What it is
A lumbar disc herniation occurs when the soft inner material of a spinal disc pushes through a weakened area of the disc's outer wall, in the lower back. The displaced material can irritate or compress a nearby nerve root.
Symptoms
- Lower back pain, sometimes radiating into the buttock or leg
- Sciatica — pain that travels down the back or side of the leg
- Numbness or tingling in the leg or foot
- Weakness in specific leg or foot movements
- Symptoms that worsen with sitting, bending or coughing
Causes
- Age-related disc degeneration
- Repetitive bending or lifting
- A single strenuous lifting injury
- Genetic predisposition to disc problems
Diagnosis
Diagnosis begins with a clinical history and a neurological examination assessing strength, sensation and reflexes. MRI is the primary imaging investigation used to confirm a disc herniation and identify which nerve root is affected.
MRI findings
MRI typically shows a focal protrusion or extrusion of disc material at the affected level, often with associated compression or displacement of the adjacent nerve root.
Non-surgical treatment
- Activity modification and short-term rest from aggravating movements
- Physiotherapy focused on core stability and nerve mobility
- Anti-inflammatory medication
- Epidural steroid injections in selected cases
Considering this for your case?
Send your MRI or CT for a specialist opinion before deciding on treatment.
When surgery may be considered
Surgery is generally considered when leg pain and neurological symptoms persist despite 6–8 weeks of appropriate non-surgical care, when there is progressive weakness, or when there are signs of cauda equina syndrome, which requires urgent evaluation.
Surgical options
- Microdiscectomy
- Endoscopic discectomy
- Open discectomy in selected complex cases
Recovery
Most patients are mobilised within a day of surgery and return to light activity within 2–4 weeks, with a graded return to physical work over 6–12 weeks depending on the procedure and occupation.
Risks
- Recurrent disc herniation at the same level
- Nerve irritation or, rarely, nerve injury
- Infection
- Incomplete relief of symptoms
Questions to ask your surgeon
- Is surgery necessary now, or can it reasonably wait?
- What non-surgical options are appropriate for my case?
- What are the realistic risks and recovery timeline for me specifically?
Indicative treatment cost
Costs vary by procedure and case complexity. See the spine surgery cost page for indicative planning ranges.
Frequently asked questions
No. Most cases are managed with non-surgical treatment first. Surgery is discussed only when appropriate criteria are met, as outlined above.
Diagnosis begins with a clinical history and a neurological examination assessing strength, sensation and reflexes. MRI is the primary imaging investigation used to confirm a disc herniation and identify which nerve root is affected.
Recent MRI or CT images and reports, a summary of symptoms and duration, and details of any treatment already tried.