Can a Herniated Disc Heal On Its Own?
Updated: Dec 29, 2021
I often hear people saying ''I used to do this activity, but I stopped because I have a slipped disc''. A high percentage of adults experience herniated disc symptoms at some point in their life, and many of them see this diagnosis as a lifelong issue that will stick with them for the rest of their lives.
However, many people suffering from this condition manage to achieve a full recovery. So how favorable is the prognosis for herniated disc injuries?
First of all, what is a herniated disc? Vertebrae are 33 bones that form the spinal column. They are separated by discs that act as shock absorbers. When a disc moves out of its original position it is referred to as herniated disc. If a disc presses against a spinal nerve it can produce neurological symptoms (pain, numbness, reduced strength) in the limbs. Back pain research has evolved dramatically over the past decade, helping us to debunk several myths about herniated discs. For this reason, I listed a few key points to keep in mind about herniated discs:
Disc herniation does not equal pain. Several studies have compared the MRI of people with back pain with the MRI of pain free individuals and found no differences in the results. Both groups presented disc changes such as degeneration, disc bulging and reduced disc height. Therefore, a high percentage of asymptomatic adults have herniated discs. It is normal to have disc changes as we age. MRI should be reserved to patients presenting with neurological deficiencies or symptoms that might indicate a sinister condition, and not been conducted routinely for generic back pain.
In most cases herniated discs are not lifelong.
Chances are, if you take an MRI today and you compare it to the one you took a few years ago which showed a herniated disc, it would look different. In fact, the literature tells us that the rate of spontaneous regression is 96% for disc sequestration, 70% for disc extrusion, 41% for disc protrusion, and 13% for disc bulging.
And for complete resolution, the rate is 43% for disc herniation and 15% for disc extrusion. In other words, the worse the disc herniation, the greater the healing rate. Around 90% of the time pain caused by a herniated disc will go away on its own within 6 months.
Discs are robust structures that can sustain load.
An episode of back pain triggered by simple action like bending forward or sneezing can make us feel vulnerable and reluctant to engage in physical activities. Although it is advisable to take a period of rest as we recover from an episode of back pain, movement avoidance should not be implemented long term. In fact, a sedentary lifestyle can lead to deconditioned muscles which are more prone to strain. Also, staying in the same position for too long causes ischemia (reduced circulation) which makes our bodies more sensitive to pain. Therefore, once the pain has subsides, it is advisable to perform posterior chain strengthening exercises to make the back muscles more resilient. If the load applied is gradual, allowing for the discs to adapt, no symptom will then arise. Discs are firmly attached to the vertebrae. To date, there is no evidence that any particular action or movement is a causative factor in disc herniation.
In summary, disc herniation has a more favorable prognosis than what we once thought. The emerging evidence can help patients in having a better understanding of their condition. If you are not sure about what is causing your back pain, a physiotherapist can help you to assess your symptoms and advise you on the best course of action.