Welcome, Friend!

It looks like you're new here. If you want to get involved, click one of these buttons!

Veritas-Health LLC has recently released patient forums to our Arthritis-Health web site.

Please visit http://www.arthritis-health.com/forum

There are several patient story videos on Spine-Health that talk about Arthritis. Search on Patient stories
Protect anonymity
We strongly suggest that members do not include their email addresses. Once that is published , your email address is available to anyone on the internet , including hackers.

All discussions and comments that contain an external URL will be automatically moved to the spam queue. No external URL pointing to a medical web site is permitted. Forum rules also indicate that you need prior moderator approval. If you are going to post an external URL, contact one of the moderators to get their approval.
Attention New Members
Your initial discussion or comment automatically is sent to a moderator's approval queue before it can be published.
There are no medical professionals on this forum side of the site. Therefore, no one is capable or permitted to provide any type of medical advice.
This includes any analysis, interpretation, or advice based on any diagnostic test

How to know when it's time to have surgery?

edited 07/27/2014 - 12:07 PM in Back Surgery and Neck Surgery
I am a 42-year-old woman. I herniated my C5-C6 disc approximately 3 months ago. It has been confirmed by MRI results. I have significant pain as well as numbness in my thumb, pointer, and middle fingers. I have been on a lot of medication for months (you name it). I was told that my odds of this resolving were very good, yet I continue to be very symptomatic. I cannot work or do much of anything without complete numbness down my arm and into my hand as well as severe pain. I was on prednisone 40mg/day for two months. I thought I was getting better. About a week off the steroids, I was in the emergency room due to pain. I am now back on prednisone. Also, I have had a couple episodes where I could not grab a door handle, not that I couldn't turn it, but that I couldn't make my hand reach it, if that makes sense. I have an appointment for an epidural steroid cortisone injection. I know that is just for pain management and that it does not resolve the root issue. My doctor feels that if the injection does not resolve things, I am probably looking at surgery. I have done a lot of research and am set on disc replacement versus fusion.

My questions is: When is the right time to pull the trigger, so to speak, to have surgery? How long should I wait this out? I don't really feel comfortable with the cortisone shot as it is just a patch, and it also carries risks. I know that I can't live like this forever without there being some significant nerve damage to my hand if I don't get this fixed. I just kind of wanted to know if there are some telltale things to be looking for, i.e., x-amount of time I've been living with this, numbness, et cetera that could guide me to say, okay, this is the right time.

This is a very scary thing, and trying to get feedback from my family is difficult because of course they don't ever want me to have surgery.

Feeling scared and alone and in a lot of pain.

Thanks so much!



  • Hi Julie,

    Hang in there and I know you are going through a lot like many of us have. I just had a lumbar decompression surgery 2 weeks ago and although it was not in the same area as yours, the symptoms were very similar (pain....numbness, weakness and tingling which were the scariest of all). I did the conservative treatments such as oral steroids ( prednisone), chiropractic adjustments, 3 epidural injections over a 2 month horizon, massage therapy, physical therapy for 8 weeks....pain went away but I still had numbness, weakness and tingling in my right leg all the way from hip to foot. I felt it wasn't getting any better after 4 months and decided to have the surgery because of quality of life issues. I'm a 49 year old male who was in top physical condition, and blew out my l4 l5 disc training for a marathon. The disc herniated and had an extrusion of the inner gel pinching my sciatic nerve. It was a pretty big herniation. I work in the medical field and spoke to some of the top dogs at my company in the areas of neuro and orthopedic. Bottom line is when dealing with nerve damage, there is no definite timeframe or guaranty of a specific procedure that will resolve issues 100 percent. My decision to have surgery was based on 4 months of trying every conservative method available, not making meaningful improvement in regaining strength and feeling in my right leg, and knowing that the longer you wait could mean the point of no return to restore nerve function.

    You will be the final judge on when to do surgery or not, but make sure you seek out the top professionals in their field (orthopedic or neuro surgeon) and get several opinions before you make the call. I'm still not out of the woods yet, but it gives me a piece of mind that I had one of the top spine surgeons in the country work on my back and am focusing all my energy on positive thoughts and getting through this nightmare of an injury.

    Good luck and best wishes on your journey to recovery!

  • idleideeiidleidee Posts: 12
    edited 07/27/2014 - 3:32 PM
    necksurgery has good outcomes.
    When? Well, when there is danger for permanent nervedamage. It is time.
    For me: fusion L5 S1 it was when i felt it wasn't going to take another month before i couldn't walk anymore. And so it went. I still was able to prepare everything. Because I am alone and have only myself to depend on. That was my criteria: " I need to be able to take care of myself independedly. "
  • LILZA1LLILZA1 Posts: 6
    edited 07/28/2014 - 7:05 AM
    Thank you both for taking the time to write. I am scheduled for an epidural steriod shot, but I think there are a lot of risks with that too. My hand has been numb for like three months. If I'm not on prednisone, I have constant pain. I think I am going to have to just go for it. I think I am relatively young and with a disc replacement, I can have an optimistic outcome. Otherwise, I can see myself a year down the road in the same kind of pain and discomfort, on all the same pills (and there are a lot), having spent all my money on chiro, acupuncture, diet supplements, yoga, et cetera. I think it's all a patch. If this thing isn't reabsorbing, it's just not, and all those things aren't going to help that. If I do opt for surgery, I hope for a quick recovery time.

    Fingers crossed.
  • I thought I was reading my own story. I'm scheduled for an injection this Wednesday and the only reason I haven't gone to ER is because I don't want to be overly medicated. My neurosurgeon gave me three choices, therapy, injections, or surgery so of course I chose therapy. Well because it relieved some of the numbness and tingling he recommended I get the injections. I know there are side affects but surgery is more permanent which is why I'm trying to hold off as long as possible. I will keep up with you and inform you as I find out more because I too want know when do I opt for surgery. Sorry I don't have the answer but you are not alone.
  • Why couldn't you try a microdiscectomy before jumping over to a major surgery like ADR?
    On the sunny and mild Central Coast of California

    L4-L5 endoscopic transforaminal microdiscectomy June, 2007
    L5-S1 endoscopic transforaminal microdiscectomy May, 2008
  • I think that you just "know" when it's time. I did the laminectomy first and had a really good result for 2.5 years and then it all started up again and started throwing much worse stuff at me. For 4 years I did physical therapy, shots, radio-frequency, meds, etc, etc. I "knew" it was time when I found myself taking a Norco on the way to my son's wedding. My husband asked me if I would please find out was wrong and try to come up with a plan. I danced at the wedding and had a really nice time; no one knew how much pain I was in. The bad thing about being private about the pain is that when I decided to have surgery, all my family and friends were surprised and had no idea I was hurting so much. I turned finding the right surgeon/right procedure into a job and had scheduled appointments with 5 different orthopedic surgeons and neurosurgeons. I'm so glad I had the surgery. It wasn't a magic bullet, but my quality of life has so tremendously improved I almost can't believe it! Best of luck to you!
    Lumbar laminectomy L-4/L-5, 2006
    XLIF with posterior pedicle screws L-4/L-5, 4-23-2013
  • I asked my surgeon about a microdiscectomy. Here was his response: He felt that it could be more invasive because they go in through the back of the neck which leaves the spinal cord more vulnerable. I have NOT checked up on any of this, so I don't know whether it's true at all or not. He wanted me to try an injection -- which I do not want to do based on the fact that it's only a patch for the pain, and it is invasive. If they go in too deep, there can be major complications. So I figured I should wait it out as long as i can on pain meds. But on the other hand, I figure I should just get it fixed. It's not fixing on its own, and I am so sick of being in pain and having my hand numb. I am a court stenographer, and I cannot afford to have permanent nerve damage in my hand. But then again, surgery is such a big deal.

    UGH.....I am so sad and scared and frustrated.
  • You owe it to yourself, your future, and your family to find a surgeon that offers a good technique. They do exist. I consulted with 7 consecutive surgeons before I found the one that was right for me.
    On the sunny and mild Central Coast of California

    L4-L5 endoscopic transforaminal microdiscectomy June, 2007
    L5-S1 endoscopic transforaminal microdiscectomy May, 2008
  • dmoddmo Posts: 145
    edited 07/28/2014 - 10:28 PM
    You are about three months into this. I have had c4-6 disc problems with neural foraminal stenosis for years. Tried all kinds of therapy, shots and meds. I just keep getting worse. Three consults later, all agree 2 level acdf with full instumentation is the way to go. I would say live with it as long as possible. If neurological weakness or pain that is unbearable then have surgery. I am going under the knife soon. I probably should not have waited so long but like you I hate to have surgery.
  • First, you are not alone. Anyone who has or has had back issues have been sad and scared.

    What you have to deicde is, are you more scared of the lack of quality of life, or more scared of the surgery? I got to the point that I couldn't do anything and had to go for the surgery. Sure, it was miserable and long, but now I am 90 percent functioning again. I wouldn't turn back at all.

    Whatever you decide, good luck and keep us posted. We do care.
Sign In or Register to comment.