Lumbar Disc Herniation Resorption: When and How Does It Occur?

Why This Matters

Many patients with lumbar disc herniation improve without surgery, often due to a process called disc resorption. While this is well recognized clinically, the underlying biology is less commonly understood. This study helps explain how and why disc herniations can shrink over time, and what factors may influence that process.

What the Research Found

This review examined the biological and clinical mechanisms behind spontaneous disc resorption.
Key Findings:
1. Disc resorption is an active biological process
• Herniated disc material triggers an immune response
• Macrophages and inflammatory cells infiltrate the disc
• These cells release enzymes that break down disc material
2. Inflammation plays a beneficial role
• Cytokines and proteolytic enzymes contribute to disc shrinkage
• This suggests inflammation is not purely harmful—it may be part of the healing process
3. Some treatments may interfere
• Certain anti-inflammatory strategies may reduce the resorption process
• This raises questions about how aggressively inflammation should be suppressed
4. Multiple factors influence outcomes
• Herniation type
• Physical activity and therapy
• Patient-specific immune response
• Lifestyle factors
5. Predicting resorption remains difficult
• No reliable biomarkers currently exist
• Clinical decision-making still relies on patterns and progression over time

Clinical Takeaways

    • Recognize that disc herniations can improve through a natural biological process
    • Understand that inflammation may play a constructive role in recovery, not just a pathological one
    • Be cautious about assuming all inflammation should be suppressed
    • Consider that recovery is influenced by both mechanical and biological factors

Where Collaborative Spine Care May Support This

This study reinforces the value of conservative spine care in allowing natural healing processes to occur. Providers trained in manual medicine—including chiropractors and physical therapists—may support recovery through mechanical unloading, movement-based care, and patient education, while the body’s intrinsic resorption mechanisms progress.

Reference

Cunha C, Yang H, Buser Z, et al. Lumbar Disc Herniation Resorption: When and How Does It Occur? Neurospine. 2026.
DOI: http://dx.doi.org/10.14245/ns.2551538.769
PubMed: https://pubmed.ncbi.nlm.nih.gov/41666864/