Lumbar and Neck Disc Hernia (Slipped Disc)

A disc hernia, or slipped disc, happens when the soft centre of a spinal disc pushes through a tear in its tough outer ring. In the lower back (lumbar) it can press on a nerve root and cause sciatica down the leg. In the neck (cervical) it causes pain, tingling or weakness running into the shoulder, arm and hand.

Disc bulges are very common on MRI in people with no pain at all, so a scan finding matters only when it matches your symptoms. Most symptomatic hernias settle within 6 to 12 weeks without surgery.

Symptoms

• Sharp, electric pain running from the buttock down the leg, often below the knee, worse on sitting, coughing or sneezing
• Neck hernia: pain spreading from the neck to the shoulder blade and arm
• Numbness or pins and needles in a strip of the foot or in particular fingers
• Weakness, such as difficulty walking on heels or toes, or a weak grip or triceps
• Back or neck stiffness and muscle spasm
• With spinal cord compression in the neck: clumsy hands, unsteady walking, stiff legs

Causes and risk factors

Discs lose water and resilience from early adult life. A tear in the outer ring can let the centre bulge or escape, sometimes after lifting or twisting, often with no clear trigger. Peak age is 30 to 50. Risk is raised by smoking, excess weight, heavy manual work, long hours of driving and family history. The levels affected most are L4 to L5 and L5 to S1 in the lower back, and C5 to C6 and C6 to C7 in the neck. Pain comes from chemical inflammation of the nerve root as well as from pressure, which is why it can ease while the hernia is still visible.

How it is diagnosed

• Neurological examination: Straight leg raise, Spurling test for the neck, strength, reflexes and sensation map the affected root.
• MRI: The test of choice; shows the level, size and type of hernia and any cord compression.
• CT or CT myelogram: When MRI is not possible, for example with some pacemakers.
• Nerve conduction studies and EMG: Help when the picture is unclear or to separate a root problem from carpal or cubital tunnel syndrome.
• X-rays: Show alignment and instability, not the disc itself.

Treatment options

• Staying active with pain relief: Short term anti-inflammatories and keeping moving; bed rest slows recovery.
• Physiotherapy: Directional exercises, posture and strengthening.
• Nerve root or epidural steroid injection: For severe limb pain that is not settling.
• Lumbar microdiscectomy or endoscopic discectomy: Removes the fragment when leg pain persists beyond 6 to 12 weeks or weakness progresses.
• Anterior cervical discectomy and fusion (ACDF): The standard neck operation: the disc is removed from the front and replaced with a cage.
• Cervical disc replacement: A motion preserving alternative for selected younger patients with one or two levels.
• Posterior cervical foraminotomy: A keyhole opening from the back for a hernia lying to the side.

When it is urgent

Go to your nearest emergency department, without planning travel, for numbness around the genitals or back passage, difficulty passing urine or new incontinence, rapidly worsening weakness in a leg or arm, or clumsy hands with unsteady walking. Back or neck pain with fever, unexplained weight loss, a history of cancer or major trauma also needs urgent local assessment.

Travelling to Türkiye for treatment

Because most hernias recover with time, do not rush to fly for surgery in the first weeks. Travel is reasonable for a second opinion on whether surgery is needed, or for a planned discectomy once conservative care has failed. Bring an MRI less than 3 months old. After lumbar discectomy most people fly at 5 to 10 days; after neck fusion, 7 to 10 days. Long term exercise follow-up happens at home.

Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.

Frequently Asked Questions