Low back disc and sciatica
A slipped disc is the most common cause of sciatica, and most of this pain improves without surgery. Surgery is for when other treatments have not helped or when weakness and numbness get worse.
What is a disc, and why does it hurt the leg?
Soft cushions called discs sit between the bones of the spine. Sometimes part of a disc pushes backward and presses on the nerve passing there. This is the most common cause of sciatica, and it becomes more likely with age.
That is why in sciatica the leg usually hurts more than the back. If you only have back pain and it does not travel down the leg, you probably do not have sciatica.
Signs
- Sharp or burning pain in the buttock and down the back of one leg, sometimes to the foot and toes
- Tingling and numbness
- Weakness in the leg
- Pain that gets worse with movement, sneezing or coughing
Some people have a slipped disc and no symptoms at all, so an MRI result alone is not enough. This article explains more.
Treatment without surgery
This is almost always the first path. According to the American Association of Neurological Surgeons, sciatica symptoms improve with time in about 9 out of 10 people.
- Carrying on with daily activity as far as you can
- Exercise and stretching with a physiotherapist
- Pain relief as your doctor advises
- A heat pack on the sore area
- Avoiding long periods of sitting or lying down
If the pain is severe and these do not help, an epidural injection or other procedures may be offered.
When does surgery come up?
- Symptoms have not improved with other treatments
- Muscle weakness or numbness is getting worse
- The emergency signs below appear
The operation usually removes the part of the disc pressing on the nerve, sometimes with a little bone so the nerve has more room. Not everyone needs all of this, and the type of operation depends on your case.
Risks of surgery
Spine surgery carries a risk of infection, bleeding, nerve injury, and a spinal fluid leak with headaches. Pain may not go away completely, or may return later. Go through these with your surgeon before you decide.
These signs cannot wait for an appointment
If any of these appear with back pain or sciatica, call 115 (Iran’s emergency number) or go to an emergency department, and do not drive yourself:
- Sciatica in both legs
- Severe or worsening weakness or numbness in both legs
- Numbness around the groin, genitals or anus
- Trouble starting to pass urine, being unable to pass urine, or losing control of urine
- Not noticing the need to pass stools, or losing control of them
These can be signs of serious pressure on the nerves and need checking in hospital as soon as possible.
Frequently asked questions
Should I stay in bed until the disc heals?
No. Bed rest is not recommended. If the pain is severe, do less for a day or two, then start walking and gentle exercise. Moving, even when it hurts, is not harmful and can speed recovery.
How long should I wait?
Sciatica usually improves in a few weeks to a few months. See a doctor if you are no better after a few weeks of treatment, if the pain gets worse, or if it stops your daily activities. Worsening weakness or numbness should not wait.
Can a disc come back after surgery?
It can. After any spine operation, back pain and later problems may return. Staying active, lifting correctly and not smoking all help.
Bring your images. We read them together.
Go to the booking page or talk to support. Bring the CD or film of your MRI and CT with you.