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Disc Herniations or Slipped Discs Get Better Without Surgery

Most disc herniations or slip discs get better without surgery.  In fact, many herniated discs do not even cause pain. I know, not what you are told by others.  But, it is the truth. 

Many research studies show herniated discs are found in many people who have no pain associated with the finding.

But,  if you do have herniated or slipped disc pain,  know that most disc related pains improve and go away. 

If we review how herniated discs happen,  the most simple way is to use the jelly donut model.

donut model

The center of the human disc,  which is the nucleus pulposus, ruptures through the annulus fibrosus, which is the woven structure containing the nucleus.  The nucleus, which has chemicals as well as a mass, irritates the surrounding tissues, including the nerves. It is like the jelly coming out of the side hole of the donut.

To be a bit more specific,  the outside structure, the annulus fibrosus, is made of crosslinked woven fibers,  that criss cross and and are tied to each other, thus holding in the center “jelly” or nucleus pulposus.

nucleus pulposus

The crosslinks of the fibers may break,  allowing a separation of the fibers, and the nucleus can push through that break.  Once that weak spot allowing an opening, the fibers themselves can also break, causing a blow out of the nucleus.  The nucleus material causes an inflammation of the tissues and nerves, and the mechanical pressure of the jelly like substance also compresses the nerves and tissues.  That causes the pain signals, numbness, and weakness. Ouch!!

disc herniation

So, how does the body fight off the pain associated with the disc herniation? 

The human body removes any foreign objects by activating special cells called macrophages and monocytes that attack and destroy foreign material.  To use another analogy, these cells are like small Pac-Men, that chomp away at that stuff.

To the body,  a herniated disk,  which is the nucleus pulposus in the wrong location , is considered a foreign object.  The macrophages and monocytes pacman away the nucleus. In addition, the largest disc herniations tend to have the most water content. With time, the disc piece will dehydrate.  Over time, the disc herniation is removed, and shrinks back so it does not irritate the nerves or the tissues. The body also heals back the tear in the annulus, and re-ties the annular fibers.  That healed annulus is now associated with a scar, and though it helps hold the nucleus back into its position, it is a weaker area, and has small but increased change of rerupture. The disc will continue with the natural dehydration process and will bulge over time.    That is why if you get serial MRI studies of large disc herniations, you will see spontaneous regress of the herniation, and longer term, the findings of a disc bulge.

spontaneous regress

The most important thing you need to know is that the body does have it’s own way to remove disc herniations.  If you are patient enough, and do not have major nerve issues that require surgery, most of the time, the body does remove the disc herniation on it’s own.  This is the reason why many people will have disc herniations or bulges on MRI without any pain. 

If you are in severe pain,  please discuss your condition with a doctor to make sure you do not have a situation that requires urgent, or emergent care.  Fortunately, these situations rarely occur. On the other hand, if you have true loss of muscle strength, loss of the ability to control your bowels or bladder,  you may need care right now. 

If your doctor determines that is not the case,  if you can tolerate the current pain, allow your body to start the process of removing the disc herniation.  Let your body Pac-man that disc.

If you are in pain,  but do not have any significant loss of body functions,  you can wait to see if your body will remove or improve the disc herniation.  That is why greater than 90% of people with disc herniations do get better after 6-8 weeks. NO SURGERY needed. 

Take HOME MESSAGE:

 If you can tolerate the pain and be patient,  you can avoid disc surgery.

Last modified: October 17, 2019

28 thoughts on “Disc Herniations or Slipped Discs Get Better Without Surgery

  1. I have herniated disc L5 S1 no more pain in my right legs and my MRI shows I have no nerve or rute issue it’s already 6 month since the accident now only minor pain daily in my lower back shifting to my SI Hip Joint. How many more months do u think I will fully recover as long back to the sorce my disc

    1. It’s a two steps forward and one step back kind of thing. You feel good, you do something that causes a little swelling, you hurt again. There is no timeline on this, but it sounds like you are actually improving. Ice after activities, and knowing to avoid what sets things off, will speed up your recovery.

  2. Hello Dr.,

    I have had a fall during soccer back in 2003. Ever since I have had perennial sharp severe pains in my waist. There is nothing to show in a scan but the pain returns each year and goes away in a week. Could you advise me on how to stop this permanently? could it be a disc herniation or tear?

    1. I’m sorry. We cannot give personalized medical advice without actually seeing a patient. A diary of what you do physically before this pain starts would help your treating physician with a diagnosis.

  3. I have problem with my right leg , I feel my right leg no strong like my left leg , and I feel some pain in my right leg , and when I am going it is some of the pain also when I am setting

    1. This pain and weakness could be originating in your back, Masood.It would certainly be a good idea to have it examined.

  4. Hello doc this was such an encouraging video.
    I am currently having stiff back with pain radiating towards my right leg. Do i need to wait for 6 to 8 weeks and let the body function?
    I am taking muscle relaxant and pregabalin at the moment along with Vitamin D and Cac.

    1. As long as you are not having neurological deficits, time is your friend. Gentle stretching and strengthening can help.

  5. I have a bulge L5/S1 left side with pressure on the nerve root (MRI) but no intense pain. However, when I try to walk my glutes and lower back tighten and spasm. This has been the case for 2-3 months. It is slowly improving with some good days and some days back to normal. Could it be a Piriformis issue vs nerve?

    1. We could not diagnose this without actually seeing you. As you are improving, keep up with mild exercise and ice afterwards. It usually takes at least 3 months for things to settle down.

  6. Dr. Shim I have herniated disc in my lower back what foods, would produce more macrophages and monocytes. Should I be on low calorie diet and would 16 hour fast help? I love your video’s there very clear.

    1. Our biggest advice is to watch your weight and go low calorie if you need to lose a few pounds. Consulting a dietician for information would assist you.

  7. I have herniated disc L5_s1
    Low back pain and buttock ,muscles spasm or thigh and leg ,pain is tolerated without pain killers for 6 months now .. will it heal or not ?

    1. We usually give it 3-6 moths to heal. You may have some residual pain you will have to deal with, either medically or surgically.

    1. If we only knew Jamal! The biggest thing we recommend is to avoid hurting yourself again and strengthen your back with exercise.

  8. I have l4 l5 disc prolapse and numbness over my feet and mild weakness over my right lower limb.what is the physiotherapy ?

    1. We would not presume to tell you the appropriate exercises. Please consult a trained and licensed Physical therapist for that information.

  9. I have a bulging disc in L4L5. I feel pain on my lower back, buttock hips also on my knees. How can i do for all of this pain? Is basketball prohibited for bulging disc?

    1. Basketball is not advised for anyone having back pain. Less “pounding” type activity such as walking or swimming is a much better idea.

    1. bilateral foot burning would not be a normal response to a “bulging disc”. There are many other causes of this including diabetes, circulatory problems or side effects of medication. Please see your medical provider for diagnosis.

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