Question
My fiance has a herniated disc in her lower back and tried an epidural injection which did nothing. She went to surgeon the other day and he said she could have a microdescectomy surgery but kept mentioning her leg. She is interested yesterday but called the office because she doesnt have pain in her leg just her lower back near her buttox and they asked the dr and called her back and said it should still help it. What is your opinion on having this surgery if the pain is in the lower back only. She is in a great deal of pain and her quality of life is suffering. She also has fibromyalgia. Thanks."

Answer
Scott,

If she does not have pain in her leg, only in her buttock, then she should try conservative methods first, before going into surgery.  
Has she tried PT, Chiropractic, or anything else?  How long has she had this problem?  If it's new, then she needs to consider using med's and conservative methods to see if it resolves.  If she's been dealing with this for a long time, and MRI shows a significant disc protrusion against a nerve, and she's failed conservative methods, then surgery may be her only option.  Also, the epidural may be helpful the second time around if it is injected in a different location or in a different way, e.g. "transforaminal" verses "interspinous."   She must talk to the pain management doctor that did the epidural to see if this is the case.   Chiropractic care would involve some of the following:  manual joint manipulation, lumbar distraction, and exercises to "centralize" the pain (bring it out of the buttock and towards the axial spine).   Fibromyalgia is a complication...makes me wonder about how she is perceiving her pain compared to what is truly anatomically wrong.   Usually microdiscectomy is used when the disc material is extruded against a nerve, causing debilitating back and leg/foot pain, but some folks only have pain in their buttock or into the groin.   

'Hope this was helpful.

Dr. G