Disc Bulge on Your MRI? Here’s What the Research Says
A guide for Brighton, Hove and Sussex residents worried about a disc bulge, protrusion or herniated disc
Seeing the words “disc bulge”, “protrusion” or “herniated disc” on an MRI report is one of the most unsettling moments in a person’s back pain journey. It’s natural to picture worn-out discs, nerve damage or even a future that involves surgery. For many of our patients across Brighton, Hove and the wider Sussex area, that fear is the first thing we need to address, often before we talk about treatment.
The reassuring news is that the picture painted by an MRI scan is just a snapshot. Things rarely turn out as frightening as it sounds. A comprehensive 2025 review of the scientific literature on lumbar disc herniation confirmed something clinicians have observed for years: a large proportion of disc herniations shrink and improve naturally over time, through a process the body carries out on its own.
This article focuses on what that research shows, what conservative care such as chiropractic and physiotherapy can realistically offer, why anti-inflammatory medication is a more nuanced topic than it first appears and what sensible next steps look like if you’re currently dealing with back or leg pain.
Disc Bulges Often Get Better by Themselves
Your body has its own clean-up system
When disc material pushes beyond its normal boundary, the immune system treats it as tissue that doesn’t belong. Specialist immune cells called macrophages move into the area over the following weeks and months, gradually breaking down and clearing the displaced material. This process is known as spontaneous disc resorption and it’s well documented in the medical literature rather than being a fringe idea.
The 2025 review found that this natural clean-up process is particularly common in larger disc extrusions and sequestrations (where a fragment has separated from the main disc), although smaller bulges and protrusions may also shrink over time.
MRI changes often line up with how patients actually feel
Across the studies reviewed, as the herniated portion of disc reduced in size on repeat scans, patients frequently reported:
- Less leg pain (sciatica)
- Reduced back pain
- Better movement and flexibility
- Improved ability to manage daily tasks, work and hobbies
The time frame varies a great deal from person to person. Some people notice real improvement within a few months. Others continue to improve gradually over six to twelve months or longer. This variation is completely normal and isn’t a sign that something has gone wrong.
This is also why major clinical guidelines, including NICE guidance in the UK, recommend a period of conservative, non-surgical management before surgery is considered, provided there are no red flag symptoms (more on those below).
What this means if you’ve just had a scan
If you’ve recently been told you have a disc bulge or herniation, it’s worth remembering:
- This is a common and well-understood finding, not a rare or alarming one.
- Many people with disc bulges on MRI have little or no pain at all. Studies of pain-free adults regularly find bulges and protrusions on imaging, which is part of why scan results are always interpreted alongside your symptoms, not in isolation.
- A degree of natural healing is the expected course for most people, not the exception.
Chiropractic and Flexion-Distraction Can Help
Conservative care supports the healing process
The review examined a range of non-surgical approaches, including exercise, spinal manipulation, traction and acupuncture. It’s genuinely difficult in research terms to separate the effects of natural healing from the effects of treatment, since both tend to happen at the same time. What the evidence does support is that conservative care can provide meaningful symptom relief while the body carries out its own repair process, helping people stay mobile and manage daily life in the meantime.
What about chiropractic care specifically?
Spinal manipulation has a solid evidence base for sciatica linked to disc herniation. A randomised, double-blind clinical trial published in the Spine Journal compared real spinal manipulation with simulated (sham) manipulation in patients with acute back pain and sciatica caused by disc protrusion. The study found meaningful improvements in the group receiving genuine treatment, including some reduction in disc protrusion size on repeat imaging.
In a separate study, researchers followed patients who had an MRI-confirmed disc herniation and were treated with chiropractic spinal manipulation. A year later, most were doing well. For some, their improvement was similar to what is typically seen in patients who had had surgery for a similar problem.
A more recent study looked at health records for a large number of adults with disc herniation and sciatica. It found that those who had chiropractic spinal manipulation were less likely to need disc surgery over the following two years, compared with those who received other kinds of care.
Importantly, this doesn’t prove that chiropractic treatment directly causes a disc to resorb faster. What it does suggest is that it can help reduce pain and improve function while the body’s own healing takes place. For the right patients it’s a reasonable, low-risk option to try before considering more invasive routes.
Why we choose flexion-distraction for disc-related pain
Flexion-distraction is a gentle, low-force chiropractic technique frequently used for disc-related back and leg pain. We love it. It often relieves the pain immediately and is very safe. The patient lies face down on a specially designed table that allows us to create a slow, controlled stretching and flexing motion through the lower back.
Laboratory research measuring pressure inside the disc during this technique has found reductions in intradiscal pressure at the treated level, along with an increase in the space available around the nerve root. Put simply, the technique appears to create space where there was previously compression, without any twisting, forceful thrust or sudden movement.
While more high-quality clinical trials are still needed to confirm exactly how much this biomechanical effect translates into faster healing, these findings offer a plausible explanation for why many of our patients describe genuine relief with this approach, particularly in the acute and early stages of a disc-related flare-up.
At Sundial Clinics, flexion-distraction is one of several tools our chiropractic team may use, chosen because it’s well suited to people who want a gentler, non-forceful option, including those who are naturally more cautious about hands-on treatment or who have more irritable symptoms.
“It’s a technique we reach for often with disc-related pain, precisely because it’s gentle enough for people who are understandably wary of hands-on treatment, while still doing something useful mechanically,” says Ben Clark, our Principal Chiropractor at Sundial Clinic Kemptown. “The assessment is what tells us whether it’s the right fit for someone, not the diagnosis on its own.”
Anti-Inflammatory Medications: A More Nuanced Picture
Inflammation isn’t always the enemy
Inflammation has a poor reputation, but in the context of disc herniation it appears to play a genuinely useful role. The same immune cells that create the inflammatory response, the macrophages, are also the cells responsible for breaking down and clearing the herniated material. In other words, some inflammation may be part of how the body heals itself, not simply a problem to be switched off.
Could anti-inflammatory drugs slow the healing process?
This is an area of active, ongoing research and the picture from human studies is genuinely mixed rather than settled.
Research has shown that high-dose steroid treatment can inhibit disc resorption, apparently by reducing the activity of the macrophages responsible for clearing disc material. Laboratory work has also shown that steroid medications can stop these immune cells developing into the specific type needed for tissue clean-up.
Other evidence is less clear-cut. One clinical trial gave patients either a steroid injection or a plain saline injection near the affected nerve. A year later, the disc had shrunk by a similar amount in both groups, with no meaningful difference between them. The researchers concluded that, in this case, the steroid injection did not seem to get in the way of the body’s natural healing process.
Other studies have suggested that patients who avoided anti-inflammatory medication saw more complete shrinkage of the disc. At the same time, some researchers think the wider use of NSAIDs and steroids for back pain is a question that still needs more research before any firm conclusions can be drawn.
Taken together, current evidence doesn’t support a firm rule for or against anti-inflammatory medication on the basis of disc healing alone. What it does support is a more thoughtful, individual conversation between patient and prescriber, rather than automatic long-term use.
Pain relief still has a genuine role
None of this means anti-inflammatory medication should never be used. NICE guidance in the UK continues to support NSAIDs, at the lowest effective dose for the shortest appropriate time, as a reasonable option for sciatica pain relief where suitable. They can make a real difference to comfort and daily function, particularly during a severe flare-up, and that quality of life matters.
The sensible takeaway is one of balance rather than avoidance: use pain relief to help you function and sleep when you need to, while being mindful that it’s a symptom-control tool rather than a healing accelerator, and always discuss the right choice and duration with your GP, particularly if you’re managing symptoms for more than a few weeks.
Healing a Disc Bulge: Self-Help Tips
If you’re dealing with a bulging disc, spine researcher Dr. Stuart McGill’s decades of work offer a reassuring message: discs can regain resilience. But healing isn’t about finding one magic stretch: it’s about giving the injury the conditions it needs to repair, and then not undoing that progress. Here are practical, simple tips based on his approach.
1. Find Your “Trigger” Movements and Stop Doing Them
A disc bulge is often a fissure that opens and closes with certain postures, usually repeated forward bending or slouching. The single most useful thing you can do is figure out which everyday movements aggravate it (bending to tie your shoes, slouched sitting, rounding your back to lift) and eliminate them for now. Every time the fissure reopens, healing resets to square one.
Try this: for a few days, notice exactly which positions bring on pain or nerve symptoms (tingling, shooting pain down a leg). Write them down. These are your movements to avoid while you heal.
2. Use the “Fists Under the Chin” Rest Position
One of McGill’s simplest recommendations: lie face-down for about five minutes with both fists stacked under your chin. This gentle position can calm the disc and ease symptoms without the strain of more aggressive extension exercises.
Try this: a few times a day, especially after sitting for a while, lie on your stomach, stack your fists under your chin and relax there for 5 minutes with good posture.
3. Be Cautious with “Standard” Back Exercises
You may have heard of the McKenzie press-up (lying face-down and pushing your chest up with your arms). McGill’s research suggests this works best for people who still have most of their disc height intact. For more degenerated discs, it can be less effective and even risk irritating the small joints in your spine. Don’t assume a popular exercise is automatically safe for your specific case.
Try this: skip aggressive extension exercises early on. Start with the gentler resting position above and only progress to more active exercises with guidance from a professional who has assessed your spine.
4. Fix Your Sitting Posture
Slouched sitting is one of the most common everyday triggers for disc bulge symptoms. Even short periods of poor posture can aggravate the fissure.
Try this: use a lumbar support pillow, avoid sitting slouched for more than 20 minutes at a stretch and get up and move regularly throughout the day.
5. Rebuild Gradually. Don’t Rush Back
Once you’re out of the acute, painful phase, resist the urge to jump straight back into your old training routine or activity level. Going back to the same movement patterns, loads and habits that caused the injury will likely cause it again. Healing happens in stages: remove the cause, let the tissue “gristle” (form resilient scar tissue), then rebuild strength and control before returning to full activity.
Try this: when you’re ready to return to exercise or sport, build back up in stages: start with basic core stability and controlled movement before returning to your previous intensity.
6. Be Patient with the Process
Discs heal slowly, and progress can be undone by a single bad movement pattern repeated over and over. The goal isn’t a quick fix. It’s consistency in avoiding provocative postures while your body does the repair work.
Red Flags: When to Take It Easy or Seek Urgent Advice
Most disc-related back and leg pain is manageable with the approach above and improves over time. However, a small number of symptoms need prompt medical attention rather than watchful waiting. Contact your GP, NHS 111, or if very sudden, A&E, if you notice:
- Loss of bladder or bowel control, or new numbness around the saddle area (inner thighs, genitals or bottom)
- Progressive weakness in one or both legs, such as a foot that increasingly drags or gives way
- Severe, unrelenting pain that isn’t easing with rest or position changes
- Unexplained weight loss alongside back pain or a history of cancer
- Fever alongside new or worsening back pain
- Significant trauma, such as a fall or accident, before the pain began
These are uncommon, but they’re important, and any reputable clinician, whether chiropractor, physiotherapist or GP, should be screening for them at your first assessment.
When a Professional Assessment Is Sensible
Many people reasonably ask: “Do I need to see someone or will this just sort itself out?” A professional assessment is worth considering if:
- Pain or leg symptoms have lasted more than two to three weeks without settling
- Pain is significantly limiting work, sleep, exercise or the activities you enjoy
- You’ve had a scan and want the findings properly explained in plain language
- You’ve tried simple self-help measures without much progress
- You simply want peace of mind and a clear plan, rather than continuing to guess
How Identifying the Problem First Sets You on the Right Track
Before anything else, most patients want one thing: to understand what’s actually going on. A proper assessment at Sundial, whether with a chiropractor or physiotherapist, is about far more than deciding on a treatment. It’s the process of working out what’s driving your symptoms, ruling out anything that needs onward referral and building a realistic picture of what recovery looks like for you specifically.
At Sundial Clinics, our chiropractors and physiotherapists are trained to assess the whole picture, not just the painful area in isolation. That includes your posture and movement patterns, your general activity levels, relevant lifestyle factors and how your symptoms behave over a typical day. Both professions share a strong foundation in musculoskeletal assessment and both are trained to recognise red flags and refer appropriately when something falls outside conservative care, whether that’s back to your GP for further investigation or on to a specialist.
A thorough initial assessment typically includes:
- A detailed history of how and when your symptoms started and how they’ve changed
- Screening questions for red flag symptoms
- A physical examination of movement, strength, reflexes and nerve function where relevant
- A plain-language explanation of what’s likely going on, including the context around any scan results
- A discussion of realistic timescales for improvement
- A tailored plan that may include hands-on treatment, exercise guidance, self-management advice or referral back to your GP or a specialist where appropriate
This matters beyond the disc itself, too. Getting a clear, confident understanding of an MSK issue early on tends to support better decision-making about activity, work and exercise. This can prevent the low mood and deconditioning that sometimes creeps in when people avoid movement altogether out of uncertainty or fear.
How Sundial Clinics May Help
Sundial Clinics is a multidisciplinary clinic across our city centre Queens Road and Kemptown locations, bringing together chiropractic, physiotherapy and sports massage under one roof. For disc-related back and leg pain, that might mean:
- Assessment and clear explanation, including what any scan findings actually mean for you
- Hands-on care, which may include spinal manipulation, flexion-distraction, soft tissue work or mobilisation, chosen to suit your presentation and preference
- Exercise and movement guidance, tailored to help you stay active safely while symptoms settle
- Practical advice on positions, pacing and returning to work, sport or hobbies
- Referral where appropriate, back to your GP or on to imaging or a specialist opinion, if your symptoms suggest that’s the more suitable route
We’re not the right first step for every cause of back or leg pain and a good assessment will tell you if that’s the case. But for the many people whose disc-related symptoms are following the expected pattern of natural improvement, conservative care alongside sensible self-management is often exactly what’s needed to stay comfortable and active while healing takes place.
Frequently Asked Questions
Does a disc bulge mean I’ll eventually need surgery? Not usually. Most disc herniations improve with time and conservative care. International guidelines recommend a period of non-surgical management first, provided there are no red flag symptoms. Surgery tends to be reserved for cases with significant, persistent neurological symptoms or where red flags are present.
How long will it take to feel better? It varies. Some people notice improvement within a few weeks, others over several months. A properly graded plan and realistic expectations tend to make this period far more manageable than facing it without guidance.
Is it safe to exercise with a disc bulge? For most people, yes, with sensible pacing and the right choice of activity. A physiotherapist or chiropractor can help you understand which movements to ease into and which to modify temporarily.
Should I stop taking anti-inflammatory medication? Don’t stop or change any prescribed medication without speaking to your GP or pharmacist first. The research on inflammation and healing is genuinely still developing and pain relief has real value, particularly during flare-ups.
Can chiropractic treatment make a disc bulge worse? When delivered by a properly trained practitioner following a thorough assessment, spinal manipulation and flexion-distraction are generally safe for appropriate patients. That’s precisely why assessment comes first, to identify who is, and isn’t, a suitable candidate for hands-on treatment.
Do I need a scan before seeing a chiropractor or physiotherapist? Not usually. Scans are generally reserved for cases with red flag symptoms or where surgery is being considered. A skilled clinical assessment can identify most disc-related presentations without imaging.
What’s the difference between a chiropractor and a physiotherapist for this kind of problem? Both professions are trained in musculoskeletal assessment and manage disc-related pain regularly, often with overlapping approaches such as exercise and manual therapy. Chiropractors have specific additional training in spinal manipulation techniques including flexion-distraction. At Sundial, our team will guide you toward whichever fits your presentation and preference, and the two professions work closely together under one roof.
References
Lumbar Disc Herniation Resorption: When and How Does It Occur? Neurospine 2025 (in press/2026), open-access comprehensive review of mechanisms, predictors and conservative management of spontaneous lumbar disc herniation resorption:
Supporting peer-reviewed studies:
Santilli V, Beghi E, Finucci S. Chiropractic manipulation in the treatment of acute back pain and sciatica with disc protrusion: a randomized double-blind clinical trial of active and simulated spinal manipulations. Spine J. 2006;6(2):131-137.
Leemann S, Peterson CK, Schmid C, Anklin B, Humphreys BK. Outcomes of acute and chronic patients with magnetic resonance imaging-confirmed symptomatic lumbar disc herniations receiving high-velocity, low-amplitude, spinal manipulative therapy: a prospective observational cohort study with one-year follow-up. J Manipulative Physiol Ther. 2014;37(3):155-163.
Trager RJ, Daniels CJ, Perez JA, Casselberry RM, Dusek JA. Association between chiropractic spinal manipulation and lumbar discectomy in adults with lumbar disc herniation and radiculopathy: retrospective cohort study using United States’ data. BMJ Open. 2022;12(12):e068262.
Gudavalli MR, Cramer GD, Patwardhan AG. Changes in intradiscal pressure during flexion-distraction type of chiropractic procedure: a pilot cadaveric study. Integr Med Rep. 2022;1(1):209-214
Autio RA, et al. Effect of periradicular methylprednisolone on spontaneous resorption of intervertebral disc herniations. Spine (Phila Pa 1976). 2004;29(14):1601-1607.
About Matthew Bennett, Chiropractor Brighton
Matthew Bennett is the founder and principal chiropractor at Sundial Clinics Brighton, established in 1991. With over 35 years of clinical experience, Matthew qualified from the Anglo-European College of Chiropractic in 1987 and served as President of the British Chiropractic Association for four years. As a Fellow of the Royal College of Chiropractors and former team chiropractor for Brighton and Hove Albion FC and the British Alpine Ski Team, Matthew combines evidence-based chiropractic treatment with sports performance expertise. His authority in musculoskeletal health has been recognised through national media appearances, expert witness roles and contributions to professional publications. Matthew’s commitment to clinical excellence ensures patients receive the most effective chiropractic care in Brighton.