Most slipped discs or herniated discs get better without surgery.
In fact, many herniated discs do not even cause pain. I know, not what you're told
by others, but it is the truth. Many research studies show herniated discs
are found in many people who have no pain associated with the finding. But, if you
do have a herniated or slipped disc pain, know that most disc related pains go away
over time. Hi, I'm Dr. John Shim, and I'd like to explain how your own body
combats pain related to herniated discs. If we review how herniated discs happen
the most simple way is to use the jelly donut model. The center of the human disc,
which is the nucleus pulposus, ruptures through the annulus fibrosus, which is
the woven structure containing the nucleus. The nucleus which has chemicals
as well as a mass irritates the surrounding tissues, including the nerves.
This is like the jelly coming out of the side of the donut.
To be more specific, the outer structure of the annulus fibrosus is made up of
cross-linked woven fibers that crisscross, and are tied to each other.
Thus holding the center jelly or nucleus proposes. The cross links of the fibers
may break allowing a separation of the fibers, and the nucleus can then push
through that break. Once that weak spot allows an opening the fibers themselves
can also break causing a blowout of the nucleus. The nucleus material then causes
an inflammation of the tissues and the nerves and the mechanical pressure of
the jelly-like substance also compresses the nerves and the tissues. This causes
the pain signals, numbness, and weakness. Ouch! So, how does the body fight off the
pain associated with the disc herniation? The human body removes any foreign
object by activating special cells called macrophages and monocytes that
attack and destroy the foreign material. To use another analogy, these cells are
like small pac men that chomp away at all that stuff. Through the body a
herniated disc, which is the nucleus pulposus in the wrong location, is
considered a foreign object the macrophages and monocytes pac-man away
the nucleus. In addition, the larger disc herniations
tend to have the most water content. With time this disc piece will dehydrate. Over
time the disc herniation is removed, and shrinks back so it no longer irritates
the nerves or the tissues. The body also heals back the tear in the annulus, and
reties the annular fibers. That healed annulus is now associated with a scar,
and though it helps hold the nucleus back into its position it is a weaker
area and it has a small but increased chance of rereupture. The disc will
continue with the natural dehydration process, and will bulge over time. That's
why if you get cereal MRI studies of large disc herniations
you will see spontaneous regression of the herniation, and longer term the
findings of a disc bulge. The most important thing you need to know is that
the body does have its own way to remove disc herniations. If your patient enough,
and do not have major nerve issues that require surgery, most of the time, the
body does remove the disc herniation on its own. That is the reason why many
people will have disc herniations or bulges on MRIs, but no pain. If you are in
severe pain, please discuss this condition with your doctor to make sure
you do not have a situation that requires urgent or emergent care.
Fortunately, these situations are rare. On the other hand, if you have truly lost
muscle strength, and lost the ability to control your bladder or bowels, you may
need care right now. If your doctor determines that's not the case, and if
you can tolerate the current pain, allow your body to start the process of
removing the disc herniation. Let your body pac-man away that disk. If
you're in pain, but do not have significant loss of body functions, you
can wait to see if your body will remove or improve that disk herniation.
That's why greater than 90 percent of people with disc herniations do get better
after six to eight weeks - no surgery needed. The take-home message is, if you
can tolerate the pain, and be patient, you can avoid disc surgery. This is Dr. John
Shim, discussing how your body removes a disc herniation. If you'd like more
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