Herniated Discs: When Is Back Surgery Necessary? – La Jolla, CA

Maybe the leg pain started on your drive home. Then it began waking you at night, and now you’re cutting walks short because the pain keeps reaching your calf or foot. When your MRI comes back showing a herniated disc, it’s natural to wonder how long to give it and when to talk to a surgeon.

Many people with a herniated disc in the lower back improve with nonsurgical care. A surgical opinion becomes more relevant when leg pain continues to limit your daily activities despite appropriate care, or when the exam shows significant or worsening weakness. The clinician also looks for an MRI finding that matches your symptoms.

For La Jolla residents weighing those decisions, 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.

A Patient Who Wanted to Get Back to Work and Surfing

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“When I first came here I was suffering from sciatica pain for several months non stop. I tried many different non invasive treatments, pain killers but relief was just temporary. I heard about Dr. Boelk on social media and after reading other people testimonials about him I decided to try. It felt better since my first session. After 12 I felt I was improving a lot but still had room to get better so we decided trying 12 more. After 36 sessions I felt I was back to normal. I could get back to surf, jiu jitsu and work after 6 months away. Doctor helped me through the whole process, leaving me free to decide the next step and being honest about expectations. I totally recommend for all my friends that suffer from sciatica pain. It’s worth 100%.”

— Yuri Fresia, Patient Review

When Yuri describes getting better, he talks about going back to work, surfing, and training. If you’re weighing your own options, think about what you’d like to be able to do again. It could be as simple as sitting through dinner or making it around the block.

Start With a Complimentary, No-Obligation Consultation

If you’ve been told you have a herniated disc, bring the MRI report and the images if you have access to them. If someone has already recommended surgery, bring their notes or tell Dr. Boelk what they were concerned about.

During the consultation, you can talk through where the pain travels, whether you’ve noticed changes in strength or sensation, and what happened with the treatments you’ve already tried. Dr. Boelk can explain what a formal evaluation would involve and whether it makes sense to explore DRX9000 nonsurgical spinal decompression.

The consultation is complimentary, no-charge, and carries no obligation. A physical examination, new imaging, and treatment are separate services.

Call 619-298-0800 to request your consultation.

How Do You Know Which Herniated Disc Is Causing Symptoms?

An MRI might list changes at L4–L5 and L5–S1. One finding may sound more serious on paper, but the clinician still needs to know which leg hurts, where the pain travels, and whether there are changes in strength, sensation, or reflexes. Disc changes can also show up on scans of people who have no back pain.

For example, if your main complaint is pain down your right leg and you’re having trouble lifting the front of your right foot, that combination gives your clinician something specific to check against the scan.

At your appointment, ask “Can you show me where the disc is affecting the nerve and explain what you found on my exam?” If the pieces don’t fit, ask what else could account for your symptoms.

When Does It Make Sense to Talk to a Spine Surgeon?

A surgical opinion can help when leg pain is still keeping you from walking, sleeping, or working despite an appropriate course of nonsurgical care. Ask what the surgeon expects the procedure to improve. For example, if you have both back pain and leg pain, ask which symptom the operation is intended to address.

Get prompt medical evaluation if your leg or foot is becoming weaker. You might notice that your foot slaps the floor, your toes catch on stairs, or you can’t lift the front of your foot as well as you used to. Mention 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.

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, exam findings, and relevant imaging. Some findings call for another type of care or a specialist referral.

If a trial is appropriate, pick one or two things to track before you start. Maybe you can walk five minutes before the pain reaches your calf, or you have to stand up halfway through a meal. At reassessment, compare those same activities and tell Dr. Boelk about any changes in pain, numbness, or strength. That helps you decide together whether to continue or change the plan.

Read more about DRX9000 Spinal Decompression Therapy.

7 Reasons La Jolla Patients Choose Dr. Cassidy James Boelk, DC

1. More than 22 years of clinical experience. Dr. Boelk evaluates disc-related neck and back conditions, including cases where symptoms have continued after previous treatment.

2. More than 100,000 decompression sessions performed or overseen. That experience informs how he screens patients, selects settings, and reassesses their response.

3. Training in decompression and rehabilitation. Dr. Boelk is a Certified Spinal Decompression Doctor and Certified Pain-Free Performance Specialist. He considers what you need to get back to, whether that’s walking, golfing, surfing, or getting through a workday.

4. Seven dedicated DRX9000 systems. The practice uses DRX9000 equipment exclusively for spinal decompression, with four lumbar and three cervical units.

5. Personal 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.

6. Experience teaching other doctors. He founded the Spinal Decompression Training Academy and teaches other doctors about treatment protocols and patient selection.

7. A clear recommendation. If the evaluation points toward further testing, a different form of care, or a surgical opinion, Dr. Boelk explains what led him there.

A Patient Who Appreciated a Straightforward Answer

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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

Can symptoms improve while a herniated disc is still visible on MRI?

Yes. Leg pain and function can improve even when disc changes are still visible. That’s one reason your clinician checks how you’re moving and whether strength and sensation are changing during follow-up.

What should I ask if surgery has already been recommended?

Ask what the surgeon found that supports the recommendation, what the procedure is expected to improve, and how soon a decision is needed. If you’re considering more nonsurgical care, ask whether waiting would carry a risk in your specific case.

Can I come in with only the written MRI report?

Yes. Bring the report and any notes from prior visits. If the imaging center gives you access to the actual images, bring those as well.

A Personal Message From Dr. Boelk

“If you’ve stopped walking by the water, skipped a round of golf, or started planning every drive around how long you can sit, tell me about that. I’ve had sciatica myself, and I know how quickly those little decisions add up. Bring your MRI if you have it. We’ll talk about what fits your symptoms, what needs a closer look, and whether it makes sense to explore nonsurgical care or get a surgical opinion.”

— Dr. Cassidy James Boelk, DC

Schedule Your Complimentary Consultation

The practice welcomes La Jolla residents at its Kearny Mesa office.

The Spinal Decompression & Chiropractic Center of San Diego
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 a complimentary, no-charge, no-obligation consultation. Physical examination, new imaging, and treatment are separate services.