Herniated Disc: When Is Surgery Really Necessary?

A herniated disc is a common condition that causes lower back pain and sciatica. The good news is that most cases improve with conservative treatment, without the need for surgery.

What Is a Herniated Disc?

A herniated disc occurs when the gelatinous nucleus of the intervertebral disc protrudes through a fissure in the fibrous ring, potentially compressing nerve roots and causing intense pain, tingling, and weakness in the lower limbs.

Conservative Treatment: First Option

Studies show that 80-90% of herniated discs improve with conservative treatment in 6-12 weeks:

Analgesic and anti-inflammatory medications
Lumbar epidural block
Medical acupuncture
Specialized physiotherapy
Relative rest (avoid prolonged immobilization)

Absolute Surgical Indications (Urgent)

Surgery is necessary IMMEDIATELY in cases of:

Cauda equina syndrome: loss of urinary/fecal control
Progressive motor deficit: muscle weakness that worsens rapidly
Intractable pain: pain that doesn't respond to any treatment

Relative Surgical Indications

Surgery may be considered after 6-12 weeks of conservative treatment if:

Persistent and disabling pain
Significant functional limitation
Failure of adequate conservative treatment
Hernia confirmed on imaging exam

Important: The surgical decision should be shared between doctor and patient, considering risks and benefits.

Approach at Intrador

We offer specialized conservative treatment for herniated disc:

Image-guided epidural block
Neurofunctional acupuncture
Optimized medication prescription
Guidance for safe return to activities

Have a Herniated Disc?

Schedule an evaluation for specialized conservative treatment before considering surgery.

About Lower Back Pain Talk with our team

Clinical Review

Dra. Cristina Belotserkovets Heinrich
Functional Neurosurgery, Pain and Acupuncture — CRM 18839/PE · RQE 7825, 11500, 17697

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Approaches typically considered

For this condition, our team may consider one or more of the approaches below, from least to most invasive. The actual choice depends on individual clinical evaluation.

Acupuncture
Magnetic Stimulation (SIS)
Nerve Blocks
Image-Guided Block or Injection
Radiofrequency

This list is informational. The effective indication depends on individual clinical evaluation, with criteria and limits discussed with you.

Talk with our team See all approaches

Clinically Reviewed by:

Dr. Helio Widson Alves Pinheiro

Pain Medicine | Acupuncture

Published on: January 17, 2026

Reviewed on: January 29, 2026

This content is informative and does not replace individual medical evaluation.

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Neurosurgeon with pain medicine and acupuncture credentials, with practice in spine surgery and interventional pain medicine.

Note: This content is for educational and informational purposes only. The information is based on scientific evidence and the clinical practice of the Intrador team, but it does not replace individualized medical evaluation. Conduct, indications, and treatments must be defined after medical consultation.

Clinical reviewer: Dr. Helio Widson Alves Pinheiro · Pain Medicine | Acupuncture · CRM/PE 21167 | RQE 2217, 2808

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