Intervertebral Disc Disease

Intervertebral disc disease is caused by a degeneration of the spinal discs, at either the annulus fibrosus or the nucleus pulposus.

The individual components of the human spine - the vertebral bones, house and protect the delicate spinal cord and meninges.

the vertebral bones are numbered according to the section of the spine and level they occupy. There are 7 cervical vertebrae, labeled C1-C7, beginning at C1 at the top of the spine, and C7 at the bottom of the cervical spine. There are also 12 Thoracic (T1-T12) vertebrea, 5 lumbar vertebrae (L1-L5), and the sacrum and coccyx in the pelvic spine, below the lumbar spine.

Located between these vertebrae are the intervertebral discs, that may be squeezed downwards to provide shock absorption and prevention of friction between the vertebral bones. Each disc and the vertebrae on either side of it form a joint. just as the Meniscus absorbs forces between the knee, the intervertebral discs provide a cushion to absorb energy between the vertebrae to protect the bones and soft tissues of the back. The discs also assist with movement of the spine, due to their flexibility and ability to move, due to their pliable gel interior. The discs also help maintain proper alignment of the spine and contribute to the stability of the spine.



The intervertebral discs have two main sections that are both flexible enough to allow it to bulge outwards and downwards to cushion the spine and allow for movement: the outer annulus fibrosus, and the inner nucleus pulposus. The annulus fibrosus is the tough, durable, outer shell of the disc, that is composed of fibrocartilage. Fibrocartilage, which is made up of a combination of fibrous connective tissue and cartilage, is flexible and elastic, yet durable and resistant to tearing. The interior of the disc - the nucleus pulposus, is composed of a thick, gel mixture of water and proteoglycans. This gel mixture allows for the disc to absorb and disperse energy to resist compression, when we put weigh on one or more sections of our backs. The two main sections of the discs are largely avascular, and thus are vulnerable injury because they are slow to regenerate and heal themselves. These structures bear some of the greatest loads on the body, especially when we regularly use bad posture, don't regularly stay hydrated, and when we are overweight. When one of more of these factors cause greater loads on the discs than they are designed to bear, intervertebral disc disease may occur. Intervertebral disc may occur from the outside in, such as when the annulus fibrosus becomes torn or weak, or from the inside out ,such as when the materials of the nucleus pulposus dry out and lose their ability to retain water. The discs may cause back pain when materials are ejected from the disc, such as when tears occur in the annulus - a condition known as a herniated disc.

What are some available options available to treat intervertebral disc disease? Though surgery may be required in a small number of cases, such as when the result of the problem causes enough compression of the nerve roots to cause disability, conservative treatment are usually effective. Conservative treatments for degenerative disc disease include exercise and physical therapy, analgesics (pain medications), injections (cortisone steroid shots), ultrasound, massage, and manipulations. Manipulations of the spine and soft tissues are performed by a chiropractor or an osteopath (D.O.).