Is a 4-mm lumbar disc herniation severe?

A 4-mm lumbar disc herniation is considered relatively severe. The stepwise treatment approach for lumbar disc herniation is as follows: First, standardized conservative treatment should be undertaken for 1–2 months, including oral medications and functional exercises. If symptoms improve significantly, no further intervention is required—patients need only avoid harmful habits and maintain proper posture in daily life. If conservative treatment fails to relieve symptoms or provides inadequate relief, minimally invasive surgical interventions are recommended. Common procedures include nerve root block, nerve root radiofrequency ablation, disc radiofrequency ablation, and ozone disc nucleolysis. If ablation procedures remain ineffective and symptoms progressively worsen—significantly impairing daily work and quality of life—open surgical intervention becomes necessary. Fortunately, the majority of patients achieve symptom relief through either conventional or minimally invasive surgical approaches, and open surgery is not always required.