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.

Most slipped discs or herniated discs get better without surgery. In fact, many herniated discs do not even cause pain. I know, not what you're 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 a herniated or slipped disc pain, know that most disc related pains go away over time. Hi, I'm Dr. John Shim, and I'd like to explain how your own body combats pain related to herniated discs. If we review how herniated discs happen the most simple way is to use the jelly 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. This is like the jelly coming out of the side of the donut. To be more specific, the outer structure of the annulus fibrosus is made up of cross-linked woven fibers that crisscross, and are tied to each other. Thus holding the center jelly or nucleus proposes. The cross links of the fibers may break allowing a separation of the fibers, and the nucleus can then push through that break. Once that weak spot allows an opening the fibers themselves can also break causing a blowout of the nucleus. The nucleus material then causes an inflammation of the tissues and the nerves and the mechanical pressure of the jelly-like substance also compresses the nerves and the tissues. This causes the pain signals, numbness, and weakness. Ouch! So, how does the body fight off the pain associated with the disc herniation? The human body removes any foreign object by activating special cells called macrophages and monocytes that attack and destroy the foreign material. To use another analogy, these cells are like small pac men that chomp away at all that stuff. Through the body a herniated disc, which is the nucleus pulposus in the wrong location, is considered a foreign object the macrophages and monocytes pac-man away the nucleus. In addition, the larger disc herniations tend to have the most water content. With time this disc piece will dehydrate. Over time the disc herniation is removed, and shrinks back so it no longer irritates the nerves or the tissues. The body also heals back the tear in the annulus, and reties 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 it has a small but increased chance of rereupture. The disc will continue with the natural dehydration process, and will bulge over time. That's why if you get cereal MRI studies of large disc herniations you will see spontaneous regression of the herniation, and longer term the findings of a disc bulge. The most important thing you need to know is that the body does have its own way to remove disc herniations. If your patient enough, and do not have major nerve issues that require surgery, most of the time, the body does remove the disc herniation on its own. That is the reason why many people will have disc herniations or bulges on MRIs, but no pain. If you are in severe pain, please discuss this condition with your doctor to make sure you do not have a situation that requires urgent or emergent care. Fortunately, these situations are rare. On the other hand, if you have truly lost muscle strength, and lost the ability to control your bladder or bowels, you may need care right now. If your doctor determines that's not the case, and if you can tolerate the current pain, allow your body to start the process of removing the disc herniation. Let your body pac-man away that disk. If you're in pain, but do not have significant loss of body functions, you can wait to see if your body will remove or improve that disk herniation. That's why greater than 90 percent of people with disc herniations do get better after six to eight weeks - no surgery needed. The take-home message is, if you can tolerate the pain, and be patient, you can avoid disc surgery. This is Dr. John Shim, discussing how your body removes a disc herniation. If you'd like more information about similar topics, please subscribe to our newsletter or our YouTube channel. Thank you.

Last modified: October 17, 2019

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

  1. 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.

  2. 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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