Herniated disc in the lower back: symptoms, causes and which doctor to see

For herniated disc in the lower back you can first see: Physical Medicine & Rehabilitation or Neurology or Orthopedics & Traumatology or Neurosurgery. In large hospitals, the Neurosurgery unit also deals with this. If you are not sure, a family doctor (general practitioner) can assess you first and refer you to the right specialist.

Common symptoms: pain spreading from the lower back to the buttock and the back of the leg (sciatica); numbness and tingling in the leg or foot; pain that gets worse with coughing, sneezing and sitting for long periods; weakness in the ankle or big toe. Symptoms vary from person to person; a doctor’s examination is needed for a diagnosis.

The most common causes: age-related wear of the discs; heavy lifting and sudden twisting; sitting for long periods and inactivity; excess weight; smoking; inherited tendency. Only a doctor’s examination can determine the exact cause.

Most pain from a herniated disc improves considerably within 6–12 weeks with medication, physiotherapy and exercise. Surgery is considered for weakness, bladder or bowel problems, or severe pain that does not respond to treatment.

For a first assessment you can see Physical Medicine and Rehabilitation or Neurology. If surgery is needed, Neurosurgery or an orthopaedic spine surgeon assesses it.

In most people, yes. The bulging part of the disc can shrink over time; symptoms can resolve with exercise, physiotherapy and medication.

Simple back pain stays in the back. With a herniated disc, the pain usually spreads down the leg below the knee, with numbness and tingling. An examination and an MRI if needed tell them apart for certain.

If the answer to any of these questions is yes, call 112 without delay: “Is there loss of bladder or bowel control, inability to pass urine, or numbness in the groin and inner thighs?” “Is there weakness in both legs or weakness that is increasing quickly?” “Is there confusion, fainting or difficulty waking up?” “Is there facial drooping, slurred speech or sudden weakness in an arm or leg?” “Are you struggling to breathe even at rest?”

See a doctor: pain spreading to the leg does not ease within 1–2 weeks; without waiting if there is weakness in the foot; the pain continues at night and at rest.