Spinal surgery should be last resort

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March 7, 2019 - 10:55 AM

Dear Dr. Roach: Around two years ago, I had an L4/L5 herniated disc that caused a sciatic nerve problem. My doctors tried prescription medication (including medicine to act on the nerves), two lumbar injections and physical therapy. I also tried a chiropractor and acupuncture.

After all of the above steps, my back pain has basically gone away, with the exception of numbness/tingling in my right foot. This numbness/tingling varies in intensity from light to strong. I have been reading about spinal decompression, but at this point, I am not sure what else to do. Do you have any recommendations? — M.B.

Answer: I do not recommend spinal surgery for numbness and tingling. Although most people do well with surgery, I have seen enough people have bad outcomes after surgery (including weakness and intractable pain) that I recommend surgery only with pain so severe that it can’t be effectively treated; with weakness (immediately, if the weakness is progressing); or with symptoms affecting the bladder or bowel. All of these only after optimal nonsurgical treatment for at least six weeks).

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