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Hoots : How does a herniated spinal disk correct itself? Looking at the picture below, nothing in the herniated disc seems to be able to correct itself over time. Yet, the article I took the picture from says that surgical treatment - freshhoot.com

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How does a herniated spinal disk correct itself?
Looking at the picture below, nothing in the herniated disc seems to be able to correct itself over time. Yet, the article I took the picture from says that surgical treatment is used only if the pain is not resolved within a few weeks.

My question is: How exactly can this condition be resolved within a few weeks, with drugs only? What happens to the mechanical deformation - the root cause?


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The herniated part of the disc can be resorbed by the inflammatory process, which means that inflammatory cells, such as macrophages, can remove the damaged tissue. The healing time can range from several weeks to months.

Conservatively treated massive prolapsed discs: a 7-year follow-up (The Royal College of Surgeons, 2010):

The mechanism by which herniated discs are resorbed is not fully
understood. It is generally thought that an immune response develops
to the disc tissue and inflammation helps to remove the invading
tissue.

Massive disc herniations usually reduce in volume and by 6 months most
are only a third of their original size. Several studies have shown
that the largest discs appear to have the greatest tendency to resolve.

Long-Term Course to Lumbar Disc Resorption Patients and Predictive Factors Associated with Disc Resorption (Evidence-Based Complementary and Alternative Medicine, 2017):

Of 505 participants, 19 did not show disc resorption, while 486 did. A
total of 220 displayed resorption rates of ?50%.

There is insufficient evidence that any treatment, including analgesics, physical therapy, spinal manipulation, steroid injections and surgery result in greater symptom relief 1-2 years after the onset of symptoms than no specific treatment at all (BMJ, 2007, European Spine Journal, 2007).

Early surgery should be considered when symptoms are unbearable, are bilateral, involve the perineum (the area between the legs) or bladder or bowel dysfunction (cauda equina syndrome).


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