First up, the good news: most slipped discs in the lower back heal WITHOUT surgery.
The pain usually starts easing within a few weeks, and most people are free of symptoms by 3 to 4 months.
The disc itself can heal too. In about 6 in 10 people treated without surgery, the part of the disc that pushed out shrinks or disappears on later scans. That takes months, not days.
Surgery is for a small group:
- people whose leg pain stays severe despite good care, whose leg is getting weaker, or
- who have the emergency signs listed at the end of this page
What a slipped disc actually is
- The disc is a cushion. Each disc sits between two bones of your spine. It has a tough outer ring and a soft, jelly-like center
- “Slipped” is the wrong word. Nothing slides out of place. The outer ring tears and some of the soft center bulges or pushes through. Doctors call this a herniated or prolapsed disc
- Most happen low down. The lowest two discs in your back carry the most load, and that’s where most herniations happen
- It can cause back pain, leg pain, or both. Back pain can come from the disc itself. Pain that shoots down past the knee means the disc is pressing on a nerve, which is sciatica. See sciatica and how long it lasts
Your scan may look worse than you feel
Disc changes are extremely common in people with NO back pain at all. Scans of pain-free adults show a disc bulge in about 1 in 3 people in their 20s, rising to more than 8 in 10 by age 80.
- A bulge on your report may be old news. It may have been there for years before your pain started
- The size on the scan doesn’t predict the pain. Some large herniations barely hurt, and some small ones hurt a lot
- A scan earns its place when it will change the plan, such as when surgery or an injection is being considered, or when warning signs appear
How the disc heals on its own
Your immune system treats the pushed-out disc material as something that doesn’t belong there. It sends cells to break it down and clear it away.
- Bigger herniations shrink MORE often. A piece that has broken off completely shrinks in nearly every case. Material that has pushed right through the outer ring shrinks in about 7 in 10
- Small bulges shrink least often, in roughly 1 in 8. They usually press on nerves less, so the pain often settles anyway
- It takes time. Shrinking is rarely seen in the first month or so. Most of it happens over several months
Pain tells you the disc is irritated. It doesn’t tell you it’s broken for good.
How long a slipped disc takes to heal
- The first few days: often the worst. Muscle spasm can leave you bent over and stiff, and getting out of bed or a chair hurts
- Weeks 1 to 6: pain usually starts to ease. Sitting and bending forward are often the last things to feel comfortable
- Months 3 to 4: most people are free of symptoms or close to it
- Beyond that: some people get flare-ups for longer, often after heavy lifting or long spells of sitting. A flare-up doesn’t mean a new injury
What helps a slipped disc heal
- Stay active. Walk little and often. Rest when you need to, but avoid spending days in bed
- Break up sitting. Sitting loads the disc more than walking does. Stand up and move every 20 to 30 minutes
- Find your easing position. Lying on your back with your knees bent, or on your side with a pillow between your knees, calms it for many people. Use whatever works for you
- Build back up gradually. A physio can guide exercise that loads your back safely at first, then strengthens it so you can bend and lift with confidence again
- Lift close to your body. While it’s sore, avoid lifting heavy things with your back rounded and the load held out in front of you
- Pain relief and heat: anti-inflammatory painkillers such as ibuprofen help some people. Check with your pharmacist that they’re safe for you. Heat can ease muscle spasm
Do you need surgery?
Most people don’t. Surgery is considered when:
- Leg pain stays severe after several weeks of good nonsurgical care
- Weakness in the leg or foot is getting worse, not better
- You have the emergency signs below. Then it’s urgent
The usual operation is a microdiscectomy, which removes the piece of disc pressing on the nerve. It’s done to relieve leg pain from a pinched nerve. Back pain on its own is rarely a reason for it.
Surgery tends to ease leg pain faster than waiting, and many people who wait end up in a similar place a year later. If leg pain has already dragged on for many months, surgery tends to do better. See microdiscectomy recovery week by week.
An injection around the nerve is sometimes offered for severe leg pain while you wait for the disc to settle. See epidural steroid injections.
Go to the emergency department now if
These can be signs of cauda equina syndrome, where a large disc squashes the bundle of nerves at the bottom of the spine. It’s rare, but it needs hospital treatment the same day. Don’t wait to see if it settles.
- New trouble peeing, not being able to pee, or leaking pee or poo without knowing
- Numbness around your genitals, buttocks or inner thighs, the area that would touch a saddle
- Weakness or numbness in BOTH legs, or sciatica in both legs
- New problems getting an erection, or loss of feeling during sex
Get it checked if
- Your foot catches or slaps when you walk, or your leg is getting weaker
- The pain isn’t improving at all after 4 to 6 weeks
- You also have a fever, weight loss you can’t explain, or a history of cancer
- The pain is constant and worse at night, whatever position you’re in
A slipped disc hurts like serious damage, but in most people it settles by itself.