Natural Course

The majority of low back pain episodes resolve spontaneously without the need for any specific treatment. Thirty-five percent still have pain in four months and 10%  percent still suffer symptoms at one year. Of those that recover, however, 75 percent have a recurrence of the low back pain within one year.

One study of radiculopathy (back pain radiating to the legs) showed that of the patients who had a herniated disc on CT scan, the majority did not show evidence of a herniated disc on follow-up despite the fact that they did not have surgery. More than one third had smaller herniated discs, and about a fifth of the patients remained unchanged. Another study of patients with radiculopathy showed a 75-100 percent decrease in size of the herniated disc in 46 percent and a 50-75 percent decrease in 36 percent. Only 11 percent did not show at least a 50 percent decrease in the size of the herniated disc even without surgery.

In one study of a group of 52 patients with spinal stenosis, only four required surgery. Everyone underwent exercise and some received epidural steroids. Out of the 52, 63 percent had an improvement in pain and daily function and 69 percent had no or minimal difficulty with walking. In another study of 32 patients, walking improved in 37 percent, remained unchanged in 33 percent and worsened in 30 percent.