Slipped disc

At a glance

  • A slipped disc in the lumbar (lower back) region can cause spinal disc tissue to press on nerves.
  • That can cause severe pain that sometimes spreads to the leg.
  • The symptoms usually go away on their own after a few weeks.
  • Until then, it’s a good idea to treat the pain and stay as active as possible.
  • In rare cases, it might also cause paralysis, tingling in the legs, or bladder or bowel problems. Surgery might then be needed.


Photo of a patient and doctor with x-ray image

Many people have back pain that keeps on returning. Usually it is hard to say what the exact cause is. But pain that shoots down your leg can be a sign of a slipped disc.

The spinal discs are found between the bones (vertebrae) in the spine. They have an elastic casing made of cartilage and a gel-like center (nucleus pulposus). A slipped disc occurs if the spinal disc tissue pushes out, or "herniates," between the vertebrae. This herniated tissue may put pressure on the spinal nerves and irritate them.

A slipped disc can be very unpleasant. But the good news is that the symptoms usually go away on their own within less than six weeks. And not every slipped disc is painful.


A slipped disc can cause very sudden and severe shooting pain. If it occurs in the neck area, the pain might radiate into the arms. If it occurs in the chest area, the pain might spread to the upper back. Slipped discs are most common in the lumbar region of the lower back, though. That is why this article is mainly about this type of slipped disc.

Slipped discs in the lumbar (lower back) region are the main cause of sciatica. The term sciatica is used when pain radiates into the leg. As well as the typical radiating pain, a slipped disc can also lead to pain in the lower back region.

Along with the pain, some people might also experience numbness in the bottom, paralysis in the legs, or bladder and bowel problems (Cauda equina syndrome). These symptoms are signs of a more serious problem, like nerve damage.

But a slipped disc doesn't always lead to noticeable symptoms. This can be seen in studies in which adults who didn't have back pain were examined using (MRI): Around 30 out of 100 study participants between the ages of 20 and 30 had a herniated disc, but no symptoms. Roughly 40 out of 100 participants aged 50 or over didn't have any symptoms even though they had a herniated disc.


In most people, slipped discs are the result of wear and tear. Over the years, the spinal discs lose their elasticity: Fluid leaks out of them and they become brittle and cracked. These changes are a normal part of the aging process – which varies from person to person, though. Very rarely, an accident or severe injury might also cause damage to a spinal disc and leave it herniated.

Spinal discs act as shock absorbers between the vertebrae in our spine. If a spinal disc is no longer able to bear the strain, it can result in a slipped disc. The associated pain probably arises when part of the spinal disc pushes against a nerve in the spinal cord.

Illustration: Healthy disc and slipped disc (cross-sectional view of the lumbar spine – from above)

When herniated disc tissue irritates a nerve root in the region of the (lower back), it often causes typical sciatic pain. The nerves that run through the spinal canal connect to the sciatic nerve at the pelvis. The sciatic nerve then runs down the legs. As well as being painful, an irritated sciatic nerve can also cause pins and needles and numbness.

Illustration: Position of the spinal and sciatic nerves

Doctors distinguish between the following types of slipped disc problems:

  • Protrusion: The spinal disc is pushing out from between the vertebrae, but its outer layer is still intact.
  • Extrusion: The outer layer of the disc is torn and the disc tissue has leaked out, but this tissue is still connected to the disc.
  • Sequestration: Disc tissue has entered into the spinal canal and is no longer directly connected to the disc.
Illustration: Types of slipped discs: Protrusion, extrusion and sequestration (cross-sectional view of the lumbar spine – from above)

Extrusion and sequestration more commonly cause leg symptoms than protrusion. Knowing what type of slipped disc someone has can be important when choosing the treatment and understanding how the condition might develop.


It is estimated that 1 to 3% of all people in western industrialized countries will have back pain caused by a slipped disc at some point in their lives. These symptoms are more common in people over the age of 30. They are about twice as common in men than in women.


Back pain goes away on its own within six weeks in about 90 out of 100 people. It is believed that, over time, the body gets rid of part of the prolapsed tissue or that it shifts position so that the nerves aren't irritated anymore.

A painful slipped disc can go on to develop in very different ways: The pain can start very suddenly, and then disappear again very quickly. Some people have permanent pain that lasts a long time, while others have it again and again.

If the symptoms last longer than six weeks, it is unlikely that they will go away on their own. They are considered to be chronic if they still haven’t gotten better after twelve weeks.


You doctor will ask about your symptoms and do a physical examination to find out what is causing acute back pain. Further testing such as an MRI scan () is only needed if you have

  • Numbness or paralysis in one or both legs
  • Impaired function of the bladder or bowel
  • Unbearable pain despite treatment
  • Back pain that doesn't get better after 4 weeks or leg pain that doesn’t get better after 2 weeks, or
  • Another condition that is thought to be causing the pain, for example a tumor.

There are often good reasons why doctors don't suggest doing any complex diagnostic tests at first if you have back pain: Imaging techniques may show a supposed cause of back pain that actually has nothing to do with the symptoms. This kind of misdiagnosis can then result in unnecessary treatment that may itself be harmful.


Even severe sciatic pain can go away on its own after a while. Until it does, various pain-relieving treatments can help to cope with the symptoms and stay as active as possible.

What are known as multimodal treatment programs, with treatment from specialists in different therapeutic areas such as medicine, physical therapy, and psychology, can be helpful especially if symptoms last for a long time and become chronic. They help you to stay active, cope with the pain, and perhaps also to learn and practice new behaviors.

Surgery can be an option if severe sciatic pain caused by a slipped disc persists for longer than 6 to 12 weeks despite pain-relief treatment. The aim is to take the pressure off the affected nerve.

Good to know:

This decision aid can help you to carefully weigh up the pros and cons of a treatment together with your doctor.

Surgery is needed right away if the nerves are so severely affected that you experience paralysis in your legs, or your bladder or bowels no longer function properly. The latter is a sign of what is called Cauda equina syndrome. This is a special emergency, but it is very rare.


The goal of rehabilitation is to improve the symptoms and restrictions resulting from a slipped disc, and strengthen the muscles in the torso to improve the stability of the spine.

Rehabilitation can include things like back training, stretching and relaxation exercises, and weight training. It can also provide motivation to take more regular daily exercise and help to cope with pain.

Rehabilitation programs can be an option for people who can’t work because of their back pain or who are very restricted in their daily life. Follow-up rehabilitation may help after surgery too.

It is important to also regularly exercise the joints and muscles after rehabilitation to maintain the improvements.

Further information

When people are ill or need medical advice, they usually go to see their family doctor first. In our topic "Health care in Germany" you can read about how to find the right doctor – and our list of questions can help you to prepare for your appointment.

In Germany there are numerous sources of support for people who have chronic back pain, including support groups and information centers. But there are often regional differences in how these services are organized, and they aren't always easy to find. You can use our list to help you find and make use of local services in Germany.

Brinjikji W, Luetmer PH, Comstock B et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol 2015; 36(4): 811-816.

Bundesärztekammer (BÄK), Kassenärztliche Bundesvereinigung (KBV), Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF). Nationale Versorgungsleitlinie Nicht-spezifischer Kreuzschmerz (in Überarbeitung). AWMF-Registernr.: nvl-007. 2021.

Czabanka M, Thome C, Ringel F et al. [Operative treatment of degenerative diseases of the lumbar spine]. Nervenarzt 2018; 89(6): 639-647.

Deutsche Gesellschaft für Neurologie (DGN). Lumbale Radikulopathie (S2k-Leitlinie). AWMF-Registernr.: 030-058. 2018.

Deutsche Gesellschaft für Orthopädie und Orthopädische Chirurgie (DGOOC), Deutsche Gesellschaft für Orthopädie und Unfallchirurgie (DGOU), Deutsche Gesellschaft für Neurochirurgie (DGNC) et al. Konservative, operative und rehabilitative Versorgung bei Bandscheibenvorfällen mit radikulärer Symptomatik (S2k-Leitlinie). AWMF-Registernr. (neu): 187-057. 2020.

Deyo RA, Mirza SK. Herniated Lumbar Intervertebral Disk. N Engl J Med 2016; 374(18): 1763-1772.

Jordan J, Konstantinou K, O'Dowd J. Herniated lumbar disc. BMJ Clin Evid 2011: pii: 1118.

Mayer HM, Heider FC. Der lumbale Bandscheibenvorfall. Orthopädie und Unfallchirurgie up2date 2016; 11(06): 427-447.

Oosterhuis T, Costa LO, Maher CG et al. Rehabilitation after lumbar disc surgery. Cochrane Database Syst Rev 2014; (3): CD003007.

Traeger AC, Underwood M, Ivers R et al. Low back pain in people aged 60 years and over. BMJ 2022; 376: e066928.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Updated on July 19, 2023

Next planned update: 2026


Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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