Herniated (slipped) disc: symptoms, treatment and recovery

The NHS lists lower back pain, numbness or tingling in the shoulders, back, arms, hands, legs or feet, neck pain, problems bending or straightening your back, muscle weakness, and pain in the buttocks, hips or legs if the disc is pressing on the sciatic nerve (sciatica). It also says not all slipped discs cause symptoms, and many people will never know they have slipped a disc.

The NHS sciatica page describes sciatica as a sharp, burning pain down the back of the leg, with tingling, numbness or weakness. The pain may be worse when moving, sneezing or coughing, and back pain, if present, is not usually as bad as the leg pain. It adds that you probably do not have sciatica if you only have back pain.

The NHS says keeping active and taking painkillers can help ease the pain from a slipped disc. If the pain is very bad you may need to rest at first, but you will get better more quickly if you gradually start gentle exercise such as walking, swimming and yoga as soon as you can. The type of exercise is not important as long as it does not cause pain or make your back pain worse.

Try anti-inflammatory painkillers such as ibuprofen regularly (up to the recommended daily amount) rather than just when the pain is bad, to help you keep moving. Anti-inflammatories are not suitable for everyone, so check with a pharmacist. Stronger painkillers containing codeine can help with pain that has just started, but can cause addiction and should only be used for a few days.

If symptoms do not get better, a GP might prescribe a stronger painkiller, a steroid injection or a muscle relaxant for short-term use, refer you for tests like an MRI scan, or for physiotherapy. The NHS says there is some evidence that manual therapies like osteopathy can help ease lower back pain, though usually you pay for this privately.

The NHS describes the discs as soft cushions of tissue between the bones in your spine. In a herniated disc, the cushion bulges outwards, and it is painful if it presses on nerves. Herniated, slipped and prolapsed disc are different names for the same thing.

The NHS says a slipped disc is the most common cause of sciatica, and that sciatica happens when the sciatic nerve, which runs from the lower back to the feet, is irritated or compressed.

The NHS lists ageing, exercising too hard, lifting heavy objects the wrong way, sitting or driving for long periods, and being inactive or overweight. It also says nicotine weakens the disc tissue in the spine, so smoking is a risk.

To help prevent a slipped disc it recommends keeping active with regular exercise, using a safe technique when lifting heavy objects, and not smoking.

The NHS says a slipped disc usually gets better slowly with rest, gentle exercise and painkillers. For sciatica it says symptoms usually get better in a few weeks to a few months but can sometimes last longer, and sciatica can return if you have had it before.

The NHS suggests seeing a GP if painkillers are not helping, if the pain is not getting better after a few weeks, or if it is stopping you doing normal activities.

Surgery is not usually needed, according to the NHS. A GP might refer you to a specialist to discuss surgery if your symptoms have not improved using other treatments, or include worsening muscle weakness or numbness.

For sciatica, the NHS says that if pain is severe and treatments have not helped, you may be referred to a hospital specialist for options including a procedure to seal off some nerves (radiofrequency denervation), a painkilling injection such as an epidural, or decompression surgery, which can sometimes help relieve sciatica.

The NHS says to call 999 or go to A&E if you have back pain and numbness around your bottom or genitals, cannot pee, lose feeling in one or both legs, cannot control when you pee or poo, or if it started after a serious accident such as a car crash. For sciatica it adds sciatica on both sides and weakness or numbness in both legs that is severe or getting worse. These could be symptoms of a serious back problem that needs treatment in hospital as soon as possible.

See a GP if you have back pain with a very high temperature or feeling hot, cold or shivery, unexplained weight loss, a swelling in your back, or pain that is worse at night. Do not drive yourself to A&E.

In many areas you can refer yourself to NHS community musculoskeletal (MSK) services for physiotherapy without a GP referral. The NHS notes physiotherapy may not be available everywhere and waiting times can be long, and that you can also get it privately.

Private physiotherapy, osteopathy and spinal consultant appointments are available to those who prefer to pay. Whichever route you use, the emergency signs above need NHS emergency care.