It may start as a mild discomfort when you get up. Then you notice that the pain in your lower back appears more often when you sit for a long time, when you carry weight or even when you sneeze. And, without realizing it, your routine begins to adapt to the pain: you move less, you sleep worse, you work uncomfortably… but you don’t go to the doctor. “It will go away by itself,” you think.
This pattern is repeated in thousands of people every year. And although some muscular discomfort disappears with rest or physical therapy, others may be warning us of something more serious, such as neurological compromise due to a herniated disc.
Ignoring back pain, especially when it radiates to an extremity (either legs or arms), becomes persistent or limits your quality of life, can have consequences that go far beyond simple discomfort. In this article you will discover:
- Why you shouldn’t wait “for it to pass on its own”.
- What real risks exist if a herniated disc is not treated in time.
- How pain can evolve into a chronic or disabling problem.
- What solutions current medicine offers, from conservative treatments to minimally invasive surgery.
Because back pain isn’t always temporary. Sometimes it’s your body’s way of asking for help before it’s too late.
What is a herniated disc?
Between each pair of vertebrae there is a disc that acts as a shock absorber. When the nucleus of this disc is displaced out of place and presses one or both nerve roots that pass on either side of it, what is known as disc herniation occurs.
This pressure on the nerves generates symptoms such as:
- Radiating pain(sciatica if in the lumbar region; brachialgia in the cervical region)
- Numbness or tingling sensation.
- Loss of muscle strength.
- Significant functional limitation.
A hernia can occur at any level of the spine, although they are most common in the lumbar region (especially L4-L5 and L5-S1).
What happens if a herniated disc is not treated?
Many people choose to ignore pain or treat it superficially. But this not only delays proper diagnosis, but can have long-term consequences:
Chronic pain
Pain that is initially intermittent may become constant. When it becomes chronic, it affects sleep, mood and quality of life. It can even cause alterations in the central nervous system (a phenomenon known as central sensitization).
2. Loss of strength and mobility
Continued pressure on a nerve root can lead to neurological deficits, such as difficulty walking, lifting objects or even maintaining balance. In advanced cases, this weakness may be permanent.
3. Irreversible neurological damage
When the so-called “cauda equina” is affected, the patient may suffer urinary or fecal incontinence, as well as paralysis of the lower limbs. This situation, called cauda equina syndrome, is considered a surgical emergency.
4. Psychological impact
Living with constant pain is emotionally draining. In addition, many patients with chronic low back pain develop symptoms of anxiety or depression, which affects their daily life.
How does an untreated hernia evolve?
In the short term, it may improve with rest and anti-inflammatory treatment. But if the problem persists, inflammation and nerve compression increase. In the medium term, the lack of physical activity for fear of pain causes muscle atrophy, further weakening the back. In the long term, the problem may extend to other levels of the spine (adjacent discs), and the risk of needing more complex surgery or even multidisciplinary treatment increases.
Diagnosis: the key is not to wait
The first step is a complete clinical evaluation by a specialist, in this case, a neurosurgeon. The following are assessed:
- Osteotendinous reflexes (patellar and achilles in the lower limbs)
- Muscular strength.
- Tactile and thermal sensitivity.
- Specific tests such as the LasĂšgue test.
To confirm the diagnosis, an MRI is performed, which shows the location, size and degree of neurological involvement caused by the hernia.
Can it be treated without surgery?
Yes, the neurological symptoms caused by a herniated disc can improve in a high percentage (close to 80%) with conservative treatment, provided it is started early and adapted to each case.
Conservative treatment options:
- Anti-inflammatory and analgesic medication.
- Relative rest (not in bed, but without efforts).
- Individualized physiotherapy (neural mobilization, stretching, postural reeducation).
- Supervised therapeutic exercise.
- Epidural infiltrations in cases of severe pain (as symptomatic treatment).
What if conservative treatment does not work?
When pain does not improve within 4 to 6 weeks, loss of strength in any limb or neurological complications, such as cauda equina syndrome, the specialist may recommend surgery.
Minimally invasive surgery
Lumbar microdiscectomy, either with microsurgical, tubular or endoscopic technique, allows decompression of the affected nerve with a minimal incision, less muscular aggression and faster recovery times.
Advantages:
- High success rate (more than 90% in well selected patients).
- Shorter hospital stay (generally less than 24h)
- Faster functional recovery.
- Lower risk of postoperative fibrosis.
What is the recovery like after a treated hernia?
After treatment (whether conservative or surgical), follow-up is key. It is recommended:
- Strengthen the lumbar and abdominal muscles.
- Correct posture at work or while driving.
- Maintain an active lifestyle with low-impact exercise.
- Avoid excessive loads and repetitive movements.
When to see a specialist?
You should consult with a neurosurgeon or spine specialist if:
- Pain persists for more than 4 weeks.
- You notice weakness or loss of sensation in your legs.
- You have a history of herniated disc or recurrent low back pain.
- You present alterations in sphincter control.
Acting in time makes the difference between a one-time problem… or a lifelong sequel.
In summary, back pain is not normal, nor should you get used to it. It can be the sign of a pathology that, if detected in time, has a solution. But if ignored, it can become a chronic problem that conditions your work, physical and emotional life.
The good news is that there are effective treatments, from advanced physiotherapy to minimally invasive surgery, that can restore quality of life.
The key is to listen to your body and ask for help in time. Because when it comes to the spine, waiting can be costly.
đ Dr. AndrĂ©s Muñoz – Specialist in Neurosurgery and Spine Surgery
đ 609 688 469
www.drandresmunoz.com
đ Request your consultation here
