Was this a sudden onset of symptoms, or sudden worsening of symptoms? Or has it been the same for a long time?

I have always had minor low back issues on and off, suddenly got worse about 2 months ago. Very extreme pain, MRI said disc compression on S1 nerve.

I did go talk to a surgeon. He read the MRI differently, said it was a disc fragment and that with PT, antiinflammatory medications, and time, there was an 80% chance it would resolve. If surgery was needed, he said, it is the least invasive kind of spinal surgery but still there are risks and sometimes the patient does come out of surgery worse than going in.

His take - which I appreciate from my own experience as a clinician - is that whenever possible it is good to try the less invasive, less risky treatment first. In my case, if the 6 months of conservative management doesn't work, he can still do his thing.

When this thing first hit me, the pain was so severe I could not imagine conservative treatment working. But actually, it has. I did PT twice a week for a month and still doing their exercises religiously every day. Being a lot more careful about how I sit, how I pick things up, and modified how I do some of my procedures at work. I've been pain free for several weeks now, swimming and cycling with no problems. Actually, the PT work with improved core and posture has made my swimming a tisch faster.

Who knows, I may need the surgery at some point, but I appreciate this surgeon's advice. Even if the risks are relatively rare, it's best to avoid them if possible.

In seeking multiple opinions, it's good to find surgeons who are very comfortable recommending non-surgical treatments or at least trials thereof. Some surgeons - some I have worked with - fall very strongly into the "if your only tool is a hammer, then everything you see is a nail" syndrome.