If the slipped disc tissue presses on the spinal nerves in the gaps between the bony arches, you will get a feeling of pain in your leg, called sciatica. You may also feel weakness in your leg muscles. If the slipped disc tissue presses on the nerves of the cauda equina, which run through the vertebral canal, this can cause buttock numbness and bladder problems with difficulty in controlling urine.
The aim is to remove the soft part of the disc that is out of place, so that the pressure on the nerves is relieved and the condition does not come back.
The operation should stop the pain in your leg. If you have some weakness in your leg this should improve.
Are there any alternatives?
If you do not have any muscle weakness, you can wait and see if your pain settles with time. Only the minority of patients with sciatica need an operation, even if they are shown to have a herniated disc on a scan.
Some patients find that an injection of anti-inflammatory steroid around the nerves in the back relieves their pain; this is called an epidural injection.
Physiotherapy or osteopathy can help reduce back pain but cannot help reduce sciatica.
What if you do nothing?
If you only have pain, but no muscle weakness, your pain may settle if you wait long enough.
If you have weakness of your leg and you do not have an operation, the muscles may remain weak permanently.
Who should have it done?
You should have the operation if you have ALL of the following:
- Your leg pain is worse than your back pain
- You have had leg pain for several months that is not getting better
- Your leg pain is interfering with your life
- You have had a special scan (MRI scan) that shows that you have a disc pressing on the nerve
You should have an early operation if you have weakness in some of your leg muscles or numbness in your leg that is getting worse. If you have buttock numbness, leg weakness and a bladder problem (cauda equina syndrome) you need an operation urgently.
Who should not have it done?
The aim of the operation is to cure your leg pain. Your back pain may remain unchanged after the operation. If your back pain is more of a problem than your leg pain, you should not have the operation.
Author: Mr Boyd Goldie MBBS FRCS BSC DHMSA. Consultant in orthopaedics & trauma.
© Dumas Ltd 2006