Herniated Disc

A herniated disc is a condition where the outer envelope of the intervertebral disc becomes torn to the point that the nucleus inside the disc projects outwards. There are several reasons why this condition may cause back pain or neck pain. First, let's take a look at the disc's primary function. The primary function of the intervertebral disc is to cushion the spine as gravity is applied to it, when we stand, walk, and do other things. As the nucleus inside the disc is pushed outwards, the disc loses its height and the ability to provide the cushioning support to the spine that it once did. This could cause contact to the vertebral bones that the discs are supposed to separate to come in contact with one another. This contact among the bones may result in the development of osteophytes and osteoarthritis. The degenerations of the discs may also result in instability in other part of the spine as well. The spine is composed of hundreds of individual units, though all the components have a unifying function of moving in one direction at a time, and of protecting the spinal cord and its spinal nerve. When one portion of the spine has become unstable, it could also cause instability in other portions of the spine as well, resulting in pressure on the spinal nerves. Let's take a look at what a herniated disc is, how it caused back pain, as well as associated symptoms and treatment options for it.

A spinal disc herniation is a condition where a tear in the border of the intervertebral disc (annulus fibrosis) caused the material within the nucleus of the disc (nucleus pulposus) to project through the tear. Patients may experience pain when this disc material contacts the spinal nerves or spinal ligaments. Until recently, it was thought that we weren't likely to experience pain due to the changes in the discs themselves, but due to the structures in the spine that the nucleus presses into. More recently, however, new data has come forth suggesting that the discs themselves are supplied with nerves that may react to conditions such as spinal disc herniations and degenerative disc disease. When these discs do become torn, inflammatory chemical mediators are released which may be the sole cause of pain, or may increase pain levels in disc herniation conditions which involve nerve root compression.



When spinal disc herniations do occur, they are usually in the posterolateral portions of the disc due to the presence of the posterior longitudinal ligament in the spinal canal.

A herniated disc is a more severe form of a bulging disc condition. A bulging disc condition involves a disc "protrusion" in which the outer rings of the disc become worn or frayed to the point that they bulge outwards. A herniation is a condition where the wall of the disc ruptures completely. The outer layers of the disc remain intact, but the pressure from within the disc causes it to bulge under pressure.

Fortunately, these discs do have the capacity for regeneration. The walls of the disc may be able to close again, and the disc material may get reabsorbed by the discs themselves or by the body.

The healing process for spinal disc herniations could last from several weeks to never. This doesn't mean that patients are doomed to pain, discomfort, and muscles spasms in cases where disc herniations don't fully heal. The body has several protective mechanisms that enable it to adjust to these types of changes in the spine. The cases that become serious for these types of conditions are those in which the protruding material from the disc causes enough pressure on the nerve to cause severe pain or physical limitations related to the neurologic symptoms that result. Some of these neurologic symptoms include sensory changes in the arms or legs, atrophy of the muscle, loss of reflexes, paralysis, or parasthenia. Parasthenia is the feeling you get when you hold your arms or legs in a position long enough to lose partial feeling in that limb. As the feeling comes back in that arm or leg, you will feel numbness, burning, "pins and needles", or tingling. In some disc herniation conditions, the compression of the spinal nerve may cause you to feel these symptoms continuously.

This term is sometimes called a slipped disc, though these discs are well bonded to the vertebrae on their superior and inferior borders and don't actually ever slip out of their position in the spine. These discs are fused to the vertebral bones above and below them. However, one vertebral body may slip out of its ideal position in the spine relative to another vertebral body. Significant slippage of the vertebra is called spondylolisthesis, and this movement of one vertebra laterally away from the one above or below it may cause damage to the affected discs.

Other terms that may also be applied to this back condition include ruptured disc and prolapsed disc.