Disc surgery is not for back pain, but is far more effective for limb pain. Back pain is the number one reason why people undergo disc surgery, yet all disc-targeting procedures demonstrate very poor results for curing pain that occurs in the back. Instead, disc surgery is more successful at resolving pain and related neurological expressions of tingling, numbness and weakness in the arms or legs.
Disc surgery is by far the most common type of spinal operation performed worldwide. Discectomy is the most frequently used procedure, while IDET, nucleoplasty, disc replacement and spinal fusion are also available. Despite its popularity, disc surgery generally disappoints in its curative outcomes, with the vast majority of patients citing poor results over timelines of 7 years.
This important focused discussion delves into the reasons why patients should not undergo disc surgery for back pain, but might consider it if their primary symptoms are limb-based and correlate to the suspected disc location perfectly.
Disc surgery is the most frequently performed of all spinal operations. This is because herniated and degenerated discs are the most common reasons blamed for creating chronic back pain. Neither herniated nor degenerated discs respond well to conservative therapy, so many patients eventually undergo surgery for these conditions. However, as we write throughout many of our articles, the reason why these disc issues do not respond well to conservative care is not due to their ferocity as symptomatic mechanisms, but instead simply because they are misdiagnosed as the actual underlying origin of pain. Therefore when treatment is escalated to surgical varieties, one would expect that results would be just as disappointing and that is exactly what postoperative statistics point out.
Disc surgeries fail to relieve back pain in most patients. Disc surgeries fail to relieve all symptoms in many patients, including most case profiles over timelines of 7 years. In essence, disc surgeries are frequently used, but rarely successful, especially when being performed to relieve back pain, instead of symptoms that exist in the limbs, such as pinched nerves leading to arm pain or sciatica.
It is not logical that any disc issue should create back pain for an extended period of time, since discs have no nerves and usually can only create pain through structural compression of a nerve or the spinal cord that will affect innervated regions and will not necessarily signal pain at the compression site. All of our research has pointed out that back pain is rarely caused by any disc abnormality and when it is, the pain is usually transient, created by chemical radiculitis, or involves serious central spinal stenosis with other contributory issues. The typical diagnosis of a compressed nerve root is not likely to create chronic back pain in virtually any circumstances, but instead will lead to progressive tingling, numbness and weakness in any area of the body served by the affected nerve and this area is almost always in a limb.
When proper diagnostic evaluation, including symptomatic correlation, determines that a herniated disc is causing specific neurological compression of an individual nerve root, disc surgery stands the best hope of relieving the patient’s suffering. In these instances, the clinical expectation for symptoms may include transient pain at the compression site and in the affected area of the limb as deemed appropriate by innervation mapping, followed by progressive tingling, numbness and weakness in the innervated area and possibly at the compression site over time. Chronic back pain does not indicate a pinched nerve in virtually any case.
When the diagnosis of a compressive neuropathy is accurate, disc surgery may prove to be one way of successfully resolving the pathology. In these cases, bulging discs might be best treated using IDET or nucleoplasty, while comprised annulus herniations are best treated with discectomy in most instances. However, it should be known that surgery is still not inherently necessary, not does it provide better outcomes that conservative care or even "no treatment".
Time alone will resolve many disc issues and relieve structural compression of a nerve. People who do not receive any treatment actually fare better over multi-year timelines than patients who receive all forms of treatment, including conservative, moderate and surgical. In other cases, patients might enjoy relief from chiropractic adjustments, exercise therapy or nonsurgical spinal decompression.
If you remember one thing from this article, make it the factual truth that most disc issues are misdiagnosed as the source of back pain. This is not to say that disc abnormalities do not exist. In fact, disc issues are virtually universally observed in adults of all ages. I have 12 significant herniated discs in my spine and I am fine!
If you are diagnosed with a herniated disc, do not be surprised. Almost everyone has them and they often come and go. There has never been any evidence provided in any respected study which proves that disc degeneration or herniation is inherently pathological. There has been much evidence provided that states the opposite conclusion, that most disc issues are incidental to pain that may exist. Therefore, disc surgery should always be a last resort, should almost always be considered optional even at that stage and should never even be considered unless the diagnosis is verified 100% and involves limb pain due to nerve compression, rather than back pain as a primary complaint.
If you undergo surgery and it cures your back pain, then that is great. We just hope that you will beat the odds and still enjoy relief in 6 weeks, 6 months or 6 years from now. However, statistics are stacked against this possibility, since most patients will not benefit from lasting pain relief from any type of disc procedure over a 7 year timelines, while many patients receive no relief at all and some are even worsened in their condition postoperatively. Be careful!