CAN A HERNIATED DISC HEAL?

A disc herniation is a cut in the disc that enables the inner material, known as the nucleus, to squeeze out and put pressure on the surrounding ligaments and potentially a nearby nerve. As scary as this sounds, a tear in the disc is like a cut on your knuckle. Can a herniated disc heal? Yes, a herniated disc can recover the same way a cut over a joint does. Because the joint bends, this added stress makes it more difficult to mend than a laceration on your forearm that is not subjected to the tensions of stretching and bending. A cut on your elbow needs extra care of overpressure and avoiding movements that open the cut, but with knowledge, perseverance, and the body’s fantastic healing processes….a cut over a joint heals. A herniation heals in exactly the same manner.

Fear & Improper Treatments

A disc injury is often associated with fear and thoughts of permanent damage and disability. Unfortunately, this is because years of improper treatment ruined many lives with chronic pain, disability, loss of ability to do everyday activities, and even relationships. Many of our most common treatments for back pain have no validity and are shown to worsen patient outcomes.

66% of those with a disc herniation are unsure about the cause of their symptoms. The foundation of all treatment should be educated on the cause of symptoms, factors that will aggravate, and those that will relieve your symptoms. When you have pain and have no idea why or what makes it worse/better, you are blind to healing and instead rely on trial and error. Learn how to avoid these mistakes!

Education must be the foundation of all treatment.

Did you know that disc bulges are a natural part of aging and usually are painless? Similarly, degenerative disc disease (DDD) is a normal finding for everyone with a wrinkle on their face or single grey hair. Wrinkles and grey hair do not cause pain, nor do most degenerative changes. Most discs heal by themselves. Our bodies have an innate ability to recognize injury and begin a complicated process to heal any damaged tissue. Those that do not is because continued stress disrupts this natural healing process.

A cut on a joint like your elbow is more difficult to heal because moving the joint disrupts the laying down of the scar tissue. Reducing the stress on the healing tissue speeds up recovery, so applying overpressure and avoiding bending your elbow for a few days will allow the scar tissue to lay down. After a few days to a week, the scar tissue will be strong enough to withstand the bending motion. If you bend your elbow and the cut starts to open again, you will need a few more days to avoid bending your elbow. Eventually, the scar will be strong enough, and you can resume activities using your elbow without the cut reopening.

A herniation or cut in your disc heals the same way. Because the joints in your back are constantly stressed, it makes it a bit more difficult for the cuts in the disc to heal. The most common herniations are posterior or backward. Movements and positions that cause the posterior cuts to open will disrupt the healing scar tissue. These movements include bending to put on your socks/shoes, coughing/sneezing, sleeping on your back with a pillow under your knees, and slouched sitting. Anything activity that causes your to bend your back needs to be minimized/avoided for a few days, just like bending your elbow when you have a cut.

Your disc is like a hard pillow between your vertebrae. It is responsible for absorbing shock and protecting your spinal column. The disc has a jelly-like center called the nucleus. Like a jelly doughnut, the nucleus is supposed to stay in the center, but pressure on one side will cause the nucleus to move in the opposite direction. The disc has no nerve innervation other than the very outer layer. You can stab a disc, and you will not feel anything, but when a tear in the disc reaches the outer layer — you will see stars. Similar to tearing your fingernail, you don’t feel. Thing, but when the nail rips to the nailbed, it becomes very tender.

Symptoms down your leg, known in layman’s terms as “sciatica”, result from pressure on your nerve. The symptoms of radiculopathy can be pain, numbness, or tingling. The further down your leg these symptoms go, the worse your herniation, known as peripheralization. When the nucleus tears and reaches the outside of the disc, it can put pressure on the surrounding ligaments. If it comes out a bit further, it will then put pressure on the local nerve. More nerve pressure will result in symptoms going further down your leg (lumbar disc) or arm (cervical disc). Centralization is when the symptoms move closer to your spine, the opposite of peripheralization. It is critical that when you have “sciatica” or symptoms down your leg, you learn what position/movements cause your symptoms to peripheralize and which result in centralization. Anything that causes your symptoms to go further down your leg opens your cut and worsens your condition. Movements and positions that cause your symptoms to move closer to your back are closing down on your cut or putting slight over pressure and will assist in healing.

Mechanical Assessment

Your disc can heal, and with some knowledge, you can heal yourself! To heal, you must know what direction the cut or herniation opens. Then you can apply overpressure in that direction to help assist in healing. A clinician specializing in mechanical assessment will assist in evaluating your spine and determining f the disc still has a cut or if it is scarred tissue causing your pain and sciatica. If the cut is still open, the mechanical evaluation will also determine the direction you will need for overpressure. This is done by assessing your spine’s range of motion. Any loss of motion and pain with movement lead to a clear picture of the disc derangement. Movements that push the disc’s nucleus back into its central position will also improve your baseline range of motion, centralize any radicular symptoms and reduce any pain with movement.

1. Determine the direction that opens the disc herniation

2. Apply overpressure in the opposite direction x 3–10 days

3. Once the scar tissue heals, stretch in the opposite direction to ensure that the scar tissue is flexible.