Herniated Discs: When Is Back Surgery Necessary? – Chula Vista, CA
You’ve been dealing with pain down your leg for weeks. You can still get through work, but the drive home is getting harder. Your MRI shows a herniated disc, and now you’re wondering how long to give it before you talk to a surgeon.
Many people with a herniated disc in the lower back improve without surgery. A surgical opinion may make sense when leg pain remains disabling despite appropriate nonsurgical care, or when there’s significant or worsening weakness. How soon you need an opinion depends on what’s changing and how closely the MRI matches your symptoms and examination.
For Chula Vista residents weighing their options, Dr. Cassidy James Boelk, DC, evaluates disc-related back and leg symptoms at The Spinal Decompression & Chiropractic Center of San Diego in Kearny Mesa. He is a Certified Spinal Decompression Doctor and Certified Pain-Free Performance Specialist with more than 22 years of clinical experience.
What Has Changed Since the Pain Started?
When you’ve had a rough night, it’s easy to judge your recovery by how you feel the next morning. At your appointment, describe what has changed over the past few weeks. Can you sit longer before the pain starts? Does it still reach your foot? Has your walking improved, or have you started catching your toes on the stairs?
If the pain is easing and you’re doing more, tell your clinician what you’ve regained. If you’re walking less, sleeping worse, or noticing a loss of strength, say that too. Someone who still has leg pain but is walking farther is facing a different decision from someone whose foot is getting weaker.
When Should You See a Spine Surgeon?
If an appropriate course of nonsurgical care hasn’t helped you get back to basic activities, a surgical opinion can clarify what a procedure might improve. If you have both back pain and leg pain, ask the surgeon which symptom they expect the procedure to address. Also ask what they found on your exam that supports the recommendation.
New or worsening leg or foot weakness needs prompt medical evaluation. You might notice your foot slapping the ground, your toes catching when you walk, or new trouble lifting the front of your foot. Report those changes even if your pain has eased.
New difficulty urinating, loss of bladder or bowel control, or numbness around the groin or saddle area requires emergency evaluation.
A Patient Whose Leg Pain Was Interrupting His Sleep
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“I had really bad back problems to the point I couldn’t sleep, also had pain radiating along the sciatic nerve which ran down one leg from the lower back—caused by an accident.
I came in and talked to Dr. Cassidy about my back problems. He evaluated me and mentioned I was a good candidate for this treatment. After the first 2 decompression sessions my sciatic pain was gone and we were able to work on the root of the problem. I did a total of 24 sessions, after which I was able to start rehabilitation training to strengthen my core.
The office is super nice and the staff’s customer service is above and beyond.
Back and neck issues are horrible to live with—trust me, I know firsthand. I gained weight, took pain killers, went into depression, and had major anxiety. I’m over it now—feeling better, walking, sleeping well, and starting to have a better social life as well.
The experience for me has been nothing but excellent. Dr. Cassidy Boelk is hands down amazing—super glad I came here.”
— Abel T., San Diego, CA
What Should You Bring to a Herniated Disc Consultation?
Bring your MRI report and the images, if available. If a surgeon has recommended a procedure, bring the visit notes or write down what they said they were concerned about. It also helps to come with three details:
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Where the pain travels. Does it stop at the buttock or reach your calf, foot, or toes? Which side?
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What changed with prior care. If physical therapy helped you walk farther but the numbness stayed the same, mention both.
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What you still can’t do comfortably. Tell Dr. Boelk if you can’t finish your commute, stand long enough to cook dinner, or sleep without waking up with leg pain.
Dr. Boelk offers a complimentary, no-charge, no-obligation consultation to discuss your symptoms, prior care, and whether a formal evaluation for DRX9000 spinal decompression may be appropriate. A physical examination, new imaging, and treatment are separate services.
Call 619-298-0800 to request your consultation.
What If the MRI Shows More Than One Disc Problem?
Suppose your report lists a herniation at L4–L5 and a bulge at L5–S1. The finding that takes up the most space on the report may be the one you worry about, but the clinician needs to see which finding fits the side of your symptoms and what the examination shows about your strength, sensation, and reflexes. Disc changes can also appear on scans of people without back pain.
Ask your clinician, “Can you show me which finding fits my symptoms and explain what you found on the exam?” If surgery has been recommended, follow up with “What are the risks of waiting in my case?”
Where Does DRX9000 Spinal Decompression Fit?
Lumbar DRX9000 spinal decompression uses a motorized table to apply controlled traction while your body is supported. Dr. Boelk considers it for selected patients after reviewing their history, examination, and relevant imaging. Depending on the findings, he may recommend rehabilitation, further testing, or a referral.
If a trial is appropriate, agree on what you’ll track before starting. If the drive home is what bothers you most, note how long you can sit before the pain starts and how far down the leg it goes. At reassessment, you can compare that same drive and discuss any changes in numbness or strength. That gives you and Dr. Boelk a basis for deciding whether to continue or change the plan.
Learn more about DRX9000 Spinal Decompression Therapy.
7 Reasons Chula Vista Patients Choose Dr. Cassidy James Boelk, DC
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More than 22 years of clinical experience evaluating disc-related neck and back conditions, including symptoms that have persisted after previous care.
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More than 100,000 decompression sessions performed or overseen. That experience informs patient screening, treatment setup, and reassessment.
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Specialized training in decompression and rehabilitation. Dr. Boelk is a Certified Spinal Decompression Doctor and Certified Pain-Free Performance Specialist.
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Seven dedicated DRX9000 systems. The practice uses DRX9000 equipment exclusively for spinal decompression, with four lumbar and three cervical units.
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Firsthand experience with spinal injuries. Dr. Boelk fractured his lower back at 16 and later experienced lumbar disc herniations and sciatica. He has spent thousands of hours rehabilitating his own injuries and helping patients with theirs.
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Experience teaching other doctors. He founded the Spinal Decompression Training Academy and teaches doctors about treatment protocols and patient selection.
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A clear recommendation based on the evaluation. Dr. Boelk explains what the findings suggest and why further testing, a different type of care, or a surgical opinion may be appropriate.
A Patient Who Appreciated a Straightforward Recommendation
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“I found this terrific practice on social media. I followed up and did my own research so I decided to pay them a visit. The place is clean, well organized and run by a very efficient receptionist. I met with the doctor and after a honest and forthright conversation, we both determined that surgery was my only option to correct my back issues. I will return as a customer when the time is right.”
— Jeff J., Tucson, AZ
Frequently Asked Questions
Does the size of a herniated disc determine whether I need surgery?
Size is one consideration. Your clinician also looks at where the herniation is located, which symptoms it may explain, and whether you’re losing strength or function.
Can I schedule a consultation if I only have the written report?
Yes. Bring the written report and any notes from prior visits. If you can get a disc or online access to the images from the imaging center, bring that as well.
What if a surgeon has already recommended surgery?
Bring the recommendation and ask what prompted it, which symptoms the procedure is intended to improve, and how soon a decision is needed. If the surgeon is concerned about worsening weakness, ask how that affects the timing.
Schedule Your Complimentary Consultation
The Spinal Decompression & Chiropractic Center of San Diego welcomes Chula Vista residents at its Kearny Mesa office.
Dr. Cassidy James Boelk, DC
5095 Murphy Canyon Road, Suite 300
San Diego, CA 92123
Office phone 619-298-0800
Website www.SanDiegoBackCare.com
Live 24/7 Answering Service • Hablamos Español
Call 619-298-0800 to request your complimentary, no-charge, no-obligation consultation. Physical examination, new imaging, and treatment are separate services.