I have a disc herniation in my neck, which is causing pain in my neck and also pain that travels down into my arm. I was browsing through a magazine recently and came across an article that suggests that patients with painful disc herniations in the neck should have surgery, the earlier the better. What is your opinion?

A recent article published in the Journal of Neurosurgery did imply, based on inconclusive evidence, that early surgery might be better than surgery after conservative treatment. Experts in the field of spinal surgery say the study is flawed and are skeptical about its results. There is a large information base that shows that pain from most cervical disc herniations resolves spontaneously without surgery. Pain will usually resolve within two to three months after the onset of symptoms. If surgery is performed after an appropriate 23-month conservative treatment course, a good result can still be expected. Waiting longer than 68 months can compromise surgical outcomes. I recommend an adequate course of conservative treatment, which includes physical therapy, nonsteroidal anti-inflammatories and time. If your symptoms have not resolved in spite of adequate conservative treatment, surgery can be a good option.