Dr. Mukesh Haritwal

HOD - Spine Care

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Reviewed by

Dr. Mukesh Haritwal

HOD - Spine Care

Manipal Hospitals, Jaipur

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Slipped Disc: Causes, Treatment Options & When Neurosurgery Is Needed

Reviewed by:

A slipped disc, medically referred to as a herniated disc, is a common cause of back and neck pain that affects adults of all ages, particularly those between 30 and 50 years. While many people use the term “slipped disc,” the condition actually involves the soft cushion (disc) between spinal bones bulging or rupturing out of its normal position and pressing on nearby nerves. Understanding the causes, symptoms and treatment options — including when neurosurgery becomes necessary can help you take informed steps towards recovery.

At Manipal Hospital Jaipur, our multidisciplinary team, including senior neurosurgeons and physiotherapists, provides personalised care for slipped disc and herniated disc conditions.

Synopsis

What Is a Slipped Disc / Herniated Disc?
Symptoms of Herniated Disc / Slipped Disc
Diagnosing a Slipped Disc
Non-Surgical Treatment Options
When Is Herniated Disc Surgery Needed?
Herniated Disc Surgery Options
Recovery Time After Herniated Disc Treatment
Exercises for Herniated Disc: Key Guidelines
Prevention: Tips to Protect Your Spine
Why Choose Manipal Hospital Jaipur for Slipped Disc Care

What Is a Slipped Disc / Herniated Disc?

The spine consists of vertebrae separated by discs made of a tough outer ring (annulus fibrosus) and a gel-like centre (nucleus pulposus). A slipped disc occurs when the nucleus pushes through a tear in the annulus. This can irritate or compress spinal nerves, leading to pain, numbness and weakness.

Common types include:

Lumbar disc herniation – affecting the lower back
Cervical disc herniation – affecting the neck

Both types can be painful and debilitating, but treatment outcomes are generally good with early diagnosis and appropriate care.

Causes of Slipped Disc

A herniated disc doesn’t “slip” in the literal sense. Common causes include:

1. Age-related Disc Degeneration - As we age, spinal discs lose water content and elasticity, making them more prone to tears and herniation.

2. Improper Lifting - Lifting heavy objects without proper posture can strain the spine and cause a disc to bulge.

3. Sudden Injury - A fall, accident or sudden twist can trigger a disc herniation.

4. Repetitive Strain - Jobs or activities involving frequent bending, twisting or lifting increase risk.

5. Genetic Predisposition - Some individuals have a genetic tendency towards weaker disc structure.

6. Obesity - Excess body weight adds stress to spinal discs, especially in the lumbar region.

7. Smoking - Smoking impairs blood supply to discs, accelerating degeneration.

Symptoms of Herniated Disc / Slipped Disc

Symptoms vary depending on the location and severity of the disc herniation.

General Symptoms

Localised back or neck pain
Pain that worsens with movement
Muscle stiffness and spasms

Lumbar Disc Herniation Symptoms

Sharp pain in lower back
Pain radiating to buttocks, legs or feet (sciatica)
Numbness or tingling in legs
Weakness in lower limbs

Cervical Disc Herniation Symptoms

Neck pain
Pain radiating to the shoulders, arms or hands
Numbness or tingling in the upper limbs
Weak grip strength

Severe Symptoms (Urgent Care Needed)

Loss of bladder or bowel control
Severe weakness
Progressive numbness

These may indicate serious nerve compression and require immediate medical evaluation.

Diagnosing a Slipped Disc

A comprehensive assessment usually includes:

Medical history & physical examination
Neurological testing to check nerve function
Imaging such as:
- X-ray – rules out fractures
- MRI – best for visualising disc herniation
- CT scan – detailed cross-section images

Early diagnosis leads to better treatment outcomes.

Non-Surgical Treatment Options

Most people with a slipped disc improve with conservative treatment. These include:

1. Rest & Activity Modification - Short periods of rest followed by a gradual return to activity help tissues heal without stiffness.

2. Pain Relief Medication - NSAIDs, muscle relaxants or nerve pain medications may be prescribed to reduce inflammation and discomfort.

3. Physical Therapy - Exercises for a herniated disc aim to:

Strengthen core muscles
Enhance flexibility
Improve posture
Reduce nerve compression

Examples of exercises for a herniated disc may include pelvic tilts, knee-to-chest stretches, McKenzie extensions and gentle mobilisation.

4. Heat & Cold Therapy - Cold packs reduce inflammation in early stages, while heat improves blood flow and relaxes muscles.

5. Epidural Steroid Injections - In selected cases, steroid injections around the affected nerve root provide relief from pain and inflammation.

When Is Herniated Disc Surgery Needed?

Most patients respond to conservative management within 4–12 weeks. However, neurosurgical evaluation becomes essential when:

Persistent pain despite optimal medical therapy
Progressive neurological weakness
Severe nerve compression visible on MRI
Cauda equina syndrome (loss of bowel/bladder control)
Recurrent herniation affecting quality of life

At Manipal Hospital Jaipur, herniated disc surgery is recommended only when clearly indicated after comprehensive evaluation and multidisciplinary discussion.

Herniated Disc Surgery Options

When conservative treatment fails, the following surgical interventions may be considered:

1. Microdiscectomy - A minimally invasive procedure to remove the portion of the disc compressing the nerve. This is the most common surgery for lumbar herniated discs.

2. Laminectomy & Foraminotomy - Removal of a small portion of bone or ligament to relieve nerve pressure.

3. Disc Replacement - Artificial disc replacement may be an option in selected cervical disc herniation cases.

4. Spinal Fusion - In cases with instability, fusion of vertebrae provides long-term stability.

Surgical approaches are tailored based on the location, severity and overall health of the patient.