Herniated Disc Surgery: Long-Term Care

A herniated disc (also called a bulging, ruptured, or slipped disc) is a condition where the soft material between the bones (vertebrae) of the spine compresses a nerve. The compression of nerves generates pain and other symptoms such as weakness, tingling, or numbness in the area where the nerve is affected.

A herniated disc is most likely to occur in the neck (cervical) or lower back (lumbar) spine. A few reasons why a disc might herniate include trauma, deterioration, and genetic predisposition.

Benefits of Surgery

Many people who have herniated discs do not need surgery to resolve this condition. Research estimates that nine out of 10 people recover without surgical intervention, with varying times of recovery from a few days to several weeks. Numerous nonsurgical treatment options can help with recovery and return of function.

The most important benefit of surgery is dramatic relief of nerve pain almost immediately after surgery. While the full extent of pain relief may take time, muscle strength and sensations will improve over time as well. Bending, lifting, and twisting may be prohibited in the first few weeks after surgery to prevent a repeated herniation.

A serious but rare complication of a herniated disc is a condition called cauda equina. This is a surgical emergency that must be treated immediately to prevent irreparable damage to the spinal cord, permanent paralysis of the legs, and incontinence.

Anyone experiencing the symptoms of cauda equina should seek medical treatment immediately without delay. Surgery within 24 to 48 hours to remove the pressure of the bulging disc on the spinal cord is the first line of treatment and may relieve some symptoms, although it may take longer for other symptoms to resolve. 

Possible Future Surgeries

Many patients do not need future surgeries after undergoing herniated disc surgery. The success rate is high following the surgery, but it has been estimated that 5% to 10% of patients will reherniate a disc following nonsurgical or surgical treatment options. 

While few patients require subsequent surgery, those who do may undergo posterior spinal fusion surgery to provide increased spinal support through stabilization of the spine in addition to a repeat discectomy, the surgical removal of herniated disc material. 

Nonsurgical treatments such as rest, medications, physical therapy, and epidural steroid injections can also provide relief for patients with an initial herniated disc or a repeat herniation.

Lifestyle Adjustments

Daily activities—such as driving, exercising, and working—may be restricted by the surgeon immediately following surgery. Physical therapy will be ordered by the surgeon to assist with recovery for several months. During recovery, pain is a strong indication that an activity or movement may be too much and should be stopped to prevent another injury. 

There are certain risk factors for herniated discs, but not all can be modified. Risk factors for disc herniation include:

• Males between the ages of 20-50
• Improper body mechanics when lifting heavy items (using the back muscles instead of the leg muscles) or twisting while carrying a heavy load
• Extra body weight, which can add more stress to the discs in the spine
• Repetitive activities, such as in a job, that require repeat physical movements that strain the spine
• Sitting for long periods of time, such as a job requiring frequent driving with the additional risks of vibrations from the car engine
• Sedentary lifestyle without exercise
• Smoking, which is thought to damage the disc through degeneration from lack of oxygen

It’s important to note these risk factors and make changes to your lifestyle accordingly to avoid another herniated disc injury in the future.

A Word From Verywell

Experiencing a back injury such as a herniated disc can alter daily life while causing pain and other uncomfortable symptoms. For those who undergo disc herniation surgery, recovery from symptoms and pain is highly likely. While traumatic injuries, gender, and genetic predisposition cannot be changed, small modifications such as adding exercise, quitting smoking, and using proper body mechanics can greatly decrease your chances of experiencing a repeat disc herniation.