Why a Herniated Disc is not the Cause of Your Back Pain

We will show you why a bulging disc or herniated disc is not the cause of back pain in the majority of cases.

A typical case of a person with back pain starts out like this. A person who was previously fine begins to suddenly experience back pain with no apparent cause. The person may or may not have a history of back pain, and any history of back pain that they do have is not the result of a fall or accident. The person, despite the pain becoming increasingly severe, does not make an appointment with the doctor to address the problem. The pain continues for several days, with no apparent back pain relief in sight. Eventually, the person makes an appointment with their doctor to address a problem that cannot manage on their own. The doctor may then prescribe analgesic medications (pain meds) for the pain and discomfort, and an X-ray to take images of the back. What do these images show? These images show a narrowed amount of space between the discs that separate the vertebrae (vertebral bones) of the back. You and your doctor may then both assume that the cause of your problem is due to a herniated disc, or a "slipped disc", in your spine.



What actually is a herniated disc? A herniated disc is a condition where the tough fibrous envelope of the disc sustains a tear large enough for the inner gel-like interior of the disc to escape from the disc. Imagine the air being let out of a tire. We don't typically feel pain as a result of the disc disease, but rather because of the inner material from the nucleus pulposus (inner core) pressing on the adjacent nerve roots and ligaments of the spine. Though the terms and "bulging disc" and "herniated disc" are often used interchangeably, the precise pathology is a little different. With a bulging disc, the outer envelope of the disc becomes thinned or weakened to the point where it bulges outwards. With a herniated disc, the wall becomes torn completely, ejecting its contents outwards. In both of these conditions, the adjacent nerve roots and ligaments may be pressed on, causing pain and discomfort.

What are three things to know about bulging discs and herniated discs?
  1. Walls that become weakened or torn as a result of bulging/herniated discs can heal on their own. From this fact, we know that not all cases of disc disease are irreversible, and require aggressive therapies such as surgery to remove the disc.
  2. Herniated discs are actually rare, and occur in less than 10% of people that have back pain.
  3. Herniated discs are the cause of back pain in a relatively small percentage of cases. Recent data shows that herniated discs are the cause of back pain in only 10% of all cases.
The facts above demonstrate why a herniated disc is not the cause of back pain in the majority of cases. One interesting thing to know about degenerative disc disease is that the anatomical changes that the discs go through actually have the effect of preventing back pain in most cases. As we get older, the volume of gel-like watery fluid in the disc begins to diminish. The disc begins to lose its height as a result of this loss of fluid volume. As this degenerative process is occurring, the annulus (outer envelope of the discs) begins to weaken and thin as well. If both of these rates of degeneration to the two parts of the disc occur at roughly the same rate, the person will not experience pain as a result to these changes of the discs of the back. Research has shown that this is fact the case with most people.