After the amount of lurking I've done on this forum, I suppose I owe you all a post.
I'm a 33-year-old man in otherwise very good health and stays active. I had been struggling with a severe SI strain that had debilitated me, on and off, for the better part of 6 months. Through PT, I had finally gotten it more or less under control and was at the cusp of starting to resume some of my normal regimen of activity when suddenly, in June of this year, I started having a stabbing pain deep in my left glute. It felt very muscular in nature so I assumed it was a strain, though there was no particular incident that seemed to have caused it.
However, neither ice nor heat helped, and over the next 2 weeks or so, the pain intensified, spread into my quad, and was triggered by an ever-expanding range of motion. I knew something was wrong, and when I got an MRI, I was not shocked that it indicated an L5-S1 left paracentral herniation. I didn't even need to read the radiologist's report; the herniation was so obvious in the images. This was July 1 that I got the MRI results back.
I should mention here that my wife was due with our second child on Sept. 26. As my pain continued to rapidly worsen, it became clear that I needed to make some decisions quickly. Being in post-surgical recovery with a newborn was not an option, but neither was being in that amount of pain. So I blasted through the clinical progression of treatments. PT was not helping at all; the pain continued to worsen, and spread into my calf. I got an ESI (epidural steroid injection). I felt great for about 5 days after that, but then the sciatica returned in full force. It was unbearable. At that point I was taking about 1,800-2,400 mg of ibuprofen a day, and that was enabling me to hobble to the bus so I could go to work. Sitting for more than 10 minutes was agony. I was waking up constantly throughout the night from pain.
Among folks on spine-health who had undergone a microdiscectomy after months or years of pain/numbness/weakness, I saw a pattern of sentiment: "I wish I had done this sooner." That, combined with the speed with which the sciatica was worsening and the imminent baby, made it an easy decision.
On August 25, I underwent a microdiscectomy, performed by Dr.  (a professor in the Neurological Surgery Dept. at the  and his team. I was out for 90 minutes, and when I woke up, the sciatica was completely gone. I wanted to weep and sing at the same time.
The first 36 hours following the surgery were pretty rough (though I was able to stand and walk around entirely on my own). I found oxycontin and cannabis in combination to be more effective than the oxy by itself. However, by day 3 post-op, I was able to drop the oxy altogether during the day in favor of Tylenol (I still took oxy at night to help me sleep for another several days). I ultimately returned to work a week after the surgery (I work in software), and stopped the Tylenol another week or two after that.
A couple of days after the surgery, after I stopped taking the oxy, I noticed that the sciatica had returned, though much less severe than before. I knew that residual pain was normal, as nerve tissue heals very slowly. But the pain worsened somewhat over the next week or two. I became totally convinced that I had reherniated, though the surgeons repeatedly told me that it was too soon to worry. They told me that a reherniation that soon after surgery was very unlikely. They also said that the pain would not have been due to scar tissue around the nerve root, because that takes 6-12 months to form. So the only reasonable explanation for the pain was simply the nerve healing. I took some solace in those explanations, but I was still terrified that I would either need more surgeries or be in pain forever. I spent a lot of time reading similar terrified post-op posts here on spine-health.
Finally, about 8 weeks after the surgery, I noticed the pain starting to recede. Since then, improvement has been slow but steady. I'm now 12 weeks post-op, and I still have some sciatica, though it's very much in the background of my consciousness now, and most of the time I really don't feel anything at all. I've been cleared for pretty much all physical activity (though they warned me to ease back into it), and I've resumed PT to prevent future injuries. And I'm fully functional, meaning I can help my wife wrangle a toddler and a newborn.
I'm incredibly grateful for the surgery team that operated on me. I know mine was not an exciting procedure, but it completely changed my life. I'm also thankful for the people in this community who share their anecdotes and resources. Nobody will understand how debilitating back injuries are unless they've been there. I know that I'm incredibly fortunate among the folks in this community to have basically made a full recovery.
I will share one piece of information that I learned from Dr. . This is not something that I really came across in a lot of my research, but it should be a consideration for anyone with sciatica: the longer you go without correcting the pressure on the nerve, the greater the chances that you will have some degree of permanent nerve damage. I am very much an adherent of conservative treatments, but that to me seems like a pretty compelling reason not to try to tough it out when you've tried everything else. I'm glad that I tried PT and the ESI first, but I'm also glad that I chose to have the surgery when I did.