Lumbar disc prolapse is a common degenerative spinal condition in which intervertebral disc material herniates beyond its normal confines, resulting in compression or irritation of adjacent nerve roots. It is a leading cause of lower back pain and radicular leg pain and affects individuals across a wide age range, particularly those engaged in physically demanding occupations or prolonged sedentary work.

The lumbar intervertebral disc functions as a shock absorber and facilitates spinal mobility. Degenerative changes, repetitive mechanical stress, or acute injury can weaken the annulus fibrosus, allowing the nucleus pulposus to protrude or extrude. Depending on the size and location of the prolapse, nerve root compression may occur, producing characteristic neurological symptoms.

Patients typically present with lower back pain radiating into the buttock, thigh, or leg, often following a dermatomal pattern. Radicular pain is frequently sharp, burning, or electric in nature and may be associated with numbness, tingling, or muscle weakness. Symptoms are exacerbated by sitting, bending, coughing, or prolonged activity. Severe compression may lead to motor deficits or, rarely, cauda equina syndrome, which constitutes a surgical emergency.

Orthopaedic assessment focuses on correlating clinical symptoms with neurological findings. Examination includes assessment of posture, spinal mobility, straight-leg raise testing, sensory and motor evaluation, and reflexes. MRI is the imaging modality of choice and provides detailed visualization of disc pathology, nerve root compression, and associated degenerative changes. Imaging findings must be interpreted in the context of clinical presentation, as disc bulges are frequently seen in asymptomatic individuals.

Initial management of lumbar disc prolapse is conservative in the majority of cases. Treatment includes activity modification, structured physiotherapy, core strengthening, pain control, and gradual return to function. Most patients experience symptom improvement over time with appropriate non-operative care.

Surgical evaluation is indicated in patients with persistent radicular pain despite adequate conservative management, progressive neurological deficits, or significant functional impairment. Surgical objectives include decompression of the affected nerve root while preserving spinal stability. Patient selection is critical to achieving favorable outcomes.

Post-treatment rehabilitation focuses on restoring spinal mechanics, preventing recurrence, and promoting long-term spine health. Education regarding posture, ergonomics, and conditioning plays a vital role in long-term success.

Lumbar disc prolapse requires a balanced orthopaedic approach emphasizing accurate diagnosis, structured conservative care, and timely surgical evaluation to prevent chronic disability.