Minimally Invasive Lumbar Decompression (MILD) Procedure
PAIN CONDITION
Is lower back pain disrupting your life? Back pain, especially the type that worsens when standing or walking, can be caused by lumbar spinal stenosis (LSS), a condition caused by the narrowing of the spinal canal. Many adults over 50 experience this chronic condition with back and leg pain, tingling and numbness.[1] Relief can be delivered without major surgery with an innovative procedure called Minimally Invasive Lumbar Decompression (MILD®).
MILD® is a quick, outpatient treatment that relieves pressure on your nerves and improves mobility without the risks or long recovery of back surgery.[2]
How the MILD® Procedure Works
The MILD® procedure is performed through a small incision—about the size of a baby aspirin—using specialized tools and imaging guidance. During the procedure, the physician removes thickened ligament tissue, providing space in the spinal canal and relieving pressure on the spinal nerves.[3] This FDA-cleared procedure has a strong safety profile, low risk of complications, and effectively decompresses the spinal canal, reducing pain, numbness and tingling in the lower extremities.[3]
MILD® has significantly improved pain, mobility, and quality of life, providing results similar to those of more invasive surgical options.[1] The whole process typically takes under an hour and is done without general anesthesia, implants, or stitches. Most patients go home the same day and resume light activities within days.[3]
Conditions Treated with Minimally Invasive Lumbar Decompression
The non-opioid MILD® procedure offers an effective non-surgical option for painful spinal conditions, including:
- Lumbar spinal stenosis (LSS) [4]
- Neurogenic claudication [4]
- Hypertrophic ligamentum flavum [4]
- Cauda equina syndrome [5]
- Slipped disc (herniated disc) [5]
- Sciatica [5]
- Metastatic spinal cord compression (cancer) [5]
- Spinal tumors [5]
- Spinal injury [5]
- Chronic low back pain conditions like osteoarthritis and degenerative disc disease (related to spinal canal narrowing)
Benefits of the MILD® Procedure
Minimally invasive lumbar decompression is an emerging technology that offers several advantages over traditional treatments, including:
- Minimally Invasive: No general anesthesia, no stitches, and a tiny incision make it easier on the body. [6]
- Fast Recovery: Many patients walk out the same day and return to normal routines within a few days. [3]
- Drug-Free Solution: Helps reduce reliance on addictive pain medications, especially opioids. [3]
- Long-Lasting Relief: Clinical studies show sustained improvements in function and pain levels for up to two years or more. [7]
- No Open Surgery: Provides a highly effective alternative for patients who aren’t candidates for or want to avoid major surgery. [1]
- Low Risk of Complications: Reported complication rates are lower than traditional decompression surgeries. [8]
- Covered by Medicare and Most Insurances: Helps make this procedure accessible to many patients in need. [3]
Consult a MILD® Procedure Specialist for Pain Management
If you’re dealing with chronic back or leg pain from lumbar spinal stenosis or another condition that narrows the spinal canal, the MILD® procedure may be the advanced solution you’ve been looking for. Needing to sit, bend forward, or curl into a fetal position just to get temporary relief isn’t a sustainable way to live.
This minimally invasive treatment offers an alternative to traditional surgery—ideal for patients who can’t tolerate major procedures or simply want to avoid them. With a low risk of complications, it’s a proven next step when conservative treatments like physical therapy, medications, and epidural injections haven’t worked.
You don’t have to keep suffering with daily pain, numbness, or tingling that gets worse when standing or walking—basic activities that you shouldn’t have to sacrifice. Talk to a pain management specialist to see if the MILD® procedure is right for you. Getting evaluated early can help you stay active and comfortable—without resorting to invasive back surgery.
Frequently Asked Questions About Minimally Invasive Lumbar Decompression (MILD) Procedure
How can I tell whether MILD Procedure is helping?
Before MILD Procedure, identify two or three measurable goals such as sleeping longer, walking farther, sitting through work, using less rescue medication, or completing a specific daily task. After treatment, record both symptom changes and functional changes over the timeframe provided by the clinician. Improvement may be immediate, gradual, partial, or temporary depending on the treatment. A structured record is more useful than relying on a single pain score and helps the care team decide whether to continue, modify, or stop the approach.
Can MILD Procedure be repeated or continued long term?
Whether MILD Procedure can be repeated or continued depends on what the treatment involves, the benefit achieved, side effects, cumulative risks, and available alternatives. Some treatments are designed as a limited trial, some can be repeated at clinically appropriate intervals, and others are intended as one-time procedures with ongoing follow-up. Patients should ask what result would justify another treatment and whether there is a recommended limit. Continued use should be based on documented improvement in function or quality of life, not routine scheduling alone.
What questions should I ask when comparing MILD Procedure with alternatives?
Ask how MILD Procedure fits the suspected pain source, what level and duration of improvement are realistic, what evidence supports its use for the specific diagnosis, and which risks matter most for your health history. Compare recovery demands, the need for repeat care, cost, and what happens if the treatment is unsuccessful. It is also reasonable to ask about doing nothing immediately or trying a less invasive option first. A useful decision reflects the patient’s goals and preferences as well as technical eligibility.
How should follow-up be planned after starting MILD Procedure?
Follow-up after MILD Procedure should occur at a time when the expected response can be evaluated meaningfully. The care team should explain what changes may occur first, what information to track, which activities or medicines require special instructions, and whom to contact with concerns. Bring a record of symptom relief, function, side effects, and any new medical events to the visit. Earlier contact is appropriate for unexpected severe symptoms, while routine questions can usually be addressed at the planned reassessment.
How should I set realistic goals for MILD Procedure?
A realistic goal for MILD Procedure is usually specific and functional rather than simply “zero pain.” Examples include tolerating rehabilitation, sleeping with fewer interruptions, returning to part of a work schedule, or reducing reliance on rescue medication. The expected magnitude and timing of benefit depend on the diagnosis and treatment type. Discuss what would count as meaningful improvement before treatment begins, because that benchmark makes later decisions clearer and helps prevent continuing care that is burdensome without producing worthwhile benefit.
Which records should I bring when discussing MILD Procedure?
Useful records for a consultation about MILD Procedure may include imaging and reports, procedure or operative notes, medication history, rehabilitation summaries, allergy information, and a list of prior treatments with their results. Device information and relevant laboratory or nerve-test reports may also matter. Organize documents chronologically and identify the current functional problem you want addressed. Complete records help the clinician avoid repeating ineffective care and determine whether the treatment matches the suspected source of pain.
Can MILD Procedure be combined with physical therapy or other pain treatments?
MILD Procedure may be one part of a broader plan that includes rehabilitation, medication, behavioral strategies, lifestyle changes, or another procedure. Whether treatments should be combined or separated depends on the diagnosis, expected response, medical history, and the need to determine which intervention produced a benefit or side effect. Patients should give every treating clinician an updated list of therapies and avoid adding or stopping treatment independently. Coordinated timing can support recovery while reducing duplicated care or conflicting instructions.
What happens if MILD Procedure does not provide enough relief?
An incomplete response to MILD Procedure does not automatically mean that no other options remain. The clinician may reassess the diagnosis, confirm whether enough time has passed to judge the result, review technique or adherence, and look for more than one source of pain. The next step might involve rehabilitation, medication adjustment, a different targeted treatment, further testing, or referral to another specialist. Repeating an ineffective treatment without a clear reason is generally less useful than reviewing why the expected goals were not met.
Resources:
- Yuan H, Yi X. Lumbar Spinal Stenosis and Minimally Invasive Lumbar Decompression: A Narrative Review. J Pain Res [Internet]. 2023;16:3707-3724. Published 2023 Nov 6. doi:10.2147/JPR.S428112. Accessed April 30, 2025. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC10637222/
- Understanding types of back surgery. Mayo Clinic Health System [Internet]. Published May 20, 2022. Accessed April 30, 2025. Available from: https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/understanding-types-of-back-surgery
- Mild® Procedure for Lumbar Spinal Stenosis (LSS). Vertos Medical [Internet]. Published October 7, 2024. Accessed April 30, 2025. Available from: https://www.vertosmed.com/patients/
- Deer TR, Costandi SJ, Washabaugh E, Chafin TB, Wahezi SE, Jassal N, Sayed D. The MOTION Study: A Randomized Controlled Trial with Objective Real-World Outcomes for Lumbar Spinal Stenosis Patients Treated with the mild® Procedure: One-Year Results. Pain Med [Internet. 2022 Apr 8;23(4):625-634. doi: 10.1093/pm/pnac028. PMID: 35167700; PMCID: PMC8992575. Accessed April 30, 2025. Available from: https://pubmed.ncbi.nlm.nih.gov/35167700/
- Lumbar Decompression Surgery – When it’s Used. NHS [Internet]. Accessed April 30, 2025. Available from: https://www.nhs.uk/conditions/lumbar-decompression-surgery/why-its-done/
- Minimally Invasive Lumbar Decompression (MILD). UK HealthCare [Internet]. Published 2025. Accessed April 30, 2025. Available from: https://ukhealthcare.uky.edu/interventional-pain-medicine/treatments/minimally-invasive-lumbar-decompression
- Lawrence MM, Hayek SM. Minimally invasive lumbar decompression: a treatment for lumbar spinal stenosis. Curr Opin Anaesthesiol [Internet]. 2013 Oct;26(5):573-9. doi: 10.1097/01.aco.0000432520.24210.54. PMID: 23963231. Accessed April 30, 2025. Available from: https://pubmed.ncbi.nlm.nih.gov/23963231/
- Benyamin RM, Staats PS, MiDAS Encore I. MILD® Is an Effective Treatment for Lumbar Spinal Stenosis with Neurogenic Claudication: MiDAS ENCORE Randomized Controlled Trial. Pain Physician [Internet]. 2016 May;19(4):229-42. PMID: 27228511. Accessed April 30, 2025. Available from: https://pubmed.ncbi.nlm.nih.gov/27228511/