Can Herniated Discs Heal on Their Own
- chelsie462
- 3 hours ago
- 8 min read
This article is a transcribed, edited summary of a video Bob and Brad recorded in September 2024. For the original video, go to https://www.youtube.com/watch?v=JXViCFrdir0&t=297s
Mike: Welcome to our myth-busting series, where we look at common myths and tell you if they're true or false. Today's question is, can a herniated disc heal on its own?
Brad: That's right, we're going to use excellent research to back up what we're going to talk about, as well as our experience.
Mike: So, looking at studies, the study is from 2023, and it's titled "Disc Herniation," so they actually look at a lot of studies and put all the information together. So in most cases, people actually respond pretty well to conservative treatment and management of their disc herniation.
Brad: As a matter of fact, there's a lot, and they found many herniated discs that are asymptomatic, or there's no symptoms or pain associated with them; they just found out through an MRI scan that they're looking at the spine, perhaps for something else at the hip, and that is well-known.
Mike: And they also looked at people who actually had back pain; 90% of them got better within six weeks.
Brad: That's right. Now, surgery may lead to quicker results, but they have found that, over a period of time, conservative treatment of a herniated disc, as they heal, ends up with the same outcomes as with surgery.
Mike: And we wanted to bring in an expert on back pain. Dr. Stuart McGill did a couple of interviews with us, so this segment is from one he did with Bob, and he is talking about MRI imaging and how it doesn't always correlate to your back pain.
Brad: Right, if you haven't heard of Stuart McGill, he is excellent in research. He has done an incredible amount of back research and is really known throughout the world as the leading expert on back pain.
Stuart McGill: So an MRI is a picture, and what the MRI shows is the person's full history, historical life, really. And you can look at my face, it has wrinkles and scars and that kind of thing, so when you take a picture of someone's spine, is the feature that you're looking at a scar, something that was done many years ago and no longer is a pain source, or is it a fresh wound, so what's a wound and what's a scar? And this is a fundamental flaw, I think, when a radiologist reads a MRI image of someone's spine, without seeing the person, they don't know if that person is a world champion sprinter or powerlifter, or they are just a couch potato, and they have no idea what their pain mechanisms are. So when we do an assessment, we get a context, then, so when we look at the MRI, we can say, well, we already know the pain is coming from the fourth lumbar root, as an example. Your little toes are buzzing away, you've got pain in your buttocks, and this kind of thing, and then we know. Let's look at the lumbar fourth route and see what the mechanism is, and does it correlate one-to-one with what the assessment shows?
Bob: Got it, I understand.
Stuart McGill: So my point is, the MRs can be very, very helpful. I'm just thinking of the next patient I see this afternoon. I've already seen the MRs. They have a Tarlov cyst in the fifth lumbar root, so I know that if I can create some tension on that nerve root and that's their symptoms, and I already know they don't tolerate driving, so do you see, I'm getting real context now to interpret that MR very specifically.
Mike: So after looking through that study and having Stuart McGill explain MRI imaging, I think we can confirm the myth is busted: a herniated disc can heal on its own.
Brad: So the big question I have, or a lot of people have, is how long does it take to have the pain and the symptoms to go away from a herniated disc?
Mike: So the average time is typically six to 12 weeks for your symptoms to improve, so you may still actually have a herniation. Herniations can take six to 12 months to fully heal; however, pain often resolves in six to 12 weeks.
Brad: Right, and a lot of that depends on the severity. Now, if you have back pain and some pain running down the leg, you can actually resolve that or remedy it in under two weeks or less, sometimes a little more. However, if your symptoms are such that you have not just pain but numbness, tingling all the way down to your foot, and if you have weakness in some muscle groups where you cannot lift your foot up or that leg feels very weak, that's a little more serious, and that is where they can take many more weeks to get that taken care of. If you do have numbness and tingling, you really need to see a doctor, because it could be worse. Make sure you get assessed properly and don't do self-diagnosis.
Mike: So now we'd like to explain how a disc itself can actually heal or feel better. Now, there are a few different ways, so we'll kind of explain each separately.
Brad: That's right. To do this, we're going to use a model. I have a model here. We've got Gumby, who's got a very sore back, as you can see. Actually, we'll put him off to the side, but if you look at the spine, you can see two vertebrae, L4, L5, and this red disc with a bulge represents the herniation or the bulging disc.
Brad: If we go here, I've got these labeled, L5, L4; those are representative of the vertebra, and the red ball is a disc, which does have an annulus and fluid inside. It's not red like this, but you can see it. So a healthy spine looks like this, but if it's herniated, watch right here, the herniation bulges out like that, and then the nerves, or the spinal cord and the peripheral nerves, are in this area, and that's what gets pinched, and that causes a lot of pain and problems.
Brad: So the first thing that happens is spontaneous retraction.
Mike: Retraction.
Brad: In other words, naturally, just through rest and appropriate exercise that you can do, it will come back into itself, where it belongs, and it heals on its own.
Brad: That happens more often than you think. These people don't go to the doctor; they have pain, rest for a bit, maybe a few days, a week or two, things gradually get better, and it goes back in. Number two...
Mike: Number two is reabsorption of water, so your disc is actually kind of like a sponge, and there's fluid in it, and sometimes, during an injury, some of it goes out a bit like we showed, and it actually gets reabsorbed back in where it's supposed to go, taking pressure off the nerve roots that it is hitting.
Brad: That's right, the body wants to heal, and it has an incredible potential to heal if you just give it some time and don't keep irritating the problem. And what is the last one?
Mike: Immune response.
Brad: That's right, and this is where the herniation is, as pictured, and if things actually bulge or come out or sequester, the bulge actually breaks loose, the body can actually, like little Pac-Man, eat up that tissue and get rid of it and cause the problem to be no more.
Mike: The Pac-Man is your immune cells eating that up, but eventually, if that little cell is hitting on the spinal cord, causing the injury from that disc break-off section, the little Pac-Man, or immune cells, come in, eat it up, and your problems go away.
Brad: Yeah, well, I hope they appreciate that analogy.
Mike: Do girls have Pac-Girl in them, then?
Brad: Oh, Mike, this is a family show, let's keep things professional.
Mike: Now, the last thing we want to talk about is things to avoid when you have a herniated disc. Typically, with the herniated disc, flexion or bending forward of your spine makes things worse and can flare them up, but typically, extension or going backwards can help. So what flexion activities do we want to avoid, Brad?
Brad: Just as I demonstrated, reaching forward, straight knees really stresses that low back and makes that bulge want to bulge out further, and actually, just sitting, particularly if you push your butt forward, a lot of people have habitually sitted like this for years, and they don't even realize they're sitting in really poor posture, actually could be the cause of the herniated disc because of this poor posture over years. There we go, another one.
Mike: If you are standing and you are flexed over, whether you are, say, working in a clinic and looking at a patient bending over, you're reaching down to pick something up, maybe you just naturally have poor posture and you're rounded, this is not going to help your herniated disc.
Mike: You're going to make modifications. Maybe you can sit more if you need to work on a lower surface, things like that. You want your spine to be upright and not so flexed over. And you also want to avoid flexion when you're lying down or sleeping. If you are a side lier, side lier, side-lying person? I don't know what you call them; you lie in a fetal-type position. Notice my spine is rounded forward; this is not going to be good for a herniated disc.
Mike: If you really have to lie sideways, you're going to have to try to straighten out your spine, which is kind of awkward and uncomfortable, but you can try it. Otherwise, we just recommend that you sleep on your back for a while, because now it's nice and straight.
Brad: Right, there are some other options for sleeping with that that we do have on other videos. I think you're thinking of a side sleeper. Side sleeper, there you go.
Mike: Side sleeper.
Brad: Anyways, let's go on.
Mike: Now, if you happen to have some back pain or a herniated disc, and you want some exercises, because we didn't really show them in this video, check out our video, "Herniated Disc Clearly Explained & Easily Fixed."
Brad: Good luck with your back problem. I hope you learned something about the myth-busting of, Can a herniated disc heal?
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