Overview
A lumbar disc prolapse (also called a slipped disc or herniated disc) happens when one of the soft cushions (discs) between the bones of your lower spine bulges or ruptures. This can sometimes press on nearby nerves, causing pain in the lower back or shooting pain down the leg (commonly called sciatica).
It is a very common condition, especially in people aged 30–50 years. The good news is that most cases improve naturally with rest, medication, and physiotherapy, and only a small percentage of patients require surgery.
Causes
The main reasons why a lumbar disc prolapse develops include:
- Age-related disc changes – Discs lose water content with age, making them less flexible and more prone to injury.
- Sudden strain or lifting – Heavy lifting, twisting, or bending awkwardly.
- Repetitive stress – Jobs or sports that involve repeated bending, sitting, or vibration.
- Genetic factors – A family history of disc problems may increase risk.
- Lifestyle factors – Sedentary habits, smoking, obesity, or poor posture.
Studies show that lumbar disc herniation affects about 2–3% of the population at some point in life.
Signs and Symptoms
Patients may notice:
- Low back pain – Aching or sharp pain.
- Leg pain (sciatica) – Pain radiating from the back into the buttock, thigh, or calf.
- Numbness or tingling – In the leg or foot.
- Weakness – Difficulty lifting the foot or toes (in severe cases).
- Pain with movement – Bending, coughing, or sneezing may worsen symptoms.
Rarely, severe nerve compression can cause loss of bladder or bowel control, which requires urgent medical attention.
Treatment Options
Conservative (Non-surgical) Treatments – First Step
Most people improve within 6–12 weeks without surgery. Options include:
- Medications – Pain relievers (NSAIDs), short courses of muscle relaxants.
- Physiotherapy – Gentle stretching, core strengthening, and posture correction.
- Activity modification – Avoid heavy lifting but remain as active as possible.
- Heat or cold therapy – For pain relief.
- Epidural steroid injections – In some cases, to reduce inflammation around the nerve.
Research shows that 80–90% of patients with lumbar disc prolapse recover without surgery.
Surgical Treatments – When Necessary
Surgery may be considered if:
- Pain is severe and persistent despite several weeks of conservative treatment.
- There is progressive weakness, numbness, or difficulty walking.
- There are signs of cauda equina syndrome (bladder/bowel issues, severe nerve compression).
Common procedures include:
- Microdiscectomy – Removal of the part of the disc pressing on the nerve.
- Endoscopic discectomy – A minimally invasive approach using a camera and small instruments.
Surgical success rates are high, with 90–95% of patients experiencing significant relief from leg pain (sciatica).
Frequently Asked Questions
No. Most people recover with non-surgical treatment. Surgery is needed only in a small percentage of severe or persistent cases.
Many patients feel better within 6–12 weeks. Recovery may be faster with guided physiotherapy and lifestyle changes.
Yes. The body can naturally shrink or absorb the herniated part of the disc over time, reducing pressure on the nerve.
Yes, gentle and supervised exercises are very important. They help strengthen the spine and prevent recurrence. Avoid heavy lifting and high-impact activities until recovery.
If you develop sudden leg weakness, difficulty walking, or bladder/bowel control problems, you should see a doctor immediately.
