Herniated disc surgery

A herniated disc is a bulge of an intervertebral disc. Symptoms that may accompany a herniated disc include numbness, weakness, and painful or tingling radiating pain. These symptoms occur when the bulge presses on a nerve. A herniated disc can be treated with surgery, although this is not always necessary.

If you would like to read more first about what a herniated disc is exactly, then read the articles on the lumbar herniated disc and the cervical herniated disc.

What treatment options are there for a herniated disc?

Most herniated discs are not operated on. Except for the more serious cases, the first attempt will always be to treat the herniation conservatively. This means with rest, pain medication, and/or physical therapy. In practice, it has been shown that in 70 to 80 percent of herniated discs this treatment is sufficient to reduce or even eliminate the protrusion. In many cases, there is also inflammation of the nerve root, which will heal further with rest.

In some cases, the orthopedic surgeon or neurologist will advise surgery. Reasons that contribute to this decision include when the symptoms have lasted longer than six months or there is muscle weakness, for example a foot drop. In cases of severe pressure on the nerve, with the risk of permanent damage and unbearable pain, a surgical procedure will also be considered.

Before the surgery

If a surgical procedure is chosen, it is wise to start the physical therapy treatment process before the operation date (preoperative). An important focus here is to go into surgery in optimal health ('better in better out'). In addition, attention will be paid to the first period after the surgical procedure (postoperative).

The physical therapist will help with advice and guidance in learning proper posture patterns or learning to walk with crutches. Another focus is moving within the pain threshold, active or passive, and reducing pain as much as possible.

During the surgery

Depending on the location of the herniated disc, a prone position is chosen. If necessary, a roll is placed under the abdomen to slightly round the back. In general, the procedure is performed under general anesthesia. During the procedure, the orthopedic surgeon will try to remove the protrusion in its entirety.

After the surgery

On the first day after surgery, the physical therapy treatment will continue, still in the hospital. In general, people can go home a few days after the surgery to continue rehabilitation there. Especially in the first weeks after the operation there are strict activity restrictions. It is especially important not to lift heavy objects and to get sufficient rest.

Under the guidance of the physical therapist, activity is slowly increased. In general, it is recommended to allow at least six months before heavy work and sports can be resumed.