By Dr. Boris Nektalov, DNM, DC, Chiropractor & Enzyme Nutrition Specialist · Nektalov Chiropractic & Wellness, Forest Hills, Queens NY
Published: July 4, 2026 · Last reviewed: July 4, 2026
The short answer: Most herniated discs do not require surgery. Research shows roughly 90% of lumbar disc herniations improve significantly with conservative care within 6–12 weeks, and many herniations shrink or resorb on their own. Surgery is reserved for specific red-flag situations — not for a diagnosis on an MRI report.
If you've been diagnosed with a herniated disc, disc bulge, or sciatica and you're feeling pain shoot down your leg, the fear is real: Do I need surgery? Is this permanent? At Nektalov Chiropractic & Wellness in Forest Hills, Queens, we see patients every week asking exactly these questions. This article walks through what the research actually says — and how to make this decision based on evidence, not fear.
Sciatica Is a Symptom, Not a Diagnosis
Sciatica refers to irritation of the sciatic nerve — the largest nerve in the body — producing pain that radiates from the lower back into the buttock, hip, thigh, calf, or foot. Patients often describe burning, numbness, tingling, weakness, or electric-like pain traveling down the leg.
The most common underlying cause is nerve root compression from a disc injury. Spinal discs act as shock absorbers between the vertebrae. Poor posture, repetitive stress, heavy lifting, car accidents, sports injuries, and age-related degeneration can weaken a disc over time. When it bulges or herniates, it can press on nearby nerve roots — producing the classic sciatica pattern.
The key point: sciatica describes where it hurts, not why. Identifying the actual source of the nerve irritation is what determines the right treatment.
What the Research Says About Herniated Discs and Surgery
The evidence on this question is unusually consistent:
- Most herniated discs improve without surgery. Clinical research indicates approximately 90% of patients with lumbar disc herniation improve substantially with conservative care within 6–12 weeks.
- Many herniations heal on their own. A 2017 meta-analysis in Pain Physician (Zhong et al.) found that roughly two-thirds of lumbar disc herniations show spontaneous resorption — the body reabsorbs the herniated material over time.
- Surgery and conservative care often end up in a similar place. The landmark SPORT trial (Weinstein et al., JAMA, 2006) followed patients with confirmed disc herniation and found that both surgical and non-surgical groups improved substantially over two years.
- Guidelines say start conservative. The American College of Physicians' clinical guideline for low back pain (Qaseem et al., Annals of Internal Medicine, 2017) recommends non-pharmacologic treatment first — explicitly including spinal manipulation — for most acute and subacute low back pain.
This is why spinal manipulation (chiropractic adjustment) continues to appear in evidence-based guidelines for low back pain management: it addresses the mechanical stress on the spine without the risks of an invasive procedure.
Your MRI Is Not Your Destiny
One of the biggest misconceptions in spine care is that MRI findings determine the need for surgery. The data says otherwise.
A widely cited systematic review by Brinjikji et al. (American Journal of Neuroradiology, 2015) examined MRI findings in over 3,000 people with no back pain at all. Disc bulges were present in about 30% of asymptomatic 20-year-olds — rising to 84% by age 80. Disc degeneration appeared in 37% of pain-free 20-year-olds and 96% of pain-free 80-year-olds.
In other words: imaging findings are common in people who feel completely fine. The reverse is also true — some patients have significant pain with modest imaging findings.
Treatment decisions should be based on the full clinical picture: examination, symptoms, neurological findings, and imaging — never imaging alone.
When Surgery IS Necessary: Know the Red Flags
Surgery is absolutely the right call in certain situations. Seek immediate medical evaluation if you experience:
- Loss of bowel or bladder control (possible cauda equina syndrome — a surgical emergency)
- Progressive neurological weakness (a leg getting measurably weaker over days or weeks)
- Saddle numbness (loss of sensation in the groin/inner thighs)
- Severe spinal instability or significant trauma
If we identify any of these at our Forest Hills office, we refer for surgical consultation immediately. Honest guidance means knowing when conservative care is not the answer.
Conservative Care vs. Surgery: The Decision Framework
| Factor | Conservative Care First | Surgical Consultation |
|---|---|---|
| Symptoms | Pain, tingling, mild numbness | Bowel/bladder changes, progressive weakness, saddle numbness |
| Timeline | Symptoms stable or improving | Neurological deficits worsening despite care |
| Typical outcome | ~90% improve within 6–12 weeks | Indicated when benefits clearly outweigh risks |
| Risks | Minimal; non-invasive | Infection, scar tissue, failed back surgery syndrome, adjacent segment degeneration, extended recovery |
| Guideline position | First-line for uncomplicated cases (ACP, 2017) | Reserved for red flags or failed conservative care |
Every surgical procedure carries potential complications. That doesn't make surgery bad — it means it should be reserved for cases where the benefit clearly outweighs the risk. For the majority of disc injuries, conservative care deserves the first opportunity.
How We Treat Disc Injuries and Sciatica in Forest Hills
At Nektalov Chiropractic & Wellness, our approach targets the mechanical and internal factors driving nerve irritation:
Chiropractic adjustments
Chiropractic adjustments restore spinal mobility, reduce muscle tension, and decrease mechanical pressure on affected structures. Adjustments also support the nerve pathways connecting the spine to the rest of the body.
Spinal decompression therapy
Spinal decompression therapy uses controlled traction to create space within the spine, reducing pressure on compressed discs and irritated nerve roots. It has become one of the most sought-after non-surgical options for disc-related conditions among patients who want to avoid injections or surgery.
Enzyme nutrition and anti-inflammatory support
Enzyme nutrition and anti-inflammatory support address a factor most spine care ignores: disc injuries create inflammation around irritated nerve roots, and that inflammatory response amplifies pain and sensitivity. Diet, digestion, hydration, sleep, and stress all influence how quickly the body resolves inflammation. Because Dr. Nektalov is a certified enzyme nutrition specialist, treatment plans address recovery from the inside as well as the outside.
Movement and rehabilitation
Movement and rehabilitation counter the most common mistake after a disc injury: stopping all activity out of fear. While certain movements should be modified, prolonged inactivity leads to muscle weakness, stiffness, reduced circulation, and delayed healing. We build progressive movement, postural correction, and lifestyle modifications into every recovery plan.
Learn more about our full range of chiropractic services in Forest Hills.
What Recovery Actually Looks Like
Every case is different. Some herniated discs improve within weeks. Others need months of structured rehabilitation. A minority ultimately require surgical intervention — and when that's the case, we say so directly.
What matters is this: the decision should come from a thorough evaluation of your specific condition, not from fear of a word on an MRI report. Your body is designed to heal, and most disc-related conditions improve significantly when given the right environment, the right care, and enough time.
When to Seek Additional Medical Care
If you experience any of the red-flag symptoms above — bowel or bladder changes, progressive weakness, saddle numbness — or severe symptoms that interfere significantly with daily function, consult a physician or go to the emergency room immediately. Chiropractic and functional wellness care complement, but never replace, appropriate medical evaluation.
Contact our office to schedule a comprehensive evaluation, or book online.
Serving Forest Hills, Rego Park, Kew Gardens, Jackson Heights, and surrounding Queens communities · 108-50 71st Ave, Forest Hills, NY 11375 · (718) 275-9000
Frequently asked questions
Do I need surgery for a herniated disc?
Most people do not. Research indicates roughly 90% of lumbar disc herniations improve significantly with conservative care within 6–12 weeks, and a 2017 meta-analysis found about two-thirds of herniations resorb on their own. Surgery is reserved for red-flag cases like progressive weakness or bowel/bladder dysfunction.
Can a herniated disc heal on its own?
Yes, in many cases. A meta-analysis published in Pain Physician (2017) found spontaneous resorption occurs in approximately two-thirds of lumbar disc herniations — the body gradually reabsorbs the herniated material. Conservative care supports this process by reducing mechanical stress, inflammation, and pressure on the affected nerve root.
Is sciatica the same as a herniated disc?
No. Sciatica is a symptom — pain radiating along the sciatic nerve into the buttock, leg, or foot — not a diagnosis. A herniated or bulging disc compressing a nerve root is the most common cause, but proper evaluation is needed to identify the true source of the nerve irritation.
Can a chiropractor help with a herniated disc and sciatica?
Yes, for most uncomplicated cases. The American College of Physicians' 2017 guideline recommends non-pharmacologic care — including spinal manipulation — as first-line treatment for low back pain. Chiropractic adjustments and spinal decompression reduce mechanical pressure on irritated nerve roots and improve spinal mobility without surgical risk.
What is spinal decompression therapy and does it work for disc problems?
Spinal decompression is a non-surgical treatment using controlled traction to create space within the spine, reducing pressure on compressed discs and nerve roots. It's commonly used for herniated discs, bulging discs, and sciatica by patients seeking alternatives to injections or surgery. Nektalov Chiropractic & Wellness offers it in Forest Hills, Queens.
When is back surgery absolutely necessary?
Surgery is urgently indicated for red-flag conditions: loss of bowel or bladder control (possible cauda equina syndrome), progressive neurological weakness, saddle numbness, or severe spinal instability from trauma. Outside these situations, clinical guidelines recommend exhausting conservative treatment first, since surgical and non-surgical outcomes are often similar long-term.
Where can I find non-surgical herniated disc treatment in Queens?
Nektalov Chiropractic & Wellness in Forest Hills, Queens, NY offers chiropractic adjustments, spinal decompression therapy, enzyme nutrition support, and rehabilitation programs for herniated discs and sciatica. Dr. Boris Nektalov evaluates each case individually and refers patients for surgical consultation when red-flag findings are present.
This article is intended for informational purposes. It does not constitute medical advice. Patients with emergent symptoms including loss of bladder or bowel control, severe or rapidly progressing neurological deficits, or suspected spinal fracture should seek emergency medical evaluation immediately.