigh your symptoms, exam findings, imaging that matches your pain pattern, your goals, and the risks and benefits of each option. ¹ ³ ⁴

Common surgical options for a herniated disc

The right operation depends on where the herniated disc is (low back vs neck), what symptoms you have, and what your imaging shows.

Lumbar disc herniation (sciatica)

• Microdiscectomy (or discectomy): Removes the portion of disc material pressing on the nerve root to relieve leg-dominant pain. It can be done by open or endoscopic surgery (using small holes and a camera with potentially less tissue disruption). The best choice depends on the surgeon and your anatomy. ³ ⁴
• Laminectomy or decompression (selected cases): The surgeon removes the bone and tissue that is pressing on the nerve. More common when there is additional narrowing around the nerve (stenosis) along with the herniation, rather than a simple disc herniation alone. ³

Cervical disc herniation (cervical radiculopathy)

• Anterior cervical discectomy and fusion: Removes the disc material from the front of the neck and stabilizes the segment with a fusion. ⁵
• Cervical disc replacement: Removes the disc and replaces it with an artificial disc in selected people, often considered when maintaining motion is a priority and it is clinically appropriate. ⁵
• Posterior cervical foraminotomy: Creates more space for the nerve root from the back of the neck, often used when symptoms come from nerve pinching on one side and the anatomy fits. ⁵

What to expect during recovery

Recovery is different for everyone. It depends on the type of surgery, your symptoms before surgery, overall health, and how your nerve responds after decompression.

Common recovery patterns

After lumbar microdiscectomy

• Right after surgery: Many people walk the same day or the next day. It is common to feel soreness in the back, and leg pain may improve quickly, but sometimes it fades gradually. ³ ⁴
• First few weeks: Activity is usually increased step by step. Sitting may still feel uncomfortable for a while, and the nerve can stay sensitive as it heals. ³
• Weeks to months: Many people return to daily routines in stages. Heavier lifting and high-impact activity often take longer. ³ ⁴

After cervical surgery (fusion, disc replacement, or foraminotomy)

• Right after surgery: Neck soreness, swallowing discomfort, or temporary voice changes can happen, especially with surgery from the front of the neck. ⁵
• First few weeks: Arm pain often improves, but numbness or weakness can take longer. Your clinician may give guidance on neck motion and activity progression. ⁵

Common challenges

• Ups and downs are normal. Nerves can stay irritated for a while, even after pressure is relieved.
• Sleep can be tricky early on because of soreness and positioning.
• You may feel stiff or guarded, especially if you have been avoiding movement due to pain. ³ ⁵

Risks to understand

All surgery carries risks. Your surgeon will explain what applies to you, but common categories include:

• Infection, bleeding, blood clots, or anesthesia-related risks. ³ ⁵
• Persistent symptoms or incomplete relief, especially if the nerve has been irritated for a long time. ⁴ ⁵
• Recurrent disc herniation, meaning the disc can herniate again in some people. ³ ⁴
• Need for additional procedures in the future, depending on the spine segment and the surgery type. ⁴ ⁵

A realistic goal is often to reduce nerve pain and improve function, not to erase every sensation forever. ⁴ ⁵

Can surgery be avoided?

Often, yes.For most people, conservative care is the safest starting point because symptoms commonly improve over time, and many people recover enough to avoid procedures altogether. ¹ ² Conservative care typically includes education, staying active within your limits, and a structured physical therapy program that builds strength and confidence while monitoring for any worsening nerve signs. ¹ ³

High-quality studies comparing surgery with nonoperative care for sciatica due to lumbar disc herniation show that surgery often brings faster relief, but many people who continue with conservative care improve substantially over time too. That is a key reason why surgery is usually reserved for severe or persistent symptoms, or worsening weakness. ⁴ ⁶

You can learn more on the physical therapy for a herniated disc guide page.

How Sword can support you before and after surgery

Physical therapy can play an important role in preparing for surgery, supporting recovery, and, in some cases, helping people manage symptoms without surgery. Sword offers physical therapy programs designed to support you at different points along that journey.

Sword supports recovery before and after surgery, with care designed to fit into your life. You receive high-quality physical therapy at home, guided by licensed clinicians and supported by smart technology.

• Care that adapts as your body and recovery needs change
• Licensed physical therapists guiding your care at every stage
• Non-invasive, evidence-based physical therapy programs

Clinical insight

Modern guidelines emphasize a calm, stepwise approach for most people with herniated disc symptoms. For new sciatica or arm radicular pain, immediate imaging and early surgery are usually not needed unless there are red flags like cauda equina syndrome or progressive weakness. The key is a personalized pathway: active rehabilitation for most people, urgent action when red flags appear, and shared decisions that balance faster relief against risks and the natural tendency of many herniated discs to settle with time. ¹ ³ ⁴ ⁶