A disc in your lower back presses on a nerve, sending pain down one leg. Most people recover within six to twelve weeks without surgery. Surgery is for the ones who don't, or for weakness that is getting worse.
Reviewed by Dr. Kshitij Chaudhary, Last reviewed September 2026
What Is a Lumbar Disc Herniation?
The discs between the bones of your spine act as cushions. Each one has a tough outer ring and a soft, jelly-like centre. A herniation happens when the outer ring tears and some of the centre pushes out. People often call this a slip disc or slipped disc, though the disc doesn't actually slip.
What Is Sciatica?
When the pushed-out disc presses on a nerve root, it sends pain down the leg along the sciatic nerve. That leg pain is sciatica.
A herniated disc is the most common cause, but not the only one. Narrowing of the spinal canal (Lumbar Spinal Stenosis) and a slipped vertebra (Spondylolisthesis) can cause it too.
What Causes It?
Most herniations have no single cause. Discs lose water and weaken with age, which makes a tear more likely. Heavy lifting, repeated bending and twisting, your genes and smoking all add to the risk.
Who Gets It?
It is most common between the ages of 30 and 50. The two lowest discs, L4–L5 and L5–S1, are affected most often.
How Serious Is It?
It can be very painful, but it is rarely dangerous. Many people worry about paralysis. That fear is almost always unfounded. Read more: Will my slipped disc cause paralysis? →
Many people with no back pain at all show disc bulges on their MRI. A herniation on your report matters only if it matches your symptoms. Read more: How to Read Your Spine MRI Report → and Common myths about low back pain →
What Symptoms Does It Cause?
- Sharp, shooting or burning pain from the buttock down the leg, often below the knee
- Numbness or pins and needles in the leg or foot
- Weakness in the leg or foot, such as trouble lifting the front of the foot
- Lower back pain, usually milder than the leg pain
- Pain that gets worse when you sit, cough, sneeze or bend forward
Get seen urgently if
You lose control of your bladder or bowel, go numb around the groin or inner thighs, or your leg weakness is getting worse by the day. These are uncommon, but they need same-day assessment. Read more: Cauda Equina Syndrome →
How Is It Diagnosed?
- Examination: Your doctor checks your leg strength, sensation and reflexes, and does a straight leg raise test
- MRI: The most useful test. It is usually not needed in the first 4–6 weeks, unless you have weakness or warning signs, because most people improve anyway
- X-rays: These check alignment and rule out other causes
Will It Get Worse?
Usually it gets better. The inflammation around the nerve settles, and the body often reabsorbs part of the pushed-out disc. Large herniations can shrink the most.
Most people recover within 6 to 12 weeks without surgery.
How Is It Treated Without Surgery?
- Staying active: Keep moving as much as you comfortably can. Avoid bed rest
- Medicines: Pain relievers, anti-inflammatory tablets and nerve pain medicines can help. Do not use anti-inflammatory tablets for more than about 10 days in a row without asking your doctor
- Physiotherapy: Exercises improve movement and strengthen your core and back. Try the Exercise Programme for Sciatica from a Slipped Disc →
- Injection: In some people, an injection around the irritated nerve eases the pain
The first weeks of back and leg pain follow the plan in The Back Pain Guide.
When Is Surgery Needed?
Only a small number of people need surgery. It is considered when:
- Leg pain stays severe after about 6 weeks of proper non-surgical treatment
- Leg weakness develops or gets worse
- There are signs of cauda equina syndrome, which is an emergency
A herniation on your MRI is not, by itself, a reason for surgery.
If you have been advised surgery and aren't sure, you can send your MRI for a second opinion before deciding.
What Does Surgery Involve?
- Microdiscectomy: Your surgeon removes only the piece of disc pressing on the nerve, through a small cut
- Minimally invasive decompression: The same aim, done through a narrow tube that spares the muscles
Your surgeon will explain which suits you.
How Long Is Recovery?
Leg pain often eases soon after surgery. Most people walk on the day of surgery and go home the next day. Numbness and weakness recover more slowly, because nerves heal slowly.
Can I Prevent It?
Not always. Keeping your core strong, lifting with your legs, not smoking and staying at a healthy weight lower the risk.
What Questions Should I Ask My Doctor?
- Which disc is herniated, and which nerve is it pressing on?
- Is my leg pain coming from this disc?
- Do I have any weakness?
- How long should I try non-surgical treatment?
- If I need surgery, which type, and why?
- When can I go back to work, driving and exercise?
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About Dr. Kshitij Chaudhary
This page was written by Dr. Kshitij Chaudhary, a fellowship-trained spine surgeon at P.D. Hinduja Hospital, Mumbai, trained in complex spine surgery at Harvard Medical School (Beth Israel Deaconess) and the Twin Cities Spine Center, Minneapolis. About Dr. Chaudhary
This page is for general information and does not replace a medical consultation. Please see a doctor for advice about your own symptoms.
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