In the past three years, several studies have proven that the majority of disc herniations will self-reabsorb over time with non-surgical care. (3-6) One extensive study reported that 97% of all symptomatic herniations will not require surgery. (7)
And the size of the nuclear herniation has no predictive value concerning the failure of conservative management or likelihood of requiring surgery. (11) Large “herniations” trigger a significant inflammatory response and generally regress more quickly when compared to contained “bulges” that do not benefit from rapid reabsorption. (3,7,8-10)
While this fact is not surprising to most chiropractors, it has not apparently been grasped by the majority of PCP’s and patients.
Want to Up the level of understanding?
Download this new ChiroUp infographic showing that structural changes like degeneration and disc lesions do not necessarily require surgery.
Article published by ChiroUp
- Nachemson A, Elfstrom GO. Intravital dynamic pressure measurements in lumbar discs. Scand J Rehabil Med. 1970;2(suppl 1):1-40. Link
- Newell N, Carpanen D, Grigoriadis G, Little JP, Masouros SD. Material properties of human lumbar intervertebral discs across strain rates. The Spine Journal. 2019 Dec 1;19(12):2013-24. Link
- Chiu CC, Chuang TY, Chang KH, Wu CH, Lin PW, Hsu WY. The probability of spontaneous regression of lumbar herniated disc: a systematic review. Clinical rehabilitation. 2015 Feb;29(2):184-95. Link
- Ming Zhong MD, Liu JT. Incidence of spontaneous resorption of lumbar disc herniation: a meta-analysis. Pain physician. 2017 Jan;20:E45-52. Link
- Kesikburun B, Eksioglu E, Turan A, Adiguzel E, Kesikburun S, Cakci A. Spontaneous regression of extruded lumbar disc herniation: Correlation with clinical outcome. Pakistan journal of medical sciences. 2019 Jul;35(4):974. Link
- Elkholy AR, Farid AM, Shamhoot EA. Spontaneous Resorption of Herniated Lumbar Disk: Observational Retrospective Study in 9 Patients. World neurosurgery. 2019 Apr 1;124:e453-9. Link
- Lilly DT, Davison MA, Eldridge CM, Singh R, Montgomery EY, Bagley C, Adogwa O. An Assessment of Nonoperative Management Strategies in a Herniated Lumbar Disc Population: Successes Versus Failures. Global Spine Journal. 2020 Jul 7:2192568220936217. Link
- Morgan W. Management of Lumbar Disc Derangements. Presentation at the 2015 American College of Chiropractic Orthopedists Convention. Las Vegas NV April 25, 2015.
- Kjaer P, Tunset A, Boyle E, Jensen TS. 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. 2016 Dec;17(1):26. Link
- Djuric N, Yang X, El Barzouhi A, Ostelo R, van Duinen SG, à Nijeholt GL, van der Kallen BF, Peul WC, Vleggeert-Lankamp CL. Lumbar disc extrusions reduce faster than bulging discs due to an active role of macrophages in sciatica. Acta Neurochirurgica. 2019 Dec 4:1-7. Link
- Gupta A, Upadhyaya S, Yeung CM, Ostergaard PJ, Fogel HA, Cha T, Schwab J, Bono C, Hershman S. Does Size Matter? An Analysis of the Effect of Lumbar Disc Herniation Size on the Success of Nonoperative Treatment. Global Spine Journal. 2019 Oct 10:2192568219880822. Link