23/07/2026
Someone gets an MRI for their back pain, and the report comes back with a herniated disc. A bulge, a protrusion, maybe the word "extrusion." They read it as structural damage, a part that is broken, and they start treating their spine like it could give out at any moment.
The imaging usually leaves out that herniated discs tend to heal on their own. In the research, disc sequestrations, the most severe grade of herniation, spontaneously regressed about 96 percent of the time. Even extrusions, the next grade down, resorbed around 70 percent of the time without surgery. The thing on the scan that scared you is, more often than not, on its way out on its own, and the worse it looks, the more likely it is to go.
And most of those findings were never the cause of the pain to begin with. Disc degeneration and bulges show up in high proportions of people with no back pain at all, and they get more common with age. They are, in large part, normal aging that happens to be visible on an MRI. That is why the guidelines and the Choosing Wisely campaign recommend against imaging most acute low back pain in the first place. It does not improve outcomes, it drives up cost, and it can make things worse.
Worse, because the words attached to a scan stick. Patients with persistent low back pain frequently trace the belief that their back is fragile or permanently damaged back to something a healthcare professional said. The finding becomes a story: my back is broken, so I should stop moving. The fear of movement, more than the disc, is what turns a normal, self-limiting episode into a lasting disability.
None of this means back pain isn't real or that nothing serious ever happens. A small fraction of cases, roughly 1 to 4 percent, involve something that needs prompt care, and there are specific red flags for it. But the other 90-plus percent is non-specific and has a genuinely favorable course. Most people improve substantially within about six weeks.
So if you are staring at a report full of frightening words, most of what it lists is common, much of it heals, and the story you build around it often matters more than the picture.
If your back is flaring right now, what did you get told was wrong with it?
