Do I Have a Herniated Disc or Just a Strain?
Back pain has a way of making you spiral. One awkward lift, a dodgy gym session, or even sleeping funny, and suddenly you’re wondering if you’ve “slipped a disc” or if it’s just a muscle strain that’ll settle down. It’s a fair question because the early symptoms can feel similar, and Google tends to make everything sound dramatic.
The good news: most back pain is not dangerous, and many cases improve with the right care and time. But there are also some clear signs that point to a disc injury, and a few red flags that need medical attention quickly.
Summary: A back strain usually involves sore, tight muscles that hurt with movement and improve steadily over days to a couple of weeks. A herniated disc can cause deeper pain and may irritate a nerve, leading to pain that travels into the buttock or leg, plus tingling, numbness or weakness. This article explains the difference in plain language, what symptoms to watch for, and when you should seek help.
First, what’s a “strain” and what’s a “herniated disc”?
A strain (or sprain)
A strain is an injury to muscle or tendon (the tissue that connects muscle to bone). A sprain is an injury to ligaments (the tissue that stabilises joints). In the lower back, people often use “strain” as a catch-all for a painful soft tissue flare-up.
Typical triggers:
Lifting, twisting, bending awkwardly
A sudden movement (like sneezing while bent over, annoyingly)
Too much activity after being inactive
A new exercise load
A herniated disc
Your spine has discs between the vertebrae that act like cushions. A herniated disc (sometimes called a “bulging” or “slipped” disc) happens when part of the disc pushes out and can irritate nearby nerves.
Important: lots of people have disc bulges on scans without pain. What matters is whether it’s irritating a nerve and matching your symptoms.
How a strain usually feels
A strain is more likely when pain is:
Localised to the lower back (or upper back/neck)
Achy, tight, or “spasm-y”
Worse with certain movements, better with rest and gentle movement
Sore to touch in the muscles either side of the spine
Improving day by day, even if it’s slow
You might feel stiff getting out of bed or after sitting, but you generally don’t get strong nerve symptoms like tingling or numbness down the leg.
Common pattern: the first 24 to 72 hours can be rough, then it gradually settles over 1 to 2 weeks with the right approach.
How a herniated disc often feels
A disc issue is more likely when you have signs the nerve is irritated.
Look for:
Pain that travels from the back into the buttock and down the leg (sciatica-style pain)
Tingling, pins and needles, numbness, or burning sensations
Weakness (like your leg feels less reliable, foot feels floppy, or you trip more)
Pain that’s worse sitting, bending forward, coughing or sneezing
A sharp, deep pain rather than a surface muscle ache
Common pattern: back pain may come first, then leg symptoms become more obvious. Sometimes the back pain eases a bit, but the leg pain sticks around.
A quick self-check: where is the pain going?
This is not a diagnosis, but it’s a useful clue.
Pain that stays in the back
More often strain, joint irritation, or general mechanical back pain.
Pain that shoots below the knee
More suggestive of nerve involvement, which can happen with a disc herniation.
Pain with numbness or weakness
Needs assessment sooner rather than later.
What about the term “slipped disc”?
People say “slipped disc” a lot, but discs don’t really slip in and out like a bar of soap. It’s usually a bulge or herniation that may inflame a nerve. The good news is many disc-related flare-ups improve without surgery.
The key is getting assessed properly so you don’t either:
panic and stop moving completely, or
push through the wrong movements and aggravate it.
Red flags: when to seek urgent medical help
Most back pain is not an emergency, but these symptoms are. If you have any of the following, seek urgent medical care:
Loss of bladder or bowel control
Numbness in the groin or “saddle” area
Significant or worsening leg weakness
Severe pain after a major fall or accident
Fever, unexplained weight loss, or history of cancer with new severe back pain
Pain that’s constant and unrelenting, especially at night
If you’re unsure, it’s better to get checked.
Do you always need a scan to know?
Not usually.
Imaging like MRI can be helpful in certain situations, but it’s not always the first step because:
Many people have disc bulges with no symptoms
Scans can show “abnormalities” that aren’t the source of pain
Early treatment is often similar regardless: reduce pain, restore movement, rebuild strength
A hands-on assessment and movement testing can often give you a clearer direction without jumping straight to imaging.
What you should do in the first few days
Whether it’s a strain or disc flare-up, these principles tend to help:
Keep moving, gently
Total bed rest usually makes back pain worse. Short, frequent walks can help keep things from stiffening up.
Avoid the “hero” moves
Heavy lifting, deep bending, twisting, or high-intensity workouts can flare things early on.
Use pain relief sensibly (if appropriate for you)
Over-the-counter options can help you stay mobile, which is often the goal. If you have medical conditions or take regular medications, check with a pharmacist or GP.
Heat or cold
Heat can help muscle guarding and stiffness
Cold can help if it feels more inflamed or sharp
Go with what feels better.
Don’t stretch aggressively into pain
With disc irritation especially, forcing stretches can irritate the nerve further. Better to get tailored advice.
How an osteopath can help you figure it out
If you’re not sure whether it’s a strain or a disc issue, a proper assessment can take a lot of uncertainty out of it.
At Heidelberg Osteopaths, osteos can:
Assess your movement, posture, and nerve signs
Identify whether symptoms suggest muscle/joint strain vs nerve involvement
Use manual therapy to relieve pain and reduce muscle guarding
Help you improve mobility safely
Give you practical rehab exercises and load guidance
Build a plan to prevent sudden flare-ups in the future
The goal isn’t just getting you out of pain this week. It’s helping you move better so it doesn’t keep coming back.
Back pain that won’t settle? Get it assessed properly.
If you’re worried you’ve got a herniated disc, or your back pain isn’t settling, get it assessed properly.
Heidelberg Osteopaths offers affordable, hands-on care focused on real results so you can perform at your best. Book your appointment today.
Key takeaways
A strain usually causes local back pain and stiffness that improves steadily over days to weeks.
A herniated disc can irritate a nerve and cause pain, tingling, numbness or weakness down the leg.
Pain shooting below the knee and nerve symptoms are important clues.
Most cases improve with the right management, but certain red flags need urgent medical care.
A hands-on assessment can clarify what’s going on and speed up safe recovery.
FAQ
Can a strain cause pain down the leg?
It can cause referred pain into the buttock or upper thigh, but true nerve symptoms (tingling, numbness, weakness, shooting pain below the knee) are more suggestive of nerve irritation.
If I have a herniated disc, will I need surgery?
Most people don’t. Many disc-related flare-ups settle with conservative treatment, time, and rehab. Surgery is usually only considered when symptoms are severe, persistent, or there’s significant neurological change.
Should I rest or keep moving?
Gentle movement is usually better than full rest. Short walks and staying lightly active often help recovery, as long as you avoid movements that clearly flare your pain.
