Does Giant Disc Herniation and Severe Pain Require Surgery?

If you have leg pain resulting from a large disc herniation, there is good news. Conservative, non-surgical care will likely still help you.  

Over the years, I have frequently had people tell me that they or someone they know must have low back surgery because they have a large disc herniation.  This is simply not the case. Many of these cases can be successfully treated with conservative care.  I understand why a person might think this, but research has not supported it.

A study in the British Journal of Neurosurgery, published Dec 2020, looked at patients with giant herniations and severe sciatica. Pain levels went from a score of 90.8 down to 13.53 within the first 2 months. By 4 months, the pain levels had dropped to 3.13.

“these patients should be encouraged to undergo conservative care”

Pain levels dropped from 90.8 to 3.13

They concluded that regardless of the size of the disc or the severity of the pain, these patients should be encouraged to undergo conservative care. 

Are there times when patients require surgery?  The answer is yes. If people develop bowel or bladder problems, foot drop or other neurological problems, they must be watched closely. These types of patients were excluded from this study.

Help with Cox Treatment

Cox decompression manipulation allows us to decompress the discs and relieve pressure on the nerves going down your legs. Contact our office to schedule an appointment or consultation. Click here to read more about the Cox table. 


Tuncer Tascioglu & Omer Sahin (2020) The relationship between pain and herniation radiology in giant lumbar disc herniation causing severe sciatica: 15 cases, British Journal of Neurosurgery, DOI: 10.1080/02688697.2020.1866168

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