Many patients often ask me, “Can the herniated lumbar disc go back? I have gotten better with conservative treatment, and I have not had an attack for a long time, is it possible that the herniated lumbar disc has returned? Before answering this question, let’s also understand the structure of the lumbar disc. The human intervertebral disc consists of the endplate, the fibrous ring and the nucleus pulposus. The annulus fibrosus is attached to the endplate and surrounds the nucleus pulposus. In a normal person, the annulus fibrosus is strong and restricts the movement of the nucleus pulposus within the confines of the annulus fibrosus. The diagram above shows the intervertebral disc (within the red line) in the lateral position, between the upper and lower vertebrae. Above is a cross-sectional view of the intervertebral disc: it is between the upper and lower vertebral bodies. The intact fibrous ring, which surrounds the nucleus pulposus, so that the nucleus pulposus cannot protrude when normal. How does a lumbar disc herniation develop? A herniated disc occurs when the posterior fibrous ring is gradually damaged and becomes weak or fractured, so that the nucleus pulposus protrudes backward or comes out, causing nerve compression and thus symptoms. The herniated nucleus pulposus is seen in the lateral position, compressing the nerve. (red arrow) From the frontal view: the fibrous ring ruptures and the nucleus pulposus protrudes, compressing the nerve. The results of the study show that the fibular ring itself has a complex interlocking fiber structure, while the ring itself has no blood flow and poor healing ability, so once the ring tears, it is basically irreparable. From this point of view, the possibility of the lumbar disc herniation to go back is very small. If this is the case, why is conservative treatment effective for many patients with lumbar disc herniation? How does a herniated lumbar disc cause pain? 1. Direct compression of the nerve root by the herniated nucleus pulposus; 2. Inflammatory reaction of the nerve root by the herniated nucleus pulposus; 3. Edema of the nerve root; 4. Stasis of blood in the nerve root. To treat lumbar disc herniation, all conservative treatments are effective by reducing edema and inflammation of the tissues around the herniated disc, none of which can bring back the herniated disc. However, a small number of reports have found that over time (3-5 years), the herniated disc may become smaller due to dehydration, and the effect of reducing compression can also be achieved. Therefore, when people receive conservative treatment, they should not keep focusing on which method can push the disc back in or can repair the disc, which is still difficult to achieve with the current technology.