My MRI Shows a Herniated Disc. Now What?
What the report means, why it may not explain your pain, how often discs heal on their own, and when surgery is the right call.
The short answer
A herniated or bulging disc on MRI is common, and often not the cause of pain: disc bulges show up in 30% of 20-year-olds and 84% of 80-year-olds who have no back pain at all. The key question is whether the herniation matches your symptoms and exam. Many herniations shrink on their own, and most people improve without surgery. Surgery is needed for worsening weakness, loss of bladder or bowel control, or pain that does not improve with good conservative care.
Your MRI is only part of the answer
A large review of MRI findings in people with no back pain found disc bulges in 30% of 20-year-olds rising to 84% of 80-year-olds, and disc protrusions in 29% rising to 43%. So a disc finding on your report may be old and painless, or it may be exactly what is pressing on a nerve. Only your symptoms and a nerve exam can tell which.
Herniations often shrink on their own
A systematic review of follow-up MRIs found that herniated discs regress on their own surprisingly often, and the larger types most often: about 96% of sequestrations, 70% of extrusions, 41% of protrusions and 13% of bulges showed regression.
That is one reason surgery is rarely the first step unless there are warning signs.
When surgery is the right call
- Leg or arm weakness that is getting worse
- Numbness in the groin or inner thighs, or new bladder or bowel problems (go to the ER now)
- Severe pain that does not improve after a good trial of conservative care, often 8 to 12 weeks
If any of these apply, we will tell you directly and help you get to a spine surgeon.
Free MRI review: an independent second look
Before you decide on surgery, injections or a treatment plan, Utah County residents can ask for a free MRI review. Dr. Matt McClean reads your actual MRI images, not just the report, checks whether they explain your symptoms, and tells you honestly whether conservative care, injections or a surgical opinion makes the most sense. We do not perform surgery, so we have no stake in which way you decide.
Common questions
Does an MRI show a herniated disc?
Yes. MRI is the best test for showing disc herniations and nerve compression. But disc findings are common in people without pain, so they must be matched to your symptoms and exam.
Will a herniated disc heal without surgery?
Often, yes. Many herniations shrink on their own, especially larger extruded and sequestrated ones, and most people improve with conservative care.
Should I see a chiropractor for a herniated disc?
For many people, yes, after a proper exam and MRI review. Treatment should avoid loading the injured disc, and you should be referred if nerve signs worsen.
How long can you go with a herniated disc before surgery?
Without warning signs, most guidelines allow a trial of conservative care, often 6 to 12 weeks. Worsening weakness or bladder or bowel changes need urgent surgical evaluation.
Can I get a second opinion on my MRI?
Yes. Utah County residents can request a free MRI review: Dr. McClean reads the actual images and tells you honestly whether surgery looks necessary.
Sources
- Brinjikji W, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015;36(4):811-6.
- Chiu CC, et al. The probability of spontaneous regression of lumbar herniated disc: a systematic review. Clin Rehabil. 2015;29(2):184-95.
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Want an independent look at your MRI? Call us.
McClean Chiropractic Spine Care Specialists · 385 N 500 W, Provo, UT 84601 · Directions