The natural history of disc herniation and the influence of intervention

Spine (Phila Pa 1976). 1994 Oct 1;19(19):2234-8; discussion 2233. doi: 10.1097/00007632-199410000-00022.


The natural history of lumbar disc herniation must be considered when evaluating the influence and outcome of intervention. The combination of clinical signs and symptoms and corresponding radiologic findings permits a more certain diagnostic conclusion compared with many other obscure back disorders. The relationship between low back pain and a herniated disc is unclear. Mechanical compression and chemical changes may be the source of nerve root symptoms. Studies have shown that the natural course of acute radiculopathy has a good prognosis. Bed rest, information, and analgesics usually are sufficient therapeutic measures. Prolongation of symptoms requires radiologic examination. The decision regarding continued conservative therapy versus surgical intervention must be evaluated. Chemonucleolysis and percutaneous nucleotomy are being used, but the indications are uncertain.

Publication types

  • Review

MeSH terms

  • Adult
  • Analgesics / therapeutic use
  • Bed Rest
  • Clinical Trials as Topic
  • Controlled Clinical Trials as Topic
  • Diskectomy, Percutaneous
  • Humans
  • Intervertebral Disc Chemolysis
  • Intervertebral Disc Displacement* / epidemiology
  • Intervertebral Disc Displacement* / therapy
  • Lumbar Vertebrae*
  • Middle Aged
  • Multicenter Studies as Topic
  • Sciatica / etiology


  • Analgesics