Slipped disc

A "slipped disc" (medically known as a herniated, prolapsed, or ruptured intervertebral disc) happens when the soft inner core of a disc between two vertebrae pushes out through the tougher outer layer. The bulging disc can press on a nearby nerve, causing pain, numbness, or weakness.

Symptoms

Symptoms depend on which part of the spine is affected. Most commonly the lower back:

• Back pain (less often the main symptom)
• Sciatica — pain shooting down one leg, sometimes to the foot; may be sharp, burning, or electric-shock-like
• Numbness or tingling in a leg or foot
• Weakness in a leg or foot
• Worsened pain with sneezing, coughing, or straining

A slipped disc in the neck can cause arm pain, numbness, or weakness.

Seek urgent help (dial 112 or go to hospital) for any of the following — these can signal cauda equina syndrome, a neurological emergency:

• New loss of bowel or bladder control
• Numbness around the genitals or anus ("saddle anaesthesia")
• Sudden severe weakness in both legs

Causes and risk factors

• Age-related wear and tear on the spine — most common cause
• Heavy lifting with poor technique
• Sudden twisting or straining
• Occupations involving repetitive bending, lifting, or driving
• Sedentary lifestyle with weak core muscles
• Overweight
• Smoking (reduces disc blood supply)

Diagnosis

Usually a clinical diagnosis from history and examination. MRI is the most informative imaging — but not needed for everyone. Most people with back pain DON'T need an MRI; it's indicated when there are signs of nerve involvement, symptoms persisting beyond 4-6 weeks, or red-flag features.

Treatment

Most slipped discs improve over weeks to months without surgery:

• Stay as active as the pain allows — long bed rest makes things worse, not better
• Pain relief — paracetamol, NSAIDs, short courses of stronger painkillers if needed
• Physiotherapy — targeted exercises to strengthen the core and support the spine; manual therapy
• Epidural steroid injections — for severe nerve-root pain not responding to other measures
• Heat, ice, and gentle movement — simple measures that many find helpful
• Surgery — considered for persistent severe pain, progressive weakness, or cauda equina syndrome. Most commonly microdiscectomy, which has good outcomes in selected patients.

Prevention and long-term care: maintain a healthy weight, build core strength (yoga, planks, swimming), lift correctly (with legs, not back), take breaks from prolonged sitting, and don't smoke.