How do I know if my herniated disc needs surgery?

Surgery may be recommended if conservative treatments have not improved your symptoms after 6-12 weeks, if you have progressive weakness in your leg or arm, if you experience loss of bladder or bowel control (a medical emergency), or if the pain is so severe that it significantly impacts your quality of life. Dr. Hobbs performs a thorough evaluation including imaging to determine the best course of treatment.

Herniated Disc Treatment | Jonathan G. Hobbs, M.D. | Crown Point, Chesterton & Portage, IN

What Is a Herniated Disc?

A herniated disc occurs when the soft, gel-like center of a spinal disc (the nucleus pulposus) pushes through a tear in the tough outer layer (the annulus fibrosus). This displaced material can press on nearby spinal nerves, causing pain, numbness, tingling, or weakness in the areas served by those nerves.

Herniated discs most commonly occur in the lumbar spine (lower back), where they often cause sciatica — radiating pain down the leg. They can also occur in the cervical spine (neck), causing pain that radiates into the shoulder, arm, and hand. Less commonly, herniated discs occur in the thoracic spine (mid-back).

A herniated disc is sometimes called a slipped disc, ruptured disc, or prolapsed disc. While the terminology varies, the underlying problem is the same: disc material has moved out of its normal position and is irritating or compressing a spinal nerve.

Symptoms of a Herniated Disc

Symptoms depend on where the herniation occurs and whether it is pressing on a nerve. Some herniated discs cause no symptoms at all.

Lumbar Herniated Disc

Sharp or burning pain in the buttock, thigh, calf, or foot (sciatica)
Numbness or tingling in the leg or foot
Weakness in the leg or foot (difficulty lifting the foot)
Pain that worsens with sitting, bending, or coughing
Lower back pain

Cervical Herniated Disc

Pain in the neck, shoulder, or between the shoulder blades
Radiating pain down the arm into the hand or fingers
Numbness or tingling in the arm or fingers
Weakness in the arm or grip strength
Pain that worsens when turning or bending the neck

When to Seek Immediate Care

If you experience sudden loss of bladder or bowel control, progressive weakness in both legs, or numbness in the groin/inner thigh area (saddle anesthesia), seek emergency medical attention immediately. These may be signs of cauda equina syndrome, a rare but serious condition that requires urgent surgery.

Causes and Risk Factors

Herniated discs most often result from gradual, age-related disc degeneration (disc wear and tear). As you age, your spinal discs lose water content and become less flexible, making them more prone to tearing or rupturing even with a minor twist or strain.

Factors that increase your risk of a herniated disc include:

Age — Most common between ages 30 and 50 as discs naturally dehydrate and weaken
Occupation — Jobs requiring repetitive lifting, bending, twisting, or prolonged sitting
Weight — Excess body weight places additional stress on the discs in the lower back
Genetics — A family history of disc problems increases your predisposition
Smoking — Reduces oxygen supply to discs, accelerating degeneration
Sedentary lifestyle — Weak core muscles provide less support for the spine

How Dr. Hobbs Diagnoses Herniated Discs

Dr. Hobbs begins with a thorough evaluation to accurately identify the source of your pain and develop an individualized treatment plan.

Physical examination: Testing your reflexes, muscle strength, walking ability, and sensation. Specific tests such as the straight leg raise can help confirm nerve compression from a herniated disc.

Medical history: Understanding when your pain began, what activities make it better or worse, and whether you have experienced any numbness, tingling, or weakness.

Imaging studies: MRI is the gold standard for visualizing herniated discs and the degree of nerve compression. X-rays may be ordered to rule out other causes of pain such as fractures or instability. In some cases, a CT scan or nerve conduction studies may be used to provide additional diagnostic information.

Treatment Options for Herniated Discs

Dr. Hobbs strongly believes that nonsurgical solutions should be explored first before recommending surgery. The majority of herniated discs improve with conservative treatment. Surgery is reserved for cases where conservative care has not provided adequate relief or when neurological symptoms are progressing.

Conservative (Nonsurgical) Treatment

Physical therapy — Targeted exercises to strengthen core and back muscles, improve flexibility, and reduce pressure on the affected nerve
Anti-inflammatory medications — NSAIDs and other medications to reduce inflammation and manage pain
Epidural steroid injections — Corticosteroid injections delivered directly to the area of nerve compression to reduce inflammation and pain
Activity modification — Avoiding movements that aggravate symptoms while maintaining an active lifestyle

Surgical Treatment

When surgery is necessary, Dr. Hobbs uses the latest minimally invasive techniques for faster recovery and less pain:

Minimally invasive microdiscectomy — The most common surgery for herniated discs. Through a small incision (often less than one inch), Dr. Hobbs removes the portion of the disc pressing on the nerve. Most patients go home the same day.
Endoscopic discectomy — An ultra-minimally invasive option using a tiny endoscope through an incision smaller than a centimeter. This approach causes even less tissue disruption.
Minimally invasive decompression — Through a small incision, Dr. Hobbs relieves pressure on the affected nerve while preserving the surrounding muscle and tissue for a faster recovery.

Why Choose Dr. Hobbs for Herniated Disc Treatment

Specialty-Trained Neurosurgeon
Board-certified neurosurgeon with specialized expertise in treating herniated discs

Elite Training
University of Kentucky medical degree; neurosurgery residency at the University of Chicago, serving as chief resident

Tumor & Deformity Expertise
Specialty-trained in minimally invasive spine surgery

Conservative-First Approach
Dr. Hobbs always explores nonsurgical solutions before recommending surgery

Outpatient Surgery
Offers same-day spine surgery — many patients go home hours after their procedure

Lakeshore Bone & Joint Institute
Northwest Indiana's most preferred orthopedic practice

Frequently Asked Questions About Herniated Discs

Yes. Many herniated discs improve significantly with conservative treatment including physical therapy, anti-inflammatory medications, and epidural steroid injections. Dr. Hobbs always explores nonsurgical options first and finds that a majority of patients improve without surgery. Surgery is only recommended when conservative treatments fail to provide adequate relief after a reasonable period, or when there are signs of progressive neurological problems such as increasing weakness.

A minimally invasive microdiscectomy is a procedure where Dr. Hobbs removes the portion of the herniated disc that is pressing on the spinal nerve. It is performed through a small incision (often less than one inch) using specialized instruments and computerized surgical navigation. The procedure typically takes 45-60 minutes, and most patients go home the same day with significant pain relief. This approach causes far less muscle damage than traditional open surgery, resulting in faster recovery.

With Dr. Hobbs's minimally invasive approach, most patients experience significant pain relief immediately after surgery. Patients typically return to light activities within 1-2 weeks and can resume most normal activities within 4-6 weeks. Full recovery, including return to strenuous physical activity or heavy labor, usually occurs within 8-12 weeks. Recovery times vary depending on the individual, overall health, and the extent of the procedure.

Surgery may be recommended if conservative treatments have not improved your symptoms after 6-12 weeks, if you have progressive weakness in your leg or arm, if you experience loss of bladder or bowel control (which is a medical emergency), or if the pain is so severe that it significantly impacts your quality of life and daily activities. Dr. Hobbs performs a thorough evaluation including physical examination and imaging to determine the best course of treatment for your specific situation.

A bulging disc extends outward evenly beyond its normal boundary, somewhat like a hamburger patty that is too large for the bun. A herniated disc has a localized rupture where the soft inner material (nucleus pulposus) pushes through a tear in the tough outer layer (annulus fibrosus). Herniated discs are more likely to compress nearby nerves and cause symptoms like radiating pain, numbness, or weakness. Both conditions can be effectively treated by Dr. Hobbs.

Get Expert Herniated Disc Treatment

Don't let a herniated disc keep you from living your life. Dr. Hobbs offers the latest minimally invasive treatments with proven results. Call today to schedule your consultation.

(219) 250-5010

Monday – Friday · 8:00 AM – 5:00 PM

Crown Point Office

500 E. 109th Avenue
Crown Point, IN 46307

Chesterton Office

601 Gateway Boulevard
Chesterton, IN 46304