Being unable to walk due to severe pain is probably a reason to consider surgery for a HNP earlier than the recommended six weeks of conservative management.  Although back surgery is considered elective except where severe weakness, in particular a foot drop, or loss of bladder/bowel control are present, a goal of surgery is to get people mobilized and back to work. A weakness of decision analysis is comparing surgical outcomes after six weeks to non-operative management after one year. Some patients just can’t wait that long to get back in action.