Lumbar microdiscectomy: removing a slipped disc to free a trapped nerve

A disc is the cushion between two spinal bones. If part of it bulges or splits and presses on a nerve root, the result can be sharp leg pain, tingling, numbness or weakness, usually called sciatica when it follows the sciatic nerve. The NHS says sciatica usually gets better in a few weeks to a few months, but can sometimes last longer.

Because most people improve without an operation, surgery is not the default. North Bristol says surgery is not always offered and is rarely offered for chronic back pain alone, since it addresses the nerve irritation rather than general back discomfort. The NHS says a specialist referral to discuss surgery arises when symptoms have not improved with other treatments or when muscle weakness or numbness is getting worse.

The usual sequence starts with keeping active and taking painkillers as advised. The NHS lists anti-inflammatory painkillers, short courses of stronger painkillers, muscle relaxants, physiotherapy and steroid injections. North Bristol adds nerve root block injections as an option, noting that conservative treatment can reduce symptoms.

An MRI scan is usually part of the decision if symptoms persist, because it shows which disc and which nerve are involved and whether the picture fits the symptoms. Ask your clinician what the scan shows and whether the level matches where you feel the problem.

At pre-assessment you will be asked about medicines, allergies and other conditions, and given fasting instructions for the general anaesthetic. Tell the team about blood thinners and any recent infection. If you smoke, ask for support to cut down or stop before surgery.

Plan how you will manage the first few days: a firm chair with arms, a way to avoid long periods of sitting, and a short walking route near home. The Hull leaflet on back surgery recommends building walking up slowly, so it is worth deciding in advance where you will walk.

North Bristol says these operations are performed under a general anaesthetic and normally take 60 to 90 minutes. The surgeon works through the back, and the word micro in the name refers to the use of magnification; ask which approach your surgeon uses.

The fragment of disc pressing on the nerve is removed, freeing the nerve root. The skin is closed with paper strips, which North Bristol says stay for seven to ten days. A majority of North Bristol patients attend as a day case, and inpatients are usually discharged in one to two days, but your own hospital may differ.

North Bristol lists these figures in its leaflet: wound infection about 1%, a tear in the covering of the nerves (dural tear) 1 to 5%, nerve damage under 1%, return of the disc prolapse 5 to 10%, deep vein thrombosis 5 to 10% and pulmonary embolism 0.1%. These are one trust's numbers and your surgeon can explain how they apply to you.

Some leg pain may persist if the nerve was compressed for a long time, and back pain is often not fully relieved. The NHS treats cauda equina syndrome as an emergency separate from the operation: numbness around the bottom or genitals, losing feeling in one or both legs, being unable to pee or losing control of bladder or bowel need 999 or A&E.

North Bristol describes paper strips left in place for seven to ten days, driving usually around two to three weeks, light work after two to four weeks, avoiding heavy lifting for up to six weeks, and physiotherapy only recommended after six weeks.

Walking little and often is the main exercise, says the Hull leaflet, with sitting posture guided by comfort. The separate recovery timeline page puts these stages in order.

North Bristol says to contact the spinal team or your GP for constant pain that gets worse, worsening or new numbness, muscle weakness or a change in bladder function. The Hull leaflet adds fluid or bleeding coming through the dressing. Numbness around the bottom or genitals, inability to pass urine or loss of bladder or bowel control need 999 or A&E straight away, per the NHS.

• Does my scan show a disc that matches my leg symptoms?

• Is my weakness or numbness a reason to move faster?

• What are the risk figures in your own practice?

• Will I be a day case, and what should I arrange at home?

• What are the chances the disc will bulge again?

The operation is similar in both settings. On the NHS, access follows the referral and imaging pathway, and urgency is higher if there is progressive weakness. Privately you may reach a surgeon and a date sooner. Ask who will provide physiotherapy after six weeks and whether a review scan is included if symptoms return.