Can a herniated disc heal itself?
Herniated discs normally heal by themselves, but the process is slow and sometimes it is either too painful or dangerous to wait. In my experience around 94% of people with back and leg pain get better on their own without any additional treatment. However, they get better not over hours or days but weeks. Eighty four percent get better after six weeks, and the full 94% improve over 12 weeks (about 3 months).
In order to make good decisions about your own body, you need to understand what it means to have a disc herniation, and how your body deals with it.
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One of the peculiar things about the discs in your lower back is that they do not have their own blood supply. It is through the blood supply that your body recognizes what is part of ‘you’ and what is not. When a disc “herniates” the soft, inner part goes through a rip in the tough outer part. Pat’s body did not “know” that the soft inner part is part of him. So, his body generated an inflammatory response.
The weird part is that it is the healing that hurts. On the show Pat talked about feeling a “sharp pain” that “went right down my leg.” As his body tried to heal the disc herniation the inflammation spilled over and irritated the neighboring nerve root. That irritation of the nerve root causes the sense of pain going down the leg that people often call sciatica. It also caused a sense of numbness in his leg.
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When a herniated disc is the problem the most common solution is to let the body heal itself. But there is a catch. Two of them, actually.
First, the inflammation that reabsorbs the herniated disc is damaging the nerve root. If the healing takes too long, that damage can cause permanent nerve damage. To avoid permanent nerve root damage microdiscectomy surgery to remove the herniated disc fragment is necessary when the disc is causing:
Weakness that is functionally disabling.
Numbness that is functionally disabling
Uncontrollable pain
Second, sometimes pain fibers grow into the scar that heals the annulus, and causes permanent low back pain to form the torn disc. This is called discogenic pain.
