Finding the Balance between Surgery and Conservative Treatment for Disc Herniation

In this editorial, the author gives a brief overview of current treatment for lumbar disc herniation. He explains that this condition is responsible for many cases of lower back pain and most lumbar surgeries.

But little is known about lumbar disc herniation. The condition can sometimes disappear on its own. This makes many surgeries unnecessary. But in which cases? Some patients only find relief with surgery. And the chances of complete recovery are better if patients don't suffer symptoms for too long. But then again, lumbar disc surgery has a high rate of failure.

The author says there has been a shift in treatment of disc herniation over the past 20 years. In the past, aggressive surgery was the general approach. Now the author suggests the pendulum has swung to the point there is "an excess of nonoperative management." He urges surgeons to better identify which patients will do better with surgery, and when.