Six months after the onset of a herniated disc. To those torn between conservative treatment and surgery—why opinions differ
Conservative treatment or surgery? I am writing this honestly for those who are struggling to decide.
I am writing this for those who are struggling with whether to choose surgery or conservative treatment for a herniated disc.
Honestly, right after I got my herniated disc, I had no knowledge and my head was filled with pain and anxiety. That is exactly why I want to provide those in the same position with 'material to stop and think for a moment'.
To conclude, for some people surgery is the right answer, while for others, conservative treatment is a better fit.
The problem is not which one is correct, but rather,that people who are struggling do not know 'how to struggle'with the decision.
In the first 1-2 months, specialists' reactions may differ.
During the first 1-2 months when I started going to hospitals, even spine specialists had different reactions.
From my experience, there are two main patterns.
Pattern A: Recommending early surgery
Some doctors say things like, 'If you're a man, you should have surgery sooner.'
'If you have a family, it's economically better to be able to move around sooner.'
There are doctors who speak this way.
This involves not just medicine, but also social values.
In Japan, there is still an atmosphere somewhere that says 'men should work' and 'it's not good to take time off.'
Therefore, 'returning quickly' is easily placed as a prerequisite.
I feel this perspective is not often written about directly in books or on the internet.
Pattern B: Conservative treatment first (often settles in 3-6 months)
On the other hand, there are doctors who say, 'Herniated discs often settle down in 3-6 months, so let's rest and go with conservative treatment first.'
This way of thinking is also common.
What you should know here is thatmedical discussions and social discussions (gender and work styles) are mixed within the same consultationis a fact.
The more you are struggling, the more confused the information becomes here.
Actually, proposals can change depending on 'what the hospital can do'.
There is another reality that is not often talked about.
It is thatproposals lean toward the means that the hospital (or that doctor) has available.
Even within the range of hospitals I visited, there was a doctor who left an impression on me.
'What we can do at this hospital is surgery. So, the discussion will center on surgery.'
'Since we don't handle nerve block injections, the options I can explain are limited to begin with.'
'If we only have surgery as an option, I think it's natural to recommend surgery.'
There were doctors who told me this honestly.
When I heard this, I felt a little relieved.
It wasn't that 'the doctor was bad,' but I understood that it happens as a matter of the system.
A note on guidelines: There are 'symptoms you should consult about' before rushing into surgery.
Even so, there is one important premise.
While there are many cases where it is fine to 'wait and see' with a herniated disc,there are symptoms that guidelines warn you to 'see a specialist early if these troubles occur'.
For example,
Something is wrong with urination or defecation (cannot go/leaking, etc.)
Numbness or paralysis suddenly becomes stronger
Leg strength is declining, or your gait is becoming abnormal
—things like these.
I don't mean to scare you here; I just want those who are struggling to have a sense of 'priority.'If you have these symptoms, you should consult a medical institution rather than looking online.I just want you to have a sense of priority.
After 6 months, you reach a 'partially improved' zone
In the end, I gradually improved through conservative treatment (rehabilitation, muscle training, stretching).
Looking at it in 1-2 week intervals, it's at a level where I can clearly tell myself that I am getting better.
However, when 6 months had passed, this is what my doctor told me:
'Honestly, it's hard to decide because you've only partially improved.'
This is incredibly realistic and incredibly tough.
If you are completely unable to move, you start 'considering surgery as an option'
If you are completely healed, you wouldn't be worried
But it's hardest to judge when you are 'improving, but not enough for work'
I think there are quite a lot of people in this zone.
MRI is a strong piece of evidence. But sometimes it 'doesn't match the pain'
When people talk about a hernia, 'it's hitting a nerve and causing pain' is an easy explanation to understand.
However, in reality, it is said that there are cases where the MRI and the pain do not match.
There are people who have a hernia but no pain.
There are times when the pain decreases even if the size of the hernia has not changed.
And the opposite is also true.
Just knowing about this 'possibility of a mismatch' will bring your expectations for surgery closer to reality.
The risks of surgery are more realistically about 'not getting as much relief as expected/a different kind of discomfort' rather than a 'major accident'
When you hear about the risks of surgery, you tend to immediately imagine the worst-case scenario.
Of course, major risks are not zero.
But from my experience, the more common issues are much more realistic.
The possibility that pain and numbness will not be "completely eliminated"
The possibility that it will "return" after a while
The possibility that you will "become concerned about a different area" regarding the location of the pain or discomfort
Many people find short-term relief through surgery.
However, if you expect "surgery = a complete solution to everything," you will have a hard time later.
What I did to "lean toward conservative treatment" was to get my household finances in order before my body.
From here on, these are purely my own thoughts.
I decided to prepare for a long-term struggle.
So, what I did was not just focus on treatment, but also adjust my life.
Reduce rent to nearly half the level
Cut fixed costs
Review subscriptions
Talk to my family about the situation
Replan my finances on a one-year span, including unemployment benefits
This was not "to avoid surgery," but
to create a state where I wouldn't be cornered regardless of which I chose.
In the end, whether to choose surgery or conservative treatment isn't decided by medicine alone.
It is decided by your occupation, lifestyle, household finances, whether you have people to support you, and deadlines.
It is decided by all of those things.
Summary: What I want to tell those who are hesitant
If you are currently torn between surgery and conservative treatment, there is only one thing I want to say.
It is normal for doctors' opinions to differ
Sometimes social values (pressure for men to work) get mixed into medical discussions
Sometimes proposals are biased toward the methods available at the hospital
After 6 months, you enter a "half-recovered zone" where making a decision becomes difficult
MRI is a powerful tool, but it doesn't always align with the pain
In the end, it is okay to decide based on 'your situation'
I hope this article serves as material to help you regain confidence in your own judgment.