May 24, 2024
Disc herniation is the most common spinal pathology and is a well-documented spinal disorder. Once lumbar disc herniation develops, symptoms such as back pain, buttock pain, and pain and numbness in the lower limbs can affect patients’ daily lives.
It can often be seen on the Internet that this particular herniated disc healed spontaneously, but in this article, we will explain whether disc herniation may or may not heal spontaneously.
What is disc herniation?
As their name imply, intervertebral discs are located between vertebrae. The disc is composed of a gelatinous nucleus pulposus in the center encased in a collagen-rich annulus fibrosus.
Disc herniation is a condition in which the nucleus pulposus protrudes outward due to a crack present in the annulus fibrosus.
The Process of how disc herniation occurs
In a healthy intervertebral disc, even during strenuous exercise, the energy is absorbed by the disc which acts as a cushion, and as a result the surrounding bones and ligaments are rarely affected.
However, as early as around the age of 16, the intervertebral disc begins to age and sustain damage.
For a variety of reasons, a fissure may develop in the annulus fibrosus, and the nucleus pulposus inside the disc may suddenly protrude. This is what produces a herniated disc. As the nucleus pulposus slowly protrudes, the amount of nucleus pulposus matter in the disc decreases, causing a loss in the disc’s function.
Eventually, the loss of cushioning function increases the strain on the spine and begins to deform the spine and ligaments, causing intervertebral arthritis and ligament ossification, which can also lead to spinal canal stenosis and intervertebral foraminal stenosis.
This marks the beginning of the damage incurred on the intervertebral discs and the progression of various spinal pathologies.
Can a herniated disc heal spontaneously?
Various studies are available regarding the spontaneous healing of lumbar disc herniation.
To summarize, a meta-analysis found that the spontaneous absorption rate of herniation was 66.6%, while a study on the general population found that the majority of hernias remained unchanged (*1).
In most cases, the size of the herniated disc seen on the imaging remained the same: at 4 years, 14% have regressed, 81% have remained unchanged, and 5% have increased; at 8 years, 17.5% have regressed, 65% have remained unchanged, and 12.5% have increased (*2).
(*1) : “Guidelines for the Treatment of Lumbar Disc Herniation,” edited by the Committee on Clinical Practice Guidelines of the Japanese Orthopaedic Association, revised 3rd edition, 2021.
(*2) : “Per Kjaer, et al. Progression of lumbar disc herniations over an eight-year period in a group of adult Danes from the general population – a longitudinal MRI study using quantitative measures. BMC Musculoskeletal Disorders. Vol.17 No15, 2016.
Research also showed what types of hernias healed naturally.
If the hernia is large and protruding, it is usually absorbed quickly. Compared to a protrusive type or a free hernia type, the hernia area is in contact with nerves and ligaments, which causes inflammation and triggers an immunity response, resulting in the gradual resorption of the hernia area (*3).
(*3): Reijo A. Autio, et al. Determinants of Spontaneous Resorption of Intervertebral Disc Herniations. SPINE. Vol.31, No.11, 2006.
Is it safe to leave a herniated disc untreated since it will eventually heal itself over time?
It would be wrong to assume that because a herniated disc may heal spontaneously over time, it is not problematic to simply leave the disc untreated indefinitely.
The reason being that even if the herniated area resorbs on the surface, the damaged disc will not heal altogether.
Once a fissure develops in the annulus fibrosus and is not repaired, the nucleus pulposus may leak out again at some point, even if the herniation has resorbed. If the nucleus pulposus leaks out of the disc again, herniation will recur.
Although herniectomy and laser therapy can remove the herniation or reduce the size of the herniation, they cannot repair the underlying cause of the herniation, which is the fissure in the annulus fibrosus.
The Cellgel Method: a fundamental treatment for disc herniation
Our clinic offers the Cellgel Method, a treatment that repairs damaged intervertebral discs.
With our Cellgel Method, a drug is injected into the cracks of the disc filling them, before turning into a gel that repairs the cracks, thus providing a fundamental treatment. It is characterized by the fact that the volume of the disc is not reduced and the drug remains in the disc as a gel-like implant after treatment, thus preserving the disc.
If you have been diagnosed with disc herniation and are suffering from back pain or other problems, please consider a consultation at our clinic.
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