--- title: "Herniated Disc" --- ## You May Not Need Surgery If you have been diagnosed with a herniated disc, there is a good chance someone has already raised the possibility of surgery. Sometimes that recommendation is appropriate. Often it is not, at least not as a first step. The reality is that most herniated discs can be treated successfully without surgery. Many resolve significantly on their own over weeks to months. Many others respond well to targeted non-surgical treatments that address the inflammation and nerve irritation causing your symptoms. This is not the same as saying surgery is never the right answer. For specific situations, including significant weakness, loss of bladder or bowel control, or pain that has not responded to thorough non-surgical treatment, surgery is a real and appropriate option. For the majority of patients, non-surgical treatment is the right starting point, and we help you understand which category you fall into. ## What a Herniated Disc Actually Is Your spinal discs sit between each pair of vertebrae and act as cushions. Each disc has a tough outer layer and a softer, gel-like center. A herniated disc happens when the soft center pushes through a weak spot in the outer layer. When this happens, the displaced disc material can press on nearby spinal nerves or release inflammatory chemicals that irritate them. The result is the symptoms most patients experience: back or neck pain combined with pain, numbness, tingling, or weakness traveling down an arm or leg. The location of your symptoms tells your physician where the herniation is. Pain into the leg suggests a lumbar herniation in your lower back; pain into the arm suggests a cervical herniation in your neck. ## What Your Symptoms Mean The patterns below are how patients usually describe herniated disc symptoms. The specific pattern affects both the diagnosis and the treatment recommendation. #### Sharp, electric pain that travels down your leg This is the most common presentation of a lumbar herniated disc. The pain often starts in the lower back or buttock and shoots down the back of the thigh, sometimes all the way to the foot. It may feel sharp, burning, or electric, and coughing, sneezing, prolonged sitting, or bending forward often makes it worse. This pattern usually responds well to targeted lumbar epidural steroid injections, which deliver anti-inflammatory medication directly to the irritated nerve. #### Pain that travels down your arm A herniated disc in your neck typically produces pain that travels down one arm into the hand, often with numbness, tingling, or weakness in specific muscles. Cervical epidural steroid injections target this pattern specifically, delivering anti-inflammatory medication near the irritated nerve in the neck. #### Significant weakness or bladder and bowel changes Substantial muscle weakness, difficulty walking, or any change in bladder or bowel control can indicate more significant nerve compression that requires prompt evaluation. If you experience these, please call us or go to an emergency department promptly. ## How Your Pain Will Likely Progress Without treatment, many herniated discs improve significantly over six to twelve weeks. The displaced disc material often shrinks over time, and the body's own anti-inflammatory response reduces nerve irritation. This natural improvement is real, but it does not mean you should suffer through it. Targeted treatment can significantly reduce pain during the healing process, allow you to maintain function and normal activities, prevent secondary issues from chronic pain, and identify whether your case is one that will not improve without intervention. Most patients want both pain relief now and a clear understanding of where their case is heading. We provide both. ## How PHI Treats Herniated Discs The most important first step is identifying which nerve is irritated and confirming the diagnosis. Imaging shows the herniation, the physical exam confirms which nerve is affected, and diagnostic injections sometimes confirm the relationship between the imaging finding and your actual symptoms. Once the diagnosis is clear, epidural steroid injections are usually the first interventional treatment, delivering anti-inflammatory medication directly to the irritated nerve. Selective nerve root blocks can both diagnose and treat pain from a specific nerve, which is particularly useful when imaging shows multiple potential sources. Regenerative options including PRP, A2M, and exosome therapy may be appropriate for patients seeking to address the underlying disc tissue rather than only the inflammation. Continued conservative care plays a role alongside interventional treatment, and PHI coordinates surgical referral for the specific situations where surgery is the right answer. ## Why PHI for Herniated Disc ## Frequently Asked Questions **Q: Do I need surgery for a herniated disc?** Most patients with herniated discs do not need surgery. The majority improve significantly with non-surgical treatment. Surgery is appropriate for specific situations including significant weakness, loss of bladder or bowel control, or pain that has not responded to thorough non-surgical treatment over an appropriate period. **Q: How long until my herniated disc improves?** Without treatment, many herniated discs show significant improvement over six to twelve weeks. With targeted treatment, pain relief is often faster, and some patients experience substantial improvement within days of their first epidural injection. Full resolution of symptoms typically takes longer, even with treatment. **Q: Will the disc heal back to normal?** The disc itself usually does not return to its pre-herniation state, but the displaced material often shrinks over time and the inflammation around the nerve resolves. Most patients become symptom-free even though the disc still looks somewhat abnormal on follow-up imaging. **Q: Can a herniated disc come back?** The same disc can re-herniate, particularly if you return to the activity or movement pattern that caused the original herniation. Recurrence rates are higher with surgery than without surgery, which is one of several reasons to consider non-surgical treatment first when appropriate. **Q: Should I rest or stay active?** Generally, gentle continued activity is better than strict rest. Brief rest during severe acute pain makes sense, but extended bed rest typically slows recovery. Your physician will give you specific guidance based on your situation. **Q: Will an epidural steroid injection cure my herniated disc?** The injection does not heal the disc itself. It reduces inflammation around the irritated nerve, which often reduces or eliminates symptoms while your body's natural healing continues. Many patients experience significant lasting relief from a single injection because the inflammation cycle is interrupted. **Q: Can I exercise during recovery?** In most cases yes, often with modifications. Physical activity is one of the best long-term protective factors against future disc problems. Your physician will guide you on what to continue, what to modify, and what to avoid during the acute recovery period. **Q: Do you take insurance?** Insurance coverage and payment options may vary. We provide documentation for you to seek reimbursement through your out-of-network benefits, which may apply to certain services. All pricing is disclosed at consultation. **Q: Do you accept international patients?** Yes. PHI regularly treats patients from outside Los Angeles, including Las Vegas, Palm Springs, London, and other international locations. ## Treatments We Offer for Herniated Disc PHI offers the full range of evidence-based treatments for herniated disc. Your physician will recommend the right option, or combination, based on the location of your herniation, the severity of your symptoms, and your treatment history. - Epidural Steroid Injections, the usual first interventional step for radiating nerve pain - Nerve Blocks, selective nerve root blocks that confirm and treat the source nerve - Radiofrequency Ablation, for selected chronic or recurrent cases - PRP Therapy - A2M Therapy - Exosome Therapy > Epidural steroids for cervical and lumbar radicular pain and spinal stenosis: systematic review summary. Peer-reviewed via PMC, 2022. — [American Academy of Neurology Guidelines Subcommittee](https://pmc.ncbi.nlm.nih.gov/articles/PMC12289388/) > Epidural injections for lumbar radiculopathy or sciatica: a comparative systematic review and meta-analysis. Peer-reviewed via PubMed, 2021. — [Manchikanti L, et al.](https://pubmed.ncbi.nlm.nih.gov/34323441/) > Epidural Steroid Injections. StatPearls, peer-reviewed via NIH/NCBI. — [StatPearls (NIH/NCBI Bookshelf)](https://www.ncbi.nlm.nih.gov/books/NBK470189/) ## Schedule Your Herniated Disc Consultation A 60-minute consultation will confirm the diagnosis, walk through your treatment options, and tell you straightforwardly whether non-surgical treatment is likely to work for you. Call (310) 856-9488 or book online now. ```ld+json { "@context": "https://schema.org", "@graph": [ { "@context": "https://schema.org", "@type": "MedicalCondition", "@id": "https://painandhealing.com/concerns/herniated-disc/#concern", "name": "Herniated Disc", "url": "https://painandhealing.com/concerns/herniated-disc/", "description": "A herniated disc can cause sharp, radiating pain down an arm or leg. Most can be treated successfully without surgery. 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At PHI in Beverly Hills, board-certified physicians Dr. Faisal Lalani and Dr. Nadiv Samimi confirm which nerve is irritated and treat it with targeted epidural injections, nerve blocks, and regenerative medicine, reserving surgery for the specific situations that genuinely require it." }, "isPartOf": { "@id": "https://painandhealing.com/concerns/herniated-disc/#webpage" }, "url": "https://painandhealing.com/concerns/herniated-disc/" }, { "@context": "https://schema.org", "@type": "FAQPage", "mainEntity": [ { "@type": "Question", "name": "Do I need surgery for a herniated disc?", "acceptedAnswer": { "@type": "Answer", "text": "

Most patients with herniated discs do not need surgery. The majority improve significantly with non-surgical treatment. Surgery is appropriate for specific situations including significant weakness, loss of bladder or bowel control, or pain that has not responded to thorough non-surgical treatment over an appropriate period.

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Without treatment, many herniated discs show significant improvement over six to twelve weeks. With targeted treatment, pain relief is often faster, and some patients experience substantial improvement within days of their first epidural injection. Full resolution of symptoms typically takes longer, even with treatment.

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The disc itself usually does not return to its pre-herniation state, but the displaced material often shrinks over time and the inflammation around the nerve resolves. Most patients become symptom-free even though the disc still looks somewhat abnormal on follow-up imaging.

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The same disc can re-herniate, particularly if you return to the activity or movement pattern that caused the original herniation. Recurrence rates are higher with surgery than without surgery, which is one of several reasons to consider non-surgical treatment first when appropriate.

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Generally, gentle continued activity is better than strict rest. Brief rest during severe acute pain makes sense, but extended bed rest typically slows recovery. Your physician will give you specific guidance based on your situation.

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The injection does not heal the disc itself. It reduces inflammation around the irritated nerve, which often reduces or eliminates symptoms while your body's natural healing continues. Many patients experience significant lasting relief from a single injection because the inflammation cycle is interrupted.

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In most cases yes, often with modifications. Physical activity is one of the best long-term protective factors against future disc problems. Your physician will guide you on what to continue, what to modify, and what to avoid during the acute recovery period.

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Insurance coverage and payment options may vary. We provide documentation for you to seek reimbursement through your out-of-network benefits, which may apply to certain services. All pricing is disclosed at consultation.

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Yes. PHI regularly treats patients from outside Los Angeles, including Las Vegas, Palm Springs, London, and other international locations.

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