Disc Herniation
Also known as: Slipped disc، Herniated disc، Prolapsed disc، Ruptured disc
Disc herniation happens when the soft inner core of a spinal disc pushes through the tougher outer ring, pressing on nearby nerves. It causes back or neck pain that often radiates into the leg or arm.
Common Symptoms
- Back or neck pain — often sudden after lifting or twisting
- Pain radiating down one leg (lumbar) or down one arm (cervical) — sciatica
- Numbness or tingling in the leg, foot, arm, or hand
- Muscle weakness in the affected limb
- Pain worsened by sitting, sneezing, coughing, or bending forward
- Pain that eases with lying down
- In severe cases: difficulty controlling bowel or bladder (cauda equina — emergency)
Causes & Risk Factors
- Age-related disc degeneration (30s-50s most common)
- Sudden heavy lifting with poor technique
- Repetitive bending, twisting, or sitting
- Obesity — increased load on spinal discs
- Smoking — reduces disc nutrition and accelerates degeneration
- Genetic predisposition
- Sedentary lifestyle with weak core muscles
Treatment Options
Activity modification (not bed rest)
Reduce aggravating activities (heavy lifting, prolonged sitting) while staying gently active. Walking 15-30 minutes daily is therapeutic. Prolonged bed rest worsens outcomes.
Targeted physical therapy
Spine-trained physiotherapist using McKenzie method, neural mobilization, and core stabilization. Most patients see meaningful improvement in 4-6 weeks.
Short-course NSAIDs
10-14 days of ibuprofen or diclofenac to control inflammation around the irritated nerve. Breaks the pain cycle and allows PT participation.
Epidural steroid injection
Cortisone injected directly around the inflamed nerve root. About 60-70% of patients get significant relief lasting 2-3 months. Reserved for cases not responding to PT after 6 weeks.
Microdiscectomy (minimally invasive surgery)
2-3 cm incision, removes the part of the disc pressing on the nerve. Often day-case. Most patients report dramatic leg-pain relief within hours. Return to desk work in 2-3 weeks.
When to See a Doctor
- Back or neck pain persisting more than 4-6 weeks
- Pain radiating into the leg or arm
- Numbness or weakness in a limb
- Pain after significant trauma (fall, accident)
- Cauda equina symptoms (URGENT): loss of bladder/bowel control, numbness in groin/inner thighs, severe leg weakness
- Pain with fever, weight loss, or history of cancer
Frequently Asked Questions
Can a disc herniation heal without surgery?
Yes — about 70% of disc herniations resolve with conservative treatment in 6-12 weeks. The body reabsorbs the herniated material and inflammation settles. Imaging follow-up often shows the herniation has shrunk or disappeared.
How long should I try conservative treatment before considering surgery?
Standard: 6-12 weeks of structured conservative care. If pain hasn't meaningfully improved, consider an epidural injection. If still no improvement, surgical consultation. Exception: progressive neurological deficit or cauda equina — immediate evaluation.
Will my MRI show if I need surgery?
No — clinical symptoms determine surgery, not the MRI alone. Up to 30% of pain-free people have disc herniations visible on MRI. The decision is based on whether symptoms match the MRI findings AND haven't responded to conservative care.
What is microdiscectomy recovery like?
Walking same day, home next day, return to desk work 2-3 weeks, return to physical work 6-8 weeks, return to sport 8-12 weeks. Most patients describe dramatic leg-pain relief immediately after surgery.
Are epidural injections safe?
Yes when done by an experienced specialist under imaging guidance. Limited to 2-3 per year. Most patients tolerate well; about 60-70% experience significant pain relief lasting weeks to months.