Disc herniations are not sentences

By Dr. Lizeth Ortiz Barboza · Published September 20, 2026

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Not every disc herniation needs surgery

Operating on a disc herniation has precise indications: neurological deficit that is progressing, disabling pain that does not settle with well-done care, or red flags. Outside of that, many people improve by looking after the segment: inflammation control, strength, load and, in selected cases, intervention.

Not every disc herniation disappears

Waiting for the protrusion to “resorb” on a six-month follow-up scan is not a plan. Sometimes the disc material changes; sometimes it does not. Clinical success is not measured in millimetres of disc herniation. It is measured in function: walking, sleeping, working.

Not every disc herniation hurts the same way

Two similar MRIs do not produce the same pain. Level, nerve root, inflammation, the ligaments of the segment, the hip, sitting work and what that person asks of their spine each day all play a part.

We do not treat isolated images

We treat functional segments. The goal is not to erase the disc herniation. It is to modulate inflammation, improve stability and optimize function. Every spine is different; every patient is too.

What follows in clinic

Red flags are reviewed. The territory of the pain is correlated with the level on the image. Then it is decided whether there is a role for prolotherapy, for an ultrasound-guided injection, or for rehabilitation alone. And it is said when the next step is a surgeon.

More on spine pain.

This text is educational. It does not replace an assessment. Results vary.

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