Many patients in our clinic who have suffered a disc extrusion wonder what happens to the material from the inside of the disc once it is pushed outward and is pressing on sensitive neural structures nearby. A common misunderstanding is that that material will always be there on those sensitized nerves. This is not true! Research firmly shows that the natural order of things is for the immune system in the body to clean up the extruded disc material. How quickly this occurs and to what extent varies widely from person to person based on systemic health, genetics, and whether their movement patterns continue to provoke the disc herniation. One thing that most reliably affects the rate and extent of resorption of the extruded material is smoking. If you are a smoker with disc herniation, now might be the best time to quit! (Tsarouhas, 2011) If you have been unfortunate enough to experience a disc extrusion and the severe sciatica in the leg that sometimes accompanies it, you may have presented to a surgeon who suggested that the problem would be best managed with the surgery to remove that disc material from the nerve root. This early default to surgery is no longer standard of care. Current evidence-based recommendations in the scientific literature suggests that surgery after disc extrusion should only be considered if: Here are a few snippets from the research on how the body heals an extruded disc. This process is known as resorption. That last one was not a typo! A larger extrusion, while possibly creating more pressure on nerve roots, is managed more quickly and more thoroughly by the body. This is important because many times the size of the herniation is what drives the advice of the neurosurgeon to proceed with surgery.
As much as the pain sucks, toughing it out for a short period of time while working on your movement patterns, fitness level and headspace is the best way to go according to the current evidence. Let your body work to mend the process and support it’s efforts as best as you can. We’re here to help at FixYourOwnBack.com by providing the latest evidence-informed self-help information and exercise available anywhere. We can show you how to heal a herniated or extruded disc!
Am I Stuck With This Thing Forever?
Remember when you were a kid and you skinned your knee and as the scab healed you had a strange urge to keep picking at it? Many of us can recall our mother’s voice in our head saying “If you keep picking it, it will never heal.” A disc injury is not much different. More accurately, your skinned knee healed despite your picking it but it took a bit longer, right? Similarly, your disc injury will mend nicely if you stop “picking at it” while it’s trying to heal.
ADDENDUM: March 10, 2017-Shanghai, China-This just-released meta-analysis (http://www.painphysicianjournal.com/current/pdf?article=NDAwNA%3D%3D&journal=101) arrives at the same conclusion of the blog here, over 2/3rds of herniated discs resorb. This continues to suggest that “conservative care” rather than surgery is warranted in these cases. We provide guidance on this site to exercise in ways to promote healing of the disc and reduce likelihood of re-injury based on the methods we’ve used successfully in our Portland, OR clinic for 15 years. Click HERE to become a member and get started!
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