We’ve talked before about how to avoid back surgery for a herniated disc (and why, if you can, you should), but sometimes it’s just not possible. If you’re among those suffering from this common condition and do need surgery, it’s good to be prepared. (If you’re wondering if you even need surgery for a herniated disc, read this article first.)
Regarding herniated disc surgery, I’m frequently asked the first two questions in the list below; the other three not quite as often—though they bring up aspects of the surgery you should be aware of. Regardless of the answers provided here, I recommend posing each of the questions below to your doctor, who can provide you with more detailed responses specific to your case.
1. Is herniated disc surgery serious?
As with any type of surgery there are always risks, but herniated disc surgery is a fairly common procedure. A microdiscectomy is the typical course of action for a first-time, isolated herniated disc, where a surgeon removes a small portion of the problematic disc that’s pressing on a nearby nerve. It’s a minor procedure and you’ll go home the same day. For a relatively healthy person with an isolated herniated disc, a microdiscectomy rarely poses a problem.
2. How long does it take to recover from herniated disc surgery?
In general, most patients can return to light-duty, office type work anywhere from 10 days to two weeks after surgery, or return to heavy manual work at four to six weeks. After six weeks, there are typically no further restrictions on activities.
3. Is there a chance that more of the same disc will later reherniate?
Ten to 15 percent of herniated disc surgery patients will have a recurrent herniation in the future. It could happen just a few days after surgery, many years later, or anytime in between. The only way to tell is if you begin experiencing clinical symptoms again. Typically after the initial surgery, your hip and leg pain is resolved almost immediately because the issue of the compressed nerve has been addressed. Another herniation would usually bring on the same kind of pain again very suddenly.
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Reherniation is somewhat more common in the first six weeks after surgery because the outer rim of the disc has an opening where the disc material came through. It fills in with dense but weak scar tissue—essentially not a very good barricade to keep the disc in place should it try to push through in those early days and weeks. After six weeks, scar tissue forms and acts as a more effective barrier to keep the disc in place. (Though that won’t necessarily prevent it from happening again.)
4. Does a herniated disc have any long-term impact?
Whether you have surgery or not, once you have herniated a piece of your disc, the remaining disc that has not herniated will experience an accelerated degenerative breakdown. So deterioration that normally takes three or four decades for someone without a herniation might instead take one.
Degeneration happens naturally in everyone as we get older, but someone with a herniated disc experiences the process sooner and faster: As your disc degenerates, the bones start collapsing together, which could lead to spinal stenosis. At the same time your bones are collapsing, your facet joints are also undergoing a change. Normally the joints on either side of the disc are aligned, but as the bones collapse the joints no longer line up properly. That causes the cartilage in your facet joints to wear out as well. Some patients may eventually require surgical treatment to address the degeneration.
5. Is there anything I can do to alter the course of accelerating degeneration?
There are a few things that will be helpful for keeping your spine healthier longer, such as maintaining your ideal body weight and doing core strengthening exercises to keep the muscles of the spine as strong as possible. If you’re a smoker (or enjoy vaping), the most significant action you can take for your spinal health is to avoid nicotine. Nicotine constricts the blood vessels and restricts the blood supply to your discs; without sufficient blood your discs won’t get access to the nutrients they need to remain healthy.
If you have additional questions about herniated discs—or other spinal conditions—I encourage you to take a look our Knowledge Center for more information.