One of the most common causes of leg pain has nothing to do with a problem in your leg. Instead, it may be coming from a herniated disc in your spine.
Also known as a slipped disc, a herniated disc can cause pain felt in the leg or lower back. If medication and other conservative treatments for a herniated disc don’t provide relief, a surgical procedure called microdiscectomy may be right for you.
Flat, rubbery discs between your vertebrae help cushion the spine and protect it from damage. Injury, obesity, poor posture and other factors can put stress on a disc and cause it to bulge, rupture or slip out of place. When this happens, the disc may press on a spinal nerve.
Depending on where the damaged disc is, the irritated nerve can cause pain, weakness or numbness in the arm, leg or lower back. Most herniated discs occur in the lumbar area of the lower spine; only about 10% affect the upper spine.
A herniated disc most often occurs in people between the ages of 30 and 50, although it can affect younger and older people.
“Many patients, especially younger people, will recover from a herniated disc with nonsurgical treatments, such as medication, cortisone injections and physical therapy,” says Gregory Mundis, MD, an orthopedic spine surgeon at Scripps Clinic Torrey Pines. “If none of these treatments is effective after six to 12 weeks, microdiscectomy may be the best option.”
In rare cases, if the irritated nerve causes significant weakness or affects bowel or bladder function, surgery may be recommended sooner.
Microdiscectomy surgery helps to relieve painful symptoms of a herniated disc by removing the disc tissue that is putting pressure on the nerve. It is a minimally invasive surgery, which means the surgeon makes only a few very small incisions to perform the procedure rather than a large incision. This can result in reduced pain, a shorter (if any) hospital stay, a faster recovery and less scarring.
Before your surgery, your surgeon will order X-rays to help determine the exact surgical site.
Microdiscectomy surgery is performed in one of three ways:
The surgeon makes the incision in the back and lifts the muscles around the spine to access the herniated disc.
Rather than moving the muscles, the surgeon accesses the damaged disc by inserting small tubes through the incision to form a tunnel through the muscles.
Using a tiny camera and surgical instruments inserted through a small incision, the surgeon performs the procedure guided by video from the camera.
In most cases, microdiscectomy is an outpatient procedure, so you don’t have to spend the night in the hospital. The surgery itself is performed under general anesthesia and usually takes 30 to 60 minutes, followed by a couple of hours in the recovery room.
Once you return home, you will need to rest for about two weeks to allow the tissue to heal and limit your activities for six weeks or so. You also may begin physical therapy a few weeks after surgery to help you rebuild your strength and mobility and learn how to move safely to avoid new injuries. Your therapist may show you how to modify your activities, evaluate how you move at work, and give you exercises to do at home.
Many patients feel relief from a herniated disc almost immediately after surgery. If the nerves have been irritated and causing pain for a long time, it may take a bit longer for the pain caused by the herniated disc to subside.
“The success rate for microdiscectomy is very high,” says Dr. Mundis. “If you’re having pain from a herniated disc and nothing is helping, consider talking with an orthopedic surgeon. You don’t have to live with the pain.”