If you’ve been told you have a disc herniation in your neck or low back, your first thought might be:

“Is this permanent?”
“Will I need surgery?”
“Can this actually heal?”

The research is more detailed than most people realize.

At Central Ohio Spine and Joint in Westerville, we frequently evaluate patients from Westerville, Worthington, Dublin, Powell, Lewis Center, New Albany, Polaris, and North Columbus who are concerned about MRI findings showing a disc bulge, protrusion, extrusion, or sequestration.

The good news?
Many disc herniations improve, and many actually shrink over time. Disc herniation reabsorption is more likely than you think.

Let’s break down what that means and how it should guide your treatment decisions.

What Is Disc Herniation Reabsorption?

Disc herniation reabsorption refers to the body’s natural ability to break down and resorb displaced disc material over time. This process occurs through inflammatory-mediated phagocytosis and vascular ingrowth into the herniated fragment.

Overall Reabsorption Rates

Research shows that disc herniation reabsorption occurs in approximately 66–67% of cases overall.
(References 1–3)

However, the likelihood of resorption depends heavily on the type of herniation.

Reabsorption Rates by Herniation Type

Sequestration: 93–96% reabsorption
Extrusion: ~70%
Protrusion: 41–52%
Bulging: ~13%

(References 1–3)

Larger herniations, transligamentous herniations, and higher Komori types are also predictors of spontaneous regression. (Reference 1)

Interestingly, the more dramatic-looking herniations on MRI — like sequestrations — are actually more likely to resorb than mild bulges.

This is one reason why imaging alone should not drive treatment decisions.

How Long Does Disc Reabsorption Take?

The mean time to radiographic resorption is approximately 8–12 months.
(References 4–5)

However:

About 25% of patients show early resorption within 3 months
Complete resolution occurs in:
- 43% of sequestrated discs
- 15% of extruded discs

(Reference 3)

This timeline is important when discussing surgical decisions.

If symptoms are tolerable and neurologically stable, the body often has time to adapt and improve.

One-Year Prognosis: What Can Patients Expect?

The clinical outlook is generally favorable — even if imaging still shows a herniation.

At 3 months:

Approximately 87% of patients treated conservatively report decreased pain
(Reference 6)

At 1 year:

Up to 76% of herniated discs partially or completely resolve on MRI
(Reference 6)

Motor recovery:

81% of patients with initial muscle weakness recover without surgery by 1 year
Sensory deficits are more persistent, with about 50% recovery at 1 year
(Reference 6)

This tells us something critical:

Improvement in symptoms does not require complete MRI resolution.

MRI Findings vs. Clinical Outcomes

One of the most important studies in this space showed:

At 1 year:

85% of patients with persistent disc herniation on MRI reported favorable outcomes
83% of patients with no visible herniation reported favorable outcomes

(Reference 8)

In other words:

Persistent imaging findings do not predict poor outcomes.

This dissociation between imaging and symptoms underscores why treatment decisions must prioritize:

Pain severity
Functional ability
Neurological status
Quality of life

—not imaging alone.

Recurrence Rates: What Happens Long-Term?

Even when symptoms improve, recurrence is possible.

Approximately 25% of patients whose sciatica resolves experience recurrence within 1 year
(Reference 6)

For surgical patients:

15–25% report recurrent low back pain 2 years after discectomy
(Reference 7)

Surgery is not a guaranteed permanent fix — and conservative care is not a passive approach.

Both require long-term strategy.

Conservative vs. Surgical Management

The evidence consistently shows that:

Short-term pain relief may be faster with surgery in severe cases
Long-term functional outcomes are often similar between surgical and conservative care

The key is proper triage.

Surgery is typically considered when there is:

Progressive motor weakness
Severe, intractable pain
Cauda equina syndrome
Failure of structured conservative care

For most patients without red flags, conservative care is both safe and effective.

How We Approach Disc Herniation at Central Ohio Spine and Joint

We do not treat MRIs.

We treat people.

Our framework follows our proven system:

Repair → Retrain → Reinforce

Step 1: Repair

Reduce inflammation and nerve irritation
Improve spinal mobility
Calm acute pain

Step 2: Retrain

Restore proper movement patterns
Improve core control and spinal stability
Correct asymmetries

Step 3: Reinforce

Build long-term strength and tissue resilience
Progressive strength training
Structured return to activity

This approach aligns with the natural healing timeline of disc reabsorption.

When Should You Be Concerned?

Seek immediate evaluation if you experience:

Progressive leg weakness
Loss of bowel or bladder control
Severe unrelenting pain
Significant neurological changes

Otherwise, most disc herniations improve with structured care.

Key Takeaways

Two-thirds of disc herniations show spontaneous resorption.
Sequestrated and extruded discs are most likely to shrink.
Most patients improve clinically within 3 months.
MRI findings at 1 year do not predict outcomes.
Treatment decisions should be based on symptoms and function — not imaging alone.