A herniated disc is a common cause of back and leg pain, but only a minority of patients need surgery. How a herniation behaves over time, which methods help without surgery and when an operation is really needed.

How a herniation behaves over time

Herniations and protrusions are often found on MRI in people without pain. In most patients radicular pain decreases within 6–12 weeks, and large extruded fragments often partly resorb over time. So, in the absence of warning signs, treatment starts without surgery.

Treatment without surgery

  • Staying active and exercise therapy are the basis: bed rest does not speed up recovery.
  • Medication — a short course of NSAIDs and, for severe radicular pain, neuropathic pain medication.
  • An epidural or transforaminal corticosteroid injection often reduces radicular pain for weeks or months and helps get through the acute phase.
  • Intradiscal PRP and cell injections are being studied in small trials; some patients report less pain, but there is no evidence that the disc is restored. This is an option for selected patients when standard treatment has not helped.

When surgery is really needed

Urgently — with cauda equina syndrome (numbness in the groin area, bladder problems) and increasing leg weakness. Electively — if severe radicular pain does not ease after 6–12 weeks of treatment. Surgery relieves leg pain faster; after 1–2 years the results of surgery and non-surgical treatment are often similar (SPORT and other trials).

How we help

Send us your MRI report and a description of your symptoms: we forward them to several partner clinics, their physicians propose a plan — conservative or surgical — and a cost, and you compare the options. More on the herniated disc page.

Who it is not suitable for and possible risks

Contraindications

  • Active infection — at the injection site or systemic, with fever.
  • Active cancer or ongoing chemotherapy.
  • Blood clotting disorders or a low platelet count. Anticoagulants are discussed with the physician.
  • Pregnancy and breastfeeding — the procedure is usually postponed.
  • A corticosteroid injection into the same area in recent weeks.
  • Urgent surgery, not injections, is needed if there is progressive leg weakness, numbness in the groin area or bladder dysfunction.

Possible risks

  • Pain and swelling at the injection site for 1–3 days.
  • Bruising where blood or fat tissue is taken.
  • Rarely, infection. The procedure is therefore performed under sterile conditions with ultrasound or X-ray guidance.
  • The effect may be absent or smaller than expected.
  • Injections into the intervertebral disc carry a rare risk of disc inflammation (discitis).

If any of these apply to you, mention it in your request. The coordinator will check with the clinic physician whether treatment is possible. Contact a coordinator.

Scientific evidence

Studies of regenerative methods show mixed results. Clinic physicians rely on research including the following:

  1. Lurie JD et al. Surgical versus nonoperative treatment for lumbar disc herniation: eight-year results for the spine patient outcomes research trial. Spine (Phila Pa 1976), 2014.
  2. Chiu CC et al. The probability of spontaneous regression of lumbar herniated disc: a systematic review. Clin Rehabil, 2015.

Next steps: Treatment methods · Treatment cost · How treatment in Germany is organised

Clinic and method matching — free of charge

Describe your case and attach your MRI report. We will identify clinics that use the relevant methods and forward your request to them. No obligation; we reply within 24 hours.

Send a request

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Frequently asked questions

Can a herniated disc heal on its own?

Yes, many herniations, especially large sequestrations, shrink or disappear within a few months, as repeat MRIs show. Pain often settles even sooner.

What injections are used for a herniated disc?

Most often a periradicular injection (PRT) or epidural injection with a corticosteroid under CT or X-ray guidance. They reduce nerve pain for weeks to months and help bridge the recovery period.

When does a herniated disc need urgent surgery?

With saddle numbness, problems passing urine or stool, or rapidly increasing leg weakness — this is cauda equina syndrome and needs emergency care.

How does RegenPAS help organise treatment?

RegenPAS is a patient service centre in Munich, not a clinic. We review your images and symptoms and send a request to several partner clinics at once. Clinics that can accept you send their own conditions and price; prices differ between clinics, and you choose the option that suits you. The coordinator replies within 24 hours, and a clinic physician’s preliminary opinion follows in 1–3 business days. We then arrange the appointment, visa invitation, interpreter, transfers and accommodation. Treatment decisions are made by the clinic physician. Contact a coordinator.

How much does treatment cost and how long do I need to stay in Munich?

The cost depends on the method, the diagnostics needed and the clinic itself: prices differ between clinics. We request offers from several clinics and send you their conditions and quotes so you can compare. Price guidance is on the treatment cost page. For an outpatient procedure, 2–3 days in Munich are usually enough: examination, procedure and follow-up visit.