Often patients ask: Doctor, is there any way to get the herniated disc back? Or: What about the herniated disc after you have treated me and it doesn’t hurt anymore? So, what exactly is the regression and outcome of a herniated disc? To understand these questions, we must first start with the anatomy of the disc. The intervertebral disc is a disc-like circular structure formed by the central nucleus pulposus (elastic gelatinous material) and the surrounding fibrous rings (multi-layered fibrous rings arranged in concentric circles) and the upper and lower cartilage endplates, hence the name intervertebral disc. The intervertebral disc is located in the middle of the vertebrae, which is equivalent to a cushion of cartilage between the vertebrae to cushion the shock. The following types of pathological histological regression may occur after disc herniation: 1. Absorption: Once the disc is herniated, some cytokines in the human body will mobilize, such as fibroblast growth factor, macrophages, tumor necrosis factor, etc. These inflammatory cytokines will participate in the immunolysis process of phagocytosis, digestion and absorption of the herniated disc tissue. (1) Chemical inflammatory reaction and vascular proliferation after disc herniation can lead to infiltration of inflammatory cells such as mononuclear macrophages, which leads to resorption of herniated disc tissue due to phagocytosis of inflammatory cells. (2) In free disc herniation, the herniated material penetrates the posterior longitudinal ligament into the epidural space and becomes an antigen of the body when exposed to the blood circulation, leading to the occurrence of autoimmune reactions, and the resulting autoantibodies or self-sensitized lymphocytes produce immunolysis of the herniated disc tissue (3) Spontaneous resorption of the herniated disc tissue. The presence or absence of vascularization and the degree of its progression have a great relationship with the degree of herniation and prognosis. In patients with ruptured and free lumbar disc herniation, exposure of the herniated nucleus pulposus tissue to the vascular environment of the epidural space can lead to an inflammatory response and vascularization of the herniated nucleus pulposus tissue, which triggers phagocytosis of macrophages and an immune response leading to reabsorption of the herniated disc tissue. (4) Intervertebral disc herniation is closely related to imbalance of matrix metabolism. Among them, MMPs and tissue inhibitors of metalloproteinases (TIMPs) play an important role. In addition to the direct degradation of proteoglycans, MMP-3 induces the production of macrophage chemotactic factors that infiltrate macrophages with proteolytic activity, leading to the resorption of herniated disc tissue. 2, dehydration and atrophy: human intervertebral discs begin to degenerate after the age of 20, the water content of the nucleus pulposus gradually decreases, and the elasticity and load resistance of the intervertebral discs also decreases, the discs dehydrate and degenerate on their own can make the herniated discs shrink and reduce the symptoms of compression. 3.Retraction: In the early stage of disc herniation, the retraction of bulging and mildly herniated discs is possible. After traction, physiotherapy and exercise of the lumbar back muscle can make the surrounding muscles and ligaments more stable, the inflammatory response subsides and the negative pressure in the disc is formed, thus promoting the herniated disc to retract. 4, calcification: calcium deposition after a herniated disc is a soft fibrous protrusion of the herniated disc tissue into a hard calcified protrusion. 5, herniated disc persists: some herniated discs are dominated by fibrocartilage tissue, or the herniated disc is calcified and difficult to be absorbed by the body, and the herniation persists in the body. The above are some of the pathological histological regressions of herniated discs. Based on these pathological regressions, the following clinical outcomes will occur: 1. Retraction and reduction of the herniated disc and disappearance of clinical symptoms: Whether the herniated disc tissue is absorbed, dehydrated and atrophied or retracted, in short, the pressure on the nerve is lifted or reduced and the pain symptoms are relieved. 2.Protruding disc exists but pain disappears: Even though the herniated disc tissue still exists, the body reaches a new equilibrium and can coexist painlessly with the herniated material. Clinically, it can be seen that 80%-90% of herniated discs can be eliminated through conservative treatment. Through drugs and physiotherapy, nerve root edema can be eliminated and the herniated disc tissue can be reduced, thus reducing nerve root compression and relieving pain symptoms. 3.Protruding disc persists and pain symptoms are not relieved: some protruding disc tissues cannot be absorbed and shrunk by the body, the compression persists and the symptoms of nerve compression cannot be relieved, then the only way to remove the protruding tissue and relieve nerve compression and pain symptoms is through surgery.