Herniated Disc: Surgery or Not? Options, Injections, Recovery

Being told you have a herniated disc often comes with a hard question: operate now, or wait and see? There is rarely one right answer, and people who face the same scan make different choices. One approach many patients describe is to try other treatment first but set a deadline:

This guide explains the usual options, what each involves, when surgery is usually discussed, and how treatment in China, including Chinese medicine alongside it, can fit in.

Is surgery the only option for a herniated disc?

No. Most people start with non-surgical care, and surgery is usually discussed when symptoms do not settle or when the nerve is clearly affected. Non-surgical care typically combines staying as active as pain allows, pain relief, physiotherapy and, for some people, a steroid injection near the nerve. Discs and symptoms change over time, so a repeat MRI may be needed if your symptoms change.

Surgery is not a failure of conservative care, and conservative care is not a failure to act. The choice depends on how severe the leg pain is, whether there is weakness or numbness, how long it has lasted and how it limits your life. A second opinion from another spine surgeon is reasonable before any operation.

Is surgery recommended for an L5-S1 or L4-L5 disc herniation?

Sometimes, but the level of the disc alone does not decide it. L4-L5 and L5-S1 are the most commonly affected discs in the lower back, and many herniations at these levels are first treated without surgery. Surgeons are more likely to discuss an operation, usually a microdiscectomy to remove the part of the disc pressing on the nerve, when leg pain persists despite treatment, when there is progressive weakness, or when the scan and symptoms clearly match.

Some symptoms need same-day emergency care rather than a planned decision: numbness around the groin or buttocks, new difficulty controlling the bladder or bowel, or weakness in both legs.

How effective are epidural steroid injections for a herniated disc?

They help some people and not others, and the relief may be temporary. An epidural steroid injection places an anti-inflammatory medicine near the irritated nerve, with the aim of reducing pain enough to keep moving and do physiotherapy while the disc settles. It does not remove the disc material. Some people get long relief; others need further treatment later:

Ask your doctor how many injections they would consider and what the plan is if one does not help.

Which exercises are safe with a bulging or herniated disc?

Gentle activity such as walking is usually encouraged if you can tolerate it, and a physiotherapist can choose exercises for your particular disc and symptoms. Many people are advised to avoid heavy lifting, repeated bending and twisting during flare-ups, and to stop any exercise that makes leg pain spread further down the leg. Stretching through sharp nerve pain is generally not a good idea. Because the right exercise depends on the direction of the herniation and what makes your pain better or worse, a programme set by a physiotherapist is safer than a generic video.

What helps sciatica from a herniated disc, including Chinese medicine?

Sciatica from a disc is usually treated with the steps above. In China, many hospitals also offer Chinese medicine alongside this care, and patients often ask how that works.

How it is done in China. In Chinese hospitals, Chinese medicine for back and leg pain is usually given in the acupuncture or rehabilitation department, alongside medical care rather than instead of it. Treatment can combine acupuncture, tuina (therapeutic massage), cupping, moxibustion and herbal medicine. It is usually given as a course of several sessions, then reviewed to decide whether to continue.

How Chinese medicine sees it. A Chinese medicine doctor looks at the whole pattern, not only the disc. The same back pain can be treated differently depending on the person's constitution, so the doctor looks at your tongue and takes your pulse before choosing the treatment.

What patients describe.

Results vary. Experiences differ from person to person. Chinese medicine in China is used together with medical assessment and treatment, not as a replacement for it, and anyone with weakness or the warning signs above needs a spine doctor first.

How long is the recovery after herniated disc surgery?

For a standard microdiscectomy, most people go home the same day or after one to three nights, according to NHS patient leaflets. Return to work is usually within 2–6 weeks depending on the job: office work within days, light manual work at about 4 weeks and heavy manual work at 6–12 weeks. Driving is usually possible after 2–4 weeks. We found no published guidance on flying after a microdiscectomy, so ask your surgeon before booking a flight.

If you are considering treatment in China, cost is one reason people look. In Shanghai's 2026 price schedule, public hospitals may charge at most CNY 3,139 (≈ USD 470) per disc for the operation itself, and keyhole (endoscopic) disc surgery is charged at the same fee as open surgery. Implants, anaesthesia, the hospital bed, drugs and scans are charged on top, and foreign patients pay the full list price. An MRI at a Chinese public hospital costs about CNY 500 (≈ USD 75) after the 2024–25 national price cuts, which makes a scan and specialist opinion inexpensive to get before deciding.

Whatever you decide, keep your records portable. Ask for scan images in DICOM format as well as the written report, and for any operation note and discharge summary in English. Chinese hospitals issue reports in Chinese by default, so request English when you register. Your doctor and physiotherapist at home will need these for follow-up.