15/08/2025
Most lumbar disc herniations actually improve without surgery
Studies and reviews suggest 70-90% of herniated discs show significant symptom improvement or complete resolution within about 6-12 weeks of conservative care (rest, physical therapy, medication)
MRI follow-ups also show that within 6-12 months, the disc material itself can show significant shrinkage or completely disappear over time (especially larger, more extruded herniations) through the body’s natural healing and immune response
So how does this happen?
When disc material leaks out into the spinal canal, your immune system sees it as “foreign.” Immune cells move in, breaking it down and carrying it away, like a natural clean-up crew. This process is called phagocytosis.
Over time, water content in the herniated portion decreases, causing it to shrink. Less volume means less pressure on nerves and less inflammation.
As the swelling around the nerve calms down and the disc retracts, nerve compression decreases, leading to symptom relief
Factors that predict better self-healing outcomes include TYPE and SIZE of the herniation, overall health, and activity levels
Extruded or sequestered (where disc material has fully escaped the disc space) tends to resolve faster because the immune system can access it more easily, whereas bulges or contained protrusions may heal more slowly because the body has less direct access
Surprisingly, larger herniations often shrink more quickly than small ones because they trigger a stronger immune response
Good blood flow, healthy lifestyle, and not smoking also improve healing speed
Additionally, modifying or avoiding positions or loads that worsen symptoms while maintaining movement helps prevent ongoing irritation
So although some disc herniations DO require surgery, MOST do not!
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📚References: PMID: 6857385, PMID: 17119140, PMID: 8855462
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