By Zhong M, Liu JT, Jiang H, Mo W, Yu PF, Li XC, Xue RR
Once a spinal disc has “slipped,” it seems like it’s in a biomechanically awkward situation and can’t recover any more than a broken window can reassemble itself. And yet several studies — like Kjaer 2016, which followed dozens of patients for eight years — have suggested that herniated discs spontaneously de-herniate!
This paper (Zhong et al) is the first meta-analysis of those studies. The pooled data from eleven of them shows an extremely high overall incidence of disk resorption: a whopping 66% in patients who received conservative therapy (anything but surgery). This adds to the already large pile of evidence that back pain’s bark is usually much worse than its bite, and MRI and x-ray are almost useless for most low back pain.
More study is needed — of course, as always — because none of these studies were randomized controlled trials, and there was barely enough data for meta-analysis. However, the final number is so high that it’s safe to assume that approximately “lots” of herniations resolve on their own.
As if this wasn’t counter-intuitive enough already, the worst herniations are actually the most likely to regress (see Chiu et al). The temptation to assume the opposite is hard to resist, but “common sense” is useless in musculoskeletal medicine, a field where there seem to be no safe assumptions.
Does this data show that “conservative therapy” is the key to resorption? Unfortunately not: “conservative therapy” is vague to the point of being meaningless here. All it does mean is that these patients were treated with anything but surgery (or injections). We already suspect that resorption occurs whether people receive any treatment or not (Kjaer again), and we know that there are no clearly effective therapies for back pain at all (Machado). The only thing we can tell from this paper is that many herniations resolve without surgery, not that therapy fixes herniations.
BACKGROUND: Lumbar disc herniation (LDH), a common disease, is often treated conservatively, frequently resulting in spontaneous resorption of the herniated disc. The incidence of this phenomenon, however, remains unknown.
OBJECTIVE: To analyze the incidence of spontaneous resorption after conservative treatment of LDH using computed tomography and magnetic resonance imaging.
STUDY DESIGN: Meta-analysis and systematic review of cohort studies.
SETTING: The work was performed at The Suzhou Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine.
METHODS: We initiated a search for the period from January 1990 to December 2015 using PubMed, Embase, and the Cochrane Library. Two independent reviewers examined the relevant reports. The references from these reports were also searched for additional trials using the criteria established in the PRISMA statement.
RESULTS: Our results represent the pooled results from 11 cohort studies. The overall incidence of spontaneous resorption after LDH was 66.66% (95% CI 51% – 69%). The incidence in the United Kingdom was 82.94% (95% CI 63.77% – 102.11%). The incidence in Japan was 62.58% (95% CI 55.71% – 69.46%).
LIMITATIONS: Our study was limited because there were few sources from which to extract data, either in abstracts or published studies. There were no randomized, controlled trials that met our criteria.
CONCLUSIONS: The phenomenon of LDH reabsorption is well recognized. Because its overall incidence is now 66.66% according to our results, conservative treatment may become the first choice of treatment for LDH. More large-scale, double-blinded, randomized, controlled trials are necessary to study the phenomenon of spontaneous resorption of LDH.
The information herein on "At Least Half of Herniated Discs In El Paso, TX Spontaneously De-Herniate" is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional.
Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system.
Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.
We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.
We are here to help you and your family.
https://youtu.be/sOolG4CEBic On today’s podcast Spencer Salas and Dr. Alex Jimenez discuss CBD, TCH, and Hemp.… Read More
https://youtu.be/o348pjL26pE Dietary Supplement Quality Guide: Dr. Jimenez, Health coaches Adriana Caceres and Faith Arciniega, and… Read More
Back pain usually comes from lifting an object the wrong way or awkwardly moving the… Read More
Personal Injury, Trauma & Spine Rehab. Specialists