Because I spent so much (too much, probably) time on these forums prior to and after my surgery, I committed myself to a short write-up after my own surgery to (hopefully) counter what is probably a bad-outcome bias on these forums (because so many who have good outcomes don't end up on the boards) and also to provide my thoughts / suggestion for others to consider as they move forward.
52 year old healthy, active male. Began with back/herniation symptoms in early May 2016 in lower back, then left buttock --> left hip --> left groin & thigh down to knee. No known trauma or specific cause. Over the course of 4 weeks it went from bad, especially at night, to pretty horrific pain (8-10 many nights, if not on oxycodone). Waited, did physical therapy at 2 weeks, then saw surgeon and got an MRI at 5 weeks in, and confirmed 8.5mm L3-4 herniation and some arthritis. He recommended epidural as a start. Worst of the pain by the 6th week was deep in the left groin/hip, as if someone had put a red hot burning ember in the groin. Just horrific without round-the-clock ibuprofen, plus oxycodone at night and increasingly during the day, by 8 weeks. Still worked fulltime desk job, but in misery. Probably being overly conservative, I chose not to get the epidural until about the 10th week after first of symptoms. Helped for 24hrs, maybe 48, and then that was that. Opted for surgery (L3-4 microdiscectomy/laminotomy), which I had at about 13th week after start of symptoms. Surgeon is probably one of top recognized back surgeons in the country...very well known, widely published, great reputation, etc. (If you're going to have somebody cutting on you, do you really want an average surgeon?) Surgery went well, without incident and was home next day.
Pain seem to be resolved immediately, but returned noticeably and almost as bad as pre-surgery, at least initially, when hospital drugs (tordol, gabapentin, and percocet) wore off on day 2 or 3 post-surgery. Was very limited in what I could do without really stirring up deep groin nerve pain. Any walking at all really flared pain. Surgeon said take it slow, don't push and I spent most of first three weeks on my back or side, with limited walking to the degree it didn't stir up nerve pain. At 2-1/2 week mark, caught my toe and stumbled, didn't fall, but did wrench back, and I'm convinced that set me back 3 weeks. Didn't get back to where I as on day 17 until probably three weeks after that. Went back to desk job 3.5 weeks after surgery for four hours per day. Then 6 hours per day the week after that, and then back full time by 5th-6th week. Probably a bit too much too soon but I survived. Increased walking up to about a 1-2mile per day by week 8, in 5-15 minute segments. Was off oxycodone during day by 2.5 weeks after surgery, but continued to use every night due to groin nerve pain/some back pain until about third month, then occasionally at night only as needed. At 3 month mark was still on round the clock advil still at 2000 - 2400mg / day, but was walking 3-4 miles a day in one session at very good clip, and needing oxycodone maybe 1-2 nights per week.
Now at 6 months as I write this, I still take 1 advil every 4 hours, except middle of night, so 1000mg - 1200mg / day. Maybe 1 oxycode a month at this point. My pain is some lower back pain, but mostly deep groin nerve pain (maybe pain level 2-4 without ibuprofen), which seems to be stable, not getting worse, but not getting much better at this point. Walking 3-4 miles a day as often as I want, and can do all of the normal daily stuff -- walking around, driving, chores, etc without much pain. If I don't take advil every 4 hours, I'll usually have pain in the 2-4 range, but not horrific like before surgery. Still can't work out too terribly hard on stairmaster, exercise bike or treadmill (uphill walking) without revving up nerve pain, so I don't. I just walk. At six month checkup, surgeon said nerve pain may get better but will most likely be whatever it is going to be at year mark (if it's not already there). Also said, could consider facet joint injections and few other things if too bothersome at year mark.
Overall, while I'm not perfect, I feel pretty good with a single advil every 4 hours. I can do all the normal living stuff without much issue, and if I do have an issue, an extra advil usually takes care of it. Surgeon set realistic expectations and so I didn't go in thinking I'd be 100% again, and I'm not -- not yet anyway, and maybe never. But, importantly, I can live my life and pain isn't the big thing in my life anymore. Obviously, having to take an NSAID every 4 hrs isn't ideal and isn't without it's own risks, but my PCP knows and approves and I'll take the risk over the constantly annoying level 3 pain I'd have without.
1. Get seen early, and pursue course of treatment early. Maybe the nerve pain wouldn't have been quite so persistent now had I gotten epidural or surgery earlier. No one knows, but I dragged me feet just a bit due to being a bit conservative and maybe some work commitments I shouldn't have let get in the way.
2. Read online for options/education -- especially if you can filter well, but try not the read too much on the forums. There's definitely a bias toward catastrophically bad outcomes getting posted, and it won't help your mental health at all if you spend all of your days and sleepless nights reading that kind of stuff.
3. Make sure you get the best surgeon you can find. That's not a guarantee of a perfect outcome, but remember -- just like in all fields -- they're not all similarly equipped and you really don't want to be part of someone's learning curve while under the knife.
4. Be patient. It takes time, and I still have weeks that are better than others, but short of wrenching my back, I did generally see very gradual improvement week by week up until at least month 5, I would say.
5. Know also that there are probably things that can be done to help mitigate pain even if you don't get a perfect outcome from surgery. I haven't had to go there yet, and hopefully won't, but that is comforting to know.
Hope this gives someone else some helpful (and at least a little encouraging) input as they move through their journey.