Immune-mediated resolution of a herniated lumbar disc prolapse aided by motor control exercises—a case report

Abstract

Low back pain is the global leading cause of disability. Herniated intervertebral discs are a common cause of lower back pain. The natural history of the herniated intervertebral disc is that it can resorb spontaneously through an immune-mediated mechanism. Despite this favourable natural history, there is an increasing reliance on surgical intervention. A 64-year-old presented with a left L3/4 disc prolapse. With reassurance, simple analgesics, and motor control exercises, the MRI scan confirmed the complete resolution of the disc prolapse within 3 months. Patients with disc prolapses should be reassured that disc prolapses will naturally resolve and advised to remain active. Surgical intervention should only be considered with the presence of red flags, progressive neurology, or when clear evidence exists that all non-interventional techniques have been exhausted. With such a favourable natural history, caution should be exercised before surgical intervention is recommended.