Herniated disc is a fairly common condition that may present with anything from simple low back pain to severe radiating pain into the buttocks or down the leg. This is typically called sciatica. The disc is composed of an outer annular layer of fibrocartilage and an inner gelatinous core called the nucleus.
It’s structure resembles that of a jelly doughnut with the jelly being synonomous with the nucleus and the doughnut the annular layer. In degenerative disc disease the disc, which is composed of 70% water, becomes severely dehydrated and brittle. This makes it more susceptible to wear and tear. In some cases it becomes dessicated which creates small little tears or cracks and the jelly may leak causing a ‘leaky disc’ syndrome in which surrounding soft tissues and nerves can become irritated.
In addition to this the disc may also bulge at the margins causing a small bubble like protrustion that may impinge or compress adjacent nerve roots or spinal nerves also leading to radicular symptoms such as sciatica or leg pain. If the bulge becomes more sever the disc may herniate and a portion of the nucleus, jelly inside the doughnut, may begin to migrate outside of the confines of the annular fibers, or the doughnut.
However, it must be emphasized that research has shown that as much as 60% of the population who is currently pain free may be walking around with a disc buldge or herniation. This means that out of 100 pain free individuals with no history or present complaints of back pain may have a disc buldge or herniation.
These findings are quite interesting and indicate that the strong correlation between back pain and disc problems may not be so strong after all. Does this mean that you shouldn’t address any positive MRI findings at all?
I think not. If you locate any signs of degenerative change in the spine it is still not normal. All this means is that the disc may not be the primary mechanism that actually results in PAIN. It still however may contribute to the ultimate terminus which is of course pain.
What it really means is that a positive finding on MRI study is not a life sentence -and- conservative rehabiliatin is probably your best course of action and you shouldn’t rush into any invasive or surgical procedure until you’ve had a course of conservative treatment FIRST as in most cases symptoms and even the disc buldge or herniation will retract and repair.
The following pictures gives a better idea of the different types of disc conditions:
If you’re suffering with a spinal disc condition contact us now to learn about your options at (800) 617-0314.
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