Skip to content

Back Pain Health Center

Font Size

Slipped Disc: Surgery Best for Pain?

Study Finds Time Often Heals Pain of Herniated Disc -- But Surgery Works Faster
WebMD Health News
Reviewed by Louise Chang, MD

Nov. 21, 2006 -- With time -- and medical help -- slipped disc pain gets better. But disc surgery is faster and works better for bad pain, a large U.S. study finds.

The study shows that patients with a "slipped" or "ruptured" disc -- what doctors call a herniated disc --won't get worse or become paralyzed if they don't have surgery. Instead, they can expect to get better over time.

But when patients don't want to wait, surgery can mean a quick end to excruciating pain, says study researcher William A. Abdu, MD, medical director of the spine center at Dartmouth-Hitchcock Medical Center, in Lebanon, N.H.

"Patients with disc herniation can get better without an operation," Abdu tells WebMD. "But those who have severe leg pain -- and can't function well -- clearly will have improved outcomes if they have the operation."

Slipped Disc = Herniated Disc = Pain

Rubber-like discs pad the bones of the spine. When one of these discs bulges out into the spinal canal, it tends to push against the root of a nerve.

This causes intense back pain. Depending on which nerve is affected, pain or tingling may run down into the buttocks, hip, and leg.

With a combination of pain treatment, proper exercise, and rest, the pain often goes away or becomes only a minor nuisance.

Doctors usually consider surgery to remove the offending disc -- a discectomy -- if the pain continues for six weeks.

But some patients who've had the surgery say it wasn't worth it. And sometimes the pain of a herniated disc later gets better without surgery.

So is surgery really the best option?

That's a controversial question. There have been clinical trials in the past, but various flaws have made them difficult to interpret.

So Abdu and colleagues took a new look at the issue. Their study focused on problems with the lower back.

Waiting Works, Surgery Works Better

Dartmouth researcher James N. Weinstein, DO; Abdu; and their colleagues compared disc surgery to treatment with education and counseling, non-steroidal pain drugs, narcotic pain drugs, physical therapy, and/or steroid injections.

They gave 1,244 patients with herniated discs in the lower back a choice. The patients could let a computer assign them to either surgery or nonsurgical treatment for two years. Or they could pick one of the two options themselves.

Today on WebMD

Woman holding lower back
Or is it another form of back pain?
Hand on back
Eight out of 10 us will have it. Here’s the myths vs. the facts.
Woman doing pilates
Good and bad exercises
acupuncture needles in woman's back
Use it to manage your pain.
Man with enhanced spinal column, rear view
pain in brain and nerves
Chronic Pain Healtcheck
Health Check
break at desk
Woman holding lower back
Weight Loss Surgery
lumbar spine
back pain