Does a 12 mm disc herniation mean you need surgery?
No. A 12 mm herniation is a large herniation and it can absolutely light up your leg, go numb in your foot, and take away your ability to pick up your own kids. But size alone is not what decides surgery. What decides it is whether that disc material can be pulled back off the nerve, and in the right patient, a properly run decompression protocol does exactly that.
I reviewed an MRI recently on a woman who had already been told she needed an operation. On the scan you can see the spinal canal where the nerves live, and the nerve roots coming out both sides. On one side the opening was clear and bright. On the other side, a 12 mm disc herniation was sitting right in the exit.
Her doctors gave her three reasons she needed surgery. Number one, her calf was on fire. Number two, she could not pick up her kids. Number three, her foot was numb. Every one of those is a real finding. Not one of them is proof that surgery is the only thing that will fix it.
Listen, nobody told her the missing part. Nobody told her that if you reduce that disc even 30%, the nerve is free.
What do a burning calf, a numb foot, and losing your grip on your kids actually mean?
Those are nerve symptoms, not muscle symptoms. A calf that feels like it is on fire, toes that go achy like little critters are crawling around in there, a leg you want to kick through a door: that is a nerve under pressure, and the pressure is coming from the disc.
Think of the disc like a jelly-filled donut. The annulus is the dough on the outside, the nucleus is the jelly in the middle. When the dough tears, the jelly spits out. If it spits out into the space where the nerve exits, the nerve has nowhere to go.
That is why the symptoms show up in the leg and the foot instead of the back. People spend years chasing the calf and the foot. The calf and the foot are not the problem. They are the alarm.
The MRI in this case is worth seeing for yourself. Here is the video:
If the cortisone injection did not work, does that prove you need surgery?
No. It proves the injection did not address what is actually wrong. A cortisone shot is a chemical solution for a physical problem. It can quiet inflammation around the nerve for a while, but it does not move the disc material that is causing the inflammation in the first place.
This is where the conveyor belt starts. Online physical therapy, then the injection, then the injection wears off, then you are on the surgery waitlist. Nobody in that sequence ever tries to take the pressure off the disc.
I have been on the patient side of this. In April 2020, at 35 years old, I herniated L5-S1 about 5 mm. I had been in practice 10 years and I tried everything I knew. Nothing touched it. I was hopeless, and I mean hopeless, because that is where I was. I bought a decompression table out of desperation and I was pain-free in 5 to 8 weeks.
How much does a disc have to shrink before the nerve is free?
Less than most people assume. You do not need the herniation gone. You need enough of it out of the way that the nerve has room again, and in many cases that is around a 30% reduction.
That is what happened with Belinda. We got her disc reduced 30%, the nerve was free, and she made a 100% recovery. No surgery.
This is not just one case. In our published peer-reviewed research paper, four patients had disc reductions of 9%, 27%, 30%, and 78% in under 4 months. All four were 100% pain-free. None of them had surgery. Every disc and every patient is different and results vary, but the mechanism is the same one every time: reduce the disc, free the nerve.
What makes a decompression protocol “proper”?
Three dials, and they have to be set for your specific disc. Get them wrong and you get a machine pulling on a spine with no strategy behind it.
Dial one is angle, adjusted in 2.5 degree increments based on the type of herniation and your comfort. It is not close enough. It is 12.5 degrees. It is not 11. It is not 14. It is 12.5 degrees.
Dial two is weight. The textbook says 50% of body weight and that is flawed, way too aggressive. We start low and build.
Dial three is oscillation, the pull-and-relax accordion cycle. That is the whole difference between decompression and traction, and it is the reason an inversion table is not the same thing. An inversion table is just hanging. No oscillation, no control. That is why you spasm.
These tables are Ferraris. Incredible machines. But you still have to know how to drive stick or you crash it.
Your MRI tells you what is wrong. It never tells you how to fix it.
An MRI report will name your herniation, measure it, and stop there. That is the gap almost every patient falls into. You are not missing the information of the disc. You are missing how to fix it.
An MRI is also a static picture. It shows you one frozen moment of a spine that is supposed to move, which is why we correlate it with flexion-extension motion x-rays, a hands-on exam, and what you are actually feeling. An MRI does not equal pain, and a report on its own is misleading in both directions.
I have heard patients told their scan is “not that bad, it’s normal.” Something that is normal can also be ruining someone’s life. Those two things are not in conflict.
Where can you get non-surgical spinal decompression near Walnut Creek?
At our center in Walnut Creek. We run 13 DOC decompression tables and have performed more than 51,000 decompression treatments, and we see patients from Lafayette, Concord, Pleasant Hill, Danville, and across Contra Costa County and the greater Bay Area.
The first step is never the table. The first step is finding out whether you are actually a candidate. That means reading your MRI properly, correlating it to your exam and your symptoms, and being honest with you about what the disc will and will not do.
My job is to give you hope, and hope has to be built on something real. For a lot of people who have been handed a surgery date, the real thing is a 30% reduction they were never told was possible.
Quick questions, straight answers
Is a 12 mm herniation too big for spinal decompression?
Not automatically. Size matters less than location, disc type, and whether the herniation can be reduced enough to take pressure off the nerve. We have treated herniations larger than 12 mm. The only way to know for your disc is a proper evaluation of your MRI alongside your exam.
The cortisone injection did not help me. Does decompression still make sense?
Often yes. An injection failing tells you the inflammation was a symptom, not the cause. Decompression works on the cause, which is the mechanical pressure of the disc on the nerve. Many of our patients come to us after injections have already worn off.
How do you know the disc actually got smaller?
We take a post-MRI and compare it to the original. That is how we documented reductions of 9%, 27%, 30%, and 78% in our published research. We do not ask you to take our word for it, and we do not guess.
Where can I get a herniated disc evaluated near Walnut Creek?
Contact Dudum Chiropractic in Walnut Creek at (925) 300-3302. We serve patients throughout the East Bay, and patients fly in from around the world for this protocol.
The next step
If you’re dealing with back pain and want to find out whether you’re a candidate for spinal decompression, contact us at Dudum Chiropractic in Walnut Creek or call (925) 300-3302. You deserve relief without spinal surgery.
I’m Dr. JD Dudum. This is Back At It with Dr. Decompression.