Sciatica surgery (Surgery for sciatica (lumbar discectomy / decompression))

An operation to take pressure off a squashed sciatic nerve root — usually by removing part of a slipped disc — to relieve leg pain, pins and needles or numbness.

✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review

In short

Most sciatica settles without surgery; an operation is mainly for leg pain that has not improved with time and physiotherapy.
Surgery usually relieves leg pain faster, but it helps leg pain far more than back pain.
Recovery is often quicker than for bigger spinal operations, with many people back to lighter work in a few weeks.
A disc can slip again, so symptoms can come back and a small number of people need a second operation.

A plain-English summary. The detail — including risks and recovery — is below.

At a glance

TypeSpinal operation (often microdiscectomy)

AnaestheticUsually general anaesthetic

How long it takesOften about 1 to 2 hours

Hospital stayDay case or 1 to 2 nights

Time off workOften around 2 to 6 weeks, depending on your job

When you'll see resultsLeg pain often eases quickly; numbness can take longer

On the NHS?Available on the NHS when leg pain has not settled and scans match symptoms

A general guide. Your surgeon will give you advice for your situation.

Best fit

Can relieve leg pain, pins and needles and numbness from a trapped sciatic nerve, often quickly

Pause if

Your main problem is back pain rather than leg pain — surgery rarely cures back pain.

Main recovery point

You are up and walking the same day and often go home that day or after a night or two. Leg pain may already feel much better, even though the back is...

Good aftercare

Clear written warning signs, especially for bladder, bowel and new leg weakness, with urgent contact details.

First 1 to 2 days

You are up and walking the same day and often go home that day or after a night or two. Leg pain may already feel...

First 2 weeks

Wound soreness settles. Walk little and often. Avoid heavy lifting, bending and twisting. Many people manage...

Weeks 2 to 6

Physiotherapy builds core and back strength. Many return to lighter work around 2 to 6 weeks, depending on the job...

Weeks 6 to 12

Gradual return to all normal activities, including more physical work and sport once your surgeon agrees. Numbness...

Medical line illustration of spine surgery disc decompression for Sciatica surgery. — Illustration only - not a diagnosis, medical advice or a promise of result. Your anatomy and treatment plan may differ. Vuemedics does not publish before-and-after photos.

What is sciatica surgery?

Sciatica is pain, pins and needles, numbness or weakness that travels from the lower back down a leg, caused by pressure on a nerve root — most often from a slipped (herniated) disc, sometimes from a narrowed spinal canal. Sciatica surgery takes the pressure off that nerve.

The usual operation is a discectomy or microdiscectomy, where the surgeon removes the part of the disc pressing on the nerve, often through a small cut using a microscope. If the nerve is squashed by bone or thickened ligament, a decompression such as a small laminectomy may be done instead or as well.

The most important point is that most sciatica gets better without surgery. Many slipped discs settle over weeks to a few months with time, staying active and physiotherapy. UK guidance recommends surgery mainly when leg pain has not improved with non-surgical care and the scan matches the symptoms. Surgery tends to relieve leg pain faster than waiting, but the gap between surgery and non-surgical care narrows over time, and surgery is far better for leg pain than for back pain.

Types & techniques

There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.

Microdiscectomy

The part of the slipped disc pressing on the nerve is removed through a small cut using a microscope or magnification. The most common operation for disc-related sciatica.

Open discectomy

A similar operation through a slightly larger cut. Used in some situations; recovery is broadly similar.

Decompression (small laminectomy / foraminotomy)

If the nerve is squashed by bone or thickened ligament rather than disc, a little bone is removed to free it.

Emergency decompression

Urgent surgery if there are red-flag signs such as loss of bladder or bowel control (cauda equina syndrome). This is done quickly to protect the nerves.

Surgery versus non-surgical care for disc-related sciatica

	Surgery	Non-surgical care
Leg pain	Often eases faster	Often improves over weeks/months
Back pain	Less reliable	Managed with exercise, time
Speed	Quicker relief for many	Slower, gradual
Risks	Operation and nerve risks	Avoids surgery risks
Long term	Disc can slip again	Can also recur

Over the longer term, many people end up at a similar point either way. Surgery mainly speeds up relief of leg pain. Red-flag symptoms are an exception that needs urgent surgery.

Preparing for your surgery

Make sure you have a recent MRI scan that matches the leg with your symptoms, and ask your surgeon to show you the squashed nerve.
Check you have given non-surgical care a fair try (unless there are red-flag signs), as many slipped discs settle on their own.
Tell the team about all medicines, especially blood thinners, and about diabetes.
Stop smoking if you can, as it slows healing and is linked to worse outcomes.
Arrange a lift home and some help for the first week, as bending and lifting are limited.
Plan time off work — often a few weeks for desk work and longer for heavy jobs.
Agree realistic goals: surgery targets the leg pain rather than promising a pain-free back.

What happens

You usually have a general anaesthetic, so you are asleep. Lying face down, you have a small cut made in your lower back. Using a microscope, the surgeon gently moves the nerve aside and removes the piece of disc (or bit of bone) pressing on it, freeing the nerve.

A microdiscectomy often takes around one to two hours. The wound is closed with dissolvable stitches. Many people are up and walking the same day and go home that day or after a night or two. Leg pain is often noticeably better very soon, while the back wound stays sore for a while.

Is this operation right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

May not be suitable if…

Your main problem is back pain rather than leg pain — surgery rarely cures back pain.
Your scan does not clearly match the leg with your symptoms.
Your sciatica is mild or already improving and likely to settle with time.
You expect surgery to remove all numbness or weakness, especially if these are long-standing.

Delay surgery if…

You are in the early weeks of a fresh slipped disc that may settle on its own (without red-flag signs).
You have an active infection, or uncontrolled diabetes raising infection and healing risk.
You are on blood thinners that need safe planning.
You do not yet have a recent scan matching your current symptoms.

Alternatives to discuss

Time, reassurance and staying active — many slipped discs settle within weeks to months.
Physiotherapy and a structured exercise programme.
Sensible pain relief for a limited time.
A targeted nerve root (epidural) steroid injection in selected cases.
Continuing non-surgical care if symptoms are tolerable and improving.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

What matters most to me?

Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.

What are all my options?

Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.

What would make me pause?

Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.

What happens if I do nothing today?

For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.

Anaesthetic choices

The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.

General anaesthetic

Most discectomy operations are done asleep under a general anaesthetic.

Spinal anaesthetic

Occasionally used for selected lower-spine operations; your anaesthetist will advise.

Benefits

Can relieve leg pain, pins and needles and numbness from a trapped sciatic nerve, often quickly
Can free a nerve before long-standing pressure causes lasting weakness
Recovery is often quicker than for bigger spinal operations
May reduce the need for strong painkillers
Keeps most of the spine intact, as only the offending disc fragment is removed

Risks & complications

More common

Wound soreness and tiredness for a couple of weeks
Some ongoing back pain, which surgery may not cure
Numbness or pins and needles that take time to recover, or do not fully go

Less common

A tear in the lining around the nerves (dural tear) leaking spinal fluid
Wound infection needing antibiotics
The same disc slipping again, sometimes needing another operation
A blood clot in the leg or lung

Rare but serious

Damage to the nerve causing new weakness or numbness
Serious infection such as discitis
Loss of bladder or bowel control, or very rarely permanent nerve damage

The main things to weigh are that surgery helps leg pain more than back pain, that a disc can slip again, and that numbness or weakness present beforehand may not fully recover. Dural tears are uncommon in first-time disc surgery but more likely in repeat operations. Ask your surgeon for the realistic chance of relief and recurrence for you.

Published figures to discuss

Most people get good relief of leg pain, but rates vary with the disc, whether it is a first or repeat operation, and your general health. The figures below are cautious and from NHS and published sources; ask your surgeon for numbers specific to you.

Figure	Reported range	How to interpret it	Source / confidence
Relief of leg pain (sciatica)	High satisfaction and good leg-pain relief are reported in published microdiscectomy series	Surgery speeds relief of leg pain; back pain is less reliably helped.	Guide sourcesClinical context
Disc slipping again (re-herniation)	Reported recurrence is commonly in the low double digits over years, varying by study and follow-up	A small number need a further operation.	Guide sourcesClinical context
Accidental dural tear	Around 3 to 4 in 100 for first-time disc surgery, higher in repeat operations	Usually repaired at the time; occasionally needs extra rest.	Guide sourcesClinical context
Wound or deep infection	Low single figures in spinal-surgery series	Higher with diabetes and smoking.	Long-term outcome of revision microdiscectomy for recurrent sciatica — PubMedpubmed.ncbi.nlm.nih.govSource-linked context

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

Recovery — what to expect, and when

Recovery is usually quicker than for bigger spinal operations. Leg pain often improves early, while the back wound and muscles take a couple of weeks to settle. Walking and gradually rebuilding activity, guided by physiotherapy, tend to give the best result.

First 1 to 2 days

You are up and walking the same day and often go home that day or after a night or two. Leg pain may already feel much better, even though the back is sore.

First 2 weeks

Wound soreness settles. Walk little and often. Avoid heavy lifting, bending and twisting. Many people manage gentle daily activities within a week or two.

Weeks 2 to 6

Physiotherapy builds core and back strength. Many return to lighter work around 2 to 6 weeks, depending on the job and how they feel.

Weeks 6 to 12

Gradual return to all normal activities, including more physical work and sport once your surgeon agrees. Numbness can keep improving over months.

What's normal — and not a worry

Leg pain improving soon after surgery, sometimes immediately
Back soreness around the wound that eases over a couple of weeks
Numbness or pins and needles that recover slowly and may not fully go
Tiredness needing short rests in the first week or two

Aftercare

Keep the wound clean and dry; follow advice on showering and stitches.
Walk little and often from day one to aid recovery.
Avoid heavy lifting, bending and twisting until your team says it is safe.
Do your physiotherapy exercises to rebuild strength and confidence.
Take painkillers as advised and reduce them as the pain eases.
Do not drive until you can do an emergency stop comfortably and are off sedating painkillers.
Keep your follow-up appointment so nerve recovery and the wound can be checked.

Before-surgery checklist

A lift home and help at home for the first week
Loose, comfortable clothing and easy-on shoes
Painkillers and any prescribed medicines collected
Time off work agreed with your employer
A plan for short, regular walks
Physiotherapy or exercise advice understood before leaving
The clinic's contact number saved for problems

Scars and how they heal

A microdiscectomy leaves a small scar in the lower midline of the back, often only a few centimetres. It is pink and firm at first and usually fades to a discreet line over months.

⚠ Get urgent help if…

Loss of bladder or bowel control, or numbness around the back passage or genitals — go to A&E immediately, this can be an emergency
New or worsening weakness, numbness or heaviness in a leg or foot
Increasing redness, swelling, heat or discharge from the wound, or fever (signs of infection)
Clear fluid leaking from the wound (possible spinal fluid leak)
A severe headache that is much worse sitting or standing than lying down
Calf pain or swelling, or sudden breathlessness or chest pain (possible blood clot)
Leg pain that suddenly returns severely (possible re-herniation)

Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your surgeon gives you.

Results & realistic expectations

A good result usually means the leg pain that travelled down from the trapped nerve has eased, often quite soon after surgery. Numbness and pins and needles can take longer to recover and sometimes do not fully resolve, especially if the nerve was squashed for a long time or there was weakness beforehand.

Surgery is much better at relieving leg pain than back pain, so it is realistic to expect your leg symptoms to improve more than any background back ache. Over the longer term, people who have surgery and people who recover without it often reach a similar point — surgery mainly gets you there faster.

How long it lasts

Most people who get relief keep it, but the disc and spine continue to age. The same disc can slip again, or a different level can cause new sciatica, so symptoms can return over the years. A small number of people need a second operation. Staying active, keeping a healthy weight, lifting carefully and not smoking can help protect the result.

Combining with other procedures

Sciatica surgery is sometimes combined with a small decompression if bone or thickened ligament is also squashing the nerve. A fusion is only added in the uncommon situation where the spine is unstable (for example with a slipped vertebra) — it is not part of a routine discectomy and should be clearly justified if suggested.

Follow-up & long-term care

You will usually be reviewed in clinic a few weeks after surgery to check the wound and how the leg symptoms are recovering, with physiotherapy often arranged. Any loss of bladder or bowel control, new leg weakness, or signs of infection should be reported straight away rather than waiting.

Keep up the core and back strengthening exercises you are given.
Lift carefully and avoid repeated heavy or awkward lifting.
Stay active and avoid long periods of sitting.
Maintain a healthy weight and stop smoking to protect the disc and your recovery.
Seek review early if leg pain returns rather than letting it build.

Revision and secondary surgery reality

The same disc can re-herniate, sometimes needing a second operation.
Repeat (revision) surgery carries higher risks and less predictable results than the first operation.
Numbness or weakness present before surgery may not fully recover.
A fusion is occasionally needed later if repeated surgery or instability becomes a problem.

Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.

What good aftercare looks like

Clear written warning signs, especially for bladder, bowel and new leg weakness, with urgent contact details.
A named contact and follow-up appointment to check nerve recovery.
Access to physiotherapy and a graded return-to-activity plan.
Honest review of leg-pain relief and realistic expectations for numbness.
A plan for what happens if leg pain returns.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

The surgeon's and anaesthetist's fees
Whether it is a day case or needs an overnight stay
How complex the operation is and whether any bone is removed
Theatre and hospital facility fees
Imaging (such as MRI) and follow-up appointments
Physiotherapy included afterwards
The provider's policy if the disc slips again or further surgery is needed

Make sure your written quote includes

The named operating surgeon's fee and the anaesthetist's fee
The hospital or facility fee and whether it is a day case
How many follow-up appointments and physiotherapy sessions are included
What happens, and who pays, if a complication or readmission occurs
The policy if the disc re-herniates or further surgery is needed
Whether any imaging is included
Cancellation and rescheduling terms

On the NHS? Surgery for sciatica that has not settled is available on the NHS when scans match symptoms; private care is mainly used for speed, choice of surgeon or a second opinion.

You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

Choosing a surgeon safely

Check your surgeon is on the GMC Specialist Register for this area.
Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

How Vuemedics verifies every consultant →

Questions to ask your medical professional

Take this to your consultation. A good surgeon will welcome every one of these.

How clearly does my scan match my leg symptoms, and which nerve is trapped?
Have I given non-surgical treatment a fair try, and what would waiting longer mean for me?
What is the realistic chance surgery relieves my leg pain, and how much back pain might remain?
What is my own risk of the disc slipping again or needing another operation?
Will any numbness or weakness I already have recover after surgery?
When can I drive, return to my job and get back to sport?
Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
Will you be the surgeon who carries out my operation, and who looks after me afterwards?
What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
What does a realistic result look like — and what can this operation not achieve?
What are my options, including waiting, doing nothing for now, or choosing a different approach?
Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Frequently asked questions

Do I need surgery for sciatica?

Usually not. Most sciatica from a slipped disc settles over weeks to a few months with time, staying active and physiotherapy. Surgery is mainly for leg pain that has not improved, or for red-flag signs that need urgent treatment.

Will surgery cure my back pain?

It targets the leg pain from the trapped nerve, not back pain. Many people still have some background back ache afterwards, so be cautious of anyone promising surgery will cure back pain.

How quickly will my leg pain improve?

Leg pain is often much better within days, sometimes immediately. Numbness and pins and needles can take weeks to months to recover and may not fully go.

Can I have it on the NHS?

Yes. Surgery for sciatica that has not settled is available on the NHS when scans match your symptoms. People sometimes go private for a faster appointment, choice of surgeon, or a second opinion.

Could the disc slip again?

Yes. The same disc can re-herniate, or another level can cause new sciatica. A small number of people need a second operation, so it is worth asking your surgeon about your own risk.

What is cauda equina syndrome?

It is a rare emergency where the nerves at the base of the spine are badly squashed, causing loss of bladder or bowel control and numbness around the back passage. It needs urgent surgery — go straight to A&E if this happens.

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: NICE NG59 — Low back pain and sciatica (recommendations) NHS — Lumbar decompression surgery Effectiveness of microdiscectomy for lumbar disc herniation (RCT) — PubMed Long-term outcome of revision microdiscectomy for recurrent sciatica — PubMed Incidental durotomy in lumbar spine surgery — PubMed Microdiscectomy versus open discectomy: success and complications — PMC

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.