The disc herniation can reduce in size over time. This has a higher likelihood to occur if the herniation is very hydrated (full of water) which can be noted on MRI of high signal on T2 images. This water can be absorbed somewhat quickly and reduce the size of the compressive force. The herniation can also migrate if it is a free fragment and exit through the foramen. It will eventually “get stuck” on the surface of the psoas muscle and cause no harm.
These possibilities are balanced by the fact that this fragment can also get “stuck” in its position and continuously compress the nerve. This can cause chronic pain in the nerve root. I had just seen a patient today who had a herniation six months ago. She elected to wait and had improvement but continued leg pain and still has a sensitive nerve root.
There is no right or wrong answer to surgery for herniated disc without motor weakness. I think the die is cast if there is motor weakness (surgery is needed).
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.