What is a slipped disc?
Between the bones of your spine sit soft discs that act like cushions. A “slipped” disc (the medical word is a herniated or prolapsed disc) happens when the soft centre of a disc pushes against, or through, its tougher outer wall.
The disc does not really slip. The name is just easy to say. The bulge can press on or irritate a nearby nerve, which is why the pain may travel into a leg or an arm.
What does it feel like?
Symptoms depend on which disc and which nerve. In the lower back, you may notice a deep ache that is worse on bending or sitting, and pain, tingling or numbness running down one leg.
Coughing, sneezing and long sitting can make it worse. Some people feel a weak foot or a leg that tires quickly. When the problem is in the neck, symptoms can travel into a shoulder, arm or hand. See sciatica for leg pain that follows the nerve.
Is the scan the whole story?
No. Scans show the structure, not the pain. A disc bulge can appear on a scan in a person who has no pain, and people with bad pain can have a modest-looking scan.
That is why we match the report with what we find when we test you. Our blog explains what scans do and do not tell you. Bring the report and ask us to explain it in plain words.
What does a physiotherapist check?
We listen to your story and test your movement, strength, reflexes and feeling in the legs. We note which positions ease the pain and which bring it on.
- Pain pattern and where it travels.
- Muscle strength in the legs and feet.
- Sensation and reflexes.
- Spine movement and nerve sensitivity.
- Warning signs that need a doctor.
A 2020 international framework notes that there is little high-quality evidence for the accuracy of most red flags, so they are used within clinical reasoning and not as stand-alone tests [1]. That is why we assess the whole picture, and not one sign alone.
How does physiotherapy help?
The aim is to settle the nerve irritation, keep you moving and rebuild the strength to protect the spine. Most plans move through three stages.
- Calming: find comfortable positions and short walks, and avoid movements that flare the leg pain.
- Moving: gentle exercises and manual therapy restore movement.
- Strengthening: hips, core and back muscles take load, so you can lift and bend again.
The World Health Organization (WHO) says painkillers should not be the first-line treatment for low back pain [2]. Your doctor may still prescribe medicine for a bad flare-up. Read more about surgery or physiotherapy for the back.
When do I need urgent care?
Go to the emergency department if you have weakness in both legs, numbness around the groin or seat, or new difficulty passing urine or controlling your bowels. These can signal pressure on the nerves at the base of the spine.
See a doctor soon if one leg or foot is getting steadily weaker, or if pain does not ease after a few weeks of proper care. See when to worry about back pain.
What can I do at home this week?
Use short walks instead of long rests. Change position every half hour when you sit. When you stand up from bed, roll onto your side and push up with your arms.
Avoid heavy lifting and long car trips while the pain is fierce. A home visit can adjust your bed, chair and sofa to ease the load. Learn about home physiotherapy; our Canning Garden centre is opening soon, and prices are quoted on WhatsApp.