Space occupying disc herniation is likely.
Firm neurologic signs have potential for development of permanent residuals, and such cases may be surgical candidates. In the presence of firm neurologic signs such as significant motor weakness, muscle atrophy, severe intractable pain, and documented nerve damage, a conservative regimen is likely to have already failed. Under such circumstances, a short trial of manipulation may be warranted if not previously attempted and pain is manageable. If progressive deterioration occurs, prolonged manipulative management is not considered. Depending on the degree of annular bulging and the nature of neurologic damage, healing requires a greater amount of time than non-disc and lesser disc injuries.