A disc hernation is a sort of blowout of an intervertebral disc, which cushions the bones and soft tissues of the spine. Think of an inververtebral disc as a cushion between two vertebra (spinal bones). When we stand erect and put weight on our spines, these discs have enough malleability to expand slightly downward and outward, like the cushions of the couch. The inner gel material in the disc provides this cushioning effect, while its outer wall provides enough stability to hold the disc together. However, due to injuries or the degenerative effects of time, these discs may rupture at their outer walls. This rupture of the outer wall is known as a disc herniation. When this happens, patients may experience pain due to this disc disease or when the material within the disc presses against the spinal nerve roots.
A disc herniation is also known as a prolapsed, disc, black disc, disc disease, disc protrusion, collapsed disc, slipped disc, torn disc, and ruptured disc. Other interchangeable terms for a disc herniation are a bulging disc, pinched nerve, and herniated disc.
- The inner portion of the disc containing the gel-like material is known as the nucleus pulposus.
- The outer solid wall of the disc is known as the annulus fibrosus.
- The spinal nerve roots are the structures that exit through the sides of the spine to supply the structures and organs of the body.
In the past, it was thought that patient's did not experience pain directly as a result of a disc herniation. It was previously thought that the discs themselves were not supplied with any nerve endings. It was thought that only when the material ejected through the walls of the disc pressed against the nerve roots would we feel pain. Today, there is growing evidence supporting the fact that the discs themselves are supplied with nerve endings.
All types of pain conditions that result from disc disease still do present doctors with a number of challenges and new questions, in terms of cause and effect. This is because of the fact that some patients experience great pain and disability as a result of disc disease, while others do not. The reason why some people with disc pain become affected by it while others do not is still not well understood. Doctors are also still vexed in terms with developing a reliable scientific process for coming up with protocols with treating the condition. Some people with disc disease will respond well to physical therapy and steroid injections while others do not. Some people with chronic pain related to a disc herniation will respond well to back and neck surgery while others do not.
Why? There is much that we don't know about back physiology, back pain, and disc disease. Here are some things that we do know.
As previously discussed in this article, we do know that there are two caused of pain associated with a disc herniation: pinched nerve pain and disc pain. Let's take a closer look at each one of these two spinal disc problems.
Pinched Nerve: Many people have major disc changes in their spine that do not result in patients experiencing any pain or disability. There are less patients that remain asymptomatic when the herniated disc material presses into the spinal nerves, putting pressure on them. This pressing against the nerve, known as a pinched nerve condition, causes pain that exists near the site of compression or along the path that the nerve travels. This symptom of radiating pain along the path of the nerve is known as radicular pain. Radicular pain that occurs in the legs is usually the result of a condition known as sciatica.
Disc Pain: Today, new research indicates that patients may feel pain directly as a result of the collapse or tearing of an intervertebral disc. When the disc itself of the source of the patient's pain, this type of pain may be labeled as axial pain.