Several factors can cause or contribute to a herniated disc:

1. Age: Over time, spinal discs naturally lose water content and flexibility, making them more prone to tearing (rupture) with even minor strains or twists.
2. Injury or trauma: Sudden trauma, like a fall, or lifting something improperly, can put significant pressure on the spine, causing a disc to herniate.
3. Repetitive stress: Frequent bending, twisting, or lifting can place ongoing stress on the spine, increasing the risk of disc herniation.
4. Genetics: Some people may be predisposed to developing herniated discs due to hereditary factors.
5. Being overweight: Excess body weight adds stress to the lower back, which can contribute to disc herniation, particularly in the lumbar spine.
6. Sedentary lifestyle: Weak muscles and a lack of flexibility can make the spine more vulnerable to injury, increasing the likelihood of herniation.
7. Smoking: Smoking reduces blood flow to the spinal discs, speeding up degeneration and making them more prone to herniation.

These factors, alone or in combination, may lead to a herniated disc, depending on the location and condition of the spine.

The majority of patients (about 80-90%) improve with conservative treatments such as activity modification, medications, physical therapy, and epidural steroid injections. Surgery is generally reserved for those who do not experience relief from these non-surgical methods or those who have severe symptoms like significant weakness, loss of bladder or bowel control, or debilitating pain.

Symptoms related to a lumbar herniated disc typically resolve within a few weeks to a few months for most people. Here’s a general timeline:

• Acute Phase (First 6 weeks): In many cases, pain and symptoms (such as leg pain, numbness, or weakness) begin to improve within the first 4 to 6 weeks. Conservative treatments like rest, physical therapy, pain medications, and anti-inflammatory drugs help during this period.
• Improvement by 3 Months: By 3 months, approximately 75-90% of patients experience significant symptom relief, even if the herniation itself hasn’t completely resolved. The body’s inflammatory response may help reduce the size of the herniation and alleviate pressure on nerves.
• 6 Months to 1 Year: For those whose symptoms are slower to resolve, further improvement is common over the course of 6 to 12 months. Even persistent symptoms like mild numbness or tingling may gradually improve as the disc heals or shrinks.

Herniated discs typically shrink or resorb over time, typically without surgical intervention. Studies have shown that 60-90% of herniated discs reduce in size or resorb naturally within 6 months to a year.

The body’s immune system plays a role in breaking down and absorbing the herniated disc material, leading to symptom relief for many patients. The likelihood of spontaneous resorption is generally higher in cases of larger herniations, as the body tends to mount a more robust inflammatory response to larger fragments.

If you have a lumbar herniated disc, certain restrictions can help protect your back and reduce the risk of worsening the condition. Here are some common restrictions:

1. Avoid Heavy Lifting: Refrain from lifting objects that are heavy or awkwardly shaped. When lifting is necessary, use proper body mechanics: bend your knees, not your back, and keep the object close to your body.
2. Limit Bending and Twisting: Activities that involve bending forward, twisting, or sudden movements of the spine can put extra strain on the lumbar discs. Try to avoid these motions whenever possible.
3. Reduce Prolonged Sitting: Sitting for long periods, especially in a slouched position, can aggravate the herniated disc. Try to stand up and walk around every 30-60 minutes, or use a lumbar roll to support your lower back.
4. Avoid High-Impact Activities: High-impact exercises, like running, jumping, or sports that involve jerky movements, should be avoided, as they can increase pressure on the spine and aggravate symptoms.
5. Be Cautious with Exercise: While exercise is important, it should be gentle and tailored to your condition. Low-impact activities like walking, swimming, or stationary cycling are often recommended. Your doctor or physical therapist can guide you on specific exercises that strengthen core muscles without straining your back.
6. Limit Activities that Increase Pain: Pay attention to what activities worsen your symptoms. If an activity increases pain, numbness, or weakness in your legs, it’s best to stop and avoid it until you’ve consulted a healthcare professional.

Following these restrictions and working closely with a healthcare provider or physical therapist can help promote healing and minimize discomfort.