The spine is composed of many vertebrae stacked on top of each other. Between these bones are discs, which act as shock absorbers. The shock-absorbing discs resemble jelly donuts, each having a jelly-like center. As we age, the discs naturally become less flexible and more brittle. Normal disc degeneration which naturally occurs with old age, can also cause pain.
Discs can herniate in any direction — forward, centrally or, most commonly, backward and sideways in the direction of the spinal nerves.
Herniated discs account for a small percentage of back pain.
While herniated discs are often referred to as “slipped discs,” this really isn’t accurate because discs don’t ever slip out of position. They are actually attached by connective tissue to vertebrae above and below. A disc herniation can be “contained” or “uncontained.” With a bulge, for example, the jelly center remains within the disc wall. "Uncontained" means the jelly center has broken through the annulus wall but stays connected to the nucleus pulposus. Or the herniation can be “sequestered,” when it breaks free from the nucleus and travels away from the disc.
A bulging disc forms when the wall of the disc is deformed but not necessarily herniated. The nucleus is still contained in the wall. You NEVER need surgery to treat a bulging disc.
In the event of a fall or heavy strain, discs can rupture, causing the nucleus to break through the wall of the disc and place pressure on the nerves that branch out from the spinal cord. This results in a herniated disc, accompanied by back or neck pain. For example, sitting down for a while, then lifting a heavy object, can cause a disc to herniate.
Sometimes, people mistake excruciating pain for a herniated disc, when the pain might actually be the signal of a muscle strain.
Because the nerve roots act as telegraph lines to other parts of the body, a common complication of disc herniation is that it can cause pain that is felt in other parts of the body. In fact, leg pain below the knee is a common herniated disc symptom. This radiating pain is called radicular pain or radiculopathy. Often, back pain without leg pain can be a result of partial herniation of the disc or an internal disc disruption.
Outlined below are some of the diagnostic tools that your physician may use to gain insight into your condition and determine the best treatment plan for your condition.
Unlike muscles, which can heal somewhat quickly, a torn or degenerated disc heals more slowly. The good news is that in many cases, the pain and inflammation originating from damaged discs can be treated nonsurgically by reducing the inflammation and by strengthening the musculature surrounding the damaged disc to give it more support.
Special extension exercises can help relieve pain from a herniated disc. Exercise can work like a vacuum to suck the center of the disc back into place, helping release pressure on the nerve. Although someone suffering an attack of back pain may find it hard to believe, it has been proven that specific exercises can help relieve their pain.
Herniated discs can occur as a result of a heavy strain or fall, which causes the nucleus to break through the wall of the disc and place pressure on the nerves that branch out from the spinal cord. For example, lifting a heavy object after sitting down for a long period of time can cause a disc to herniate.
Nonsurgical treatment methods are always the best option to try first. This will most likely involve working with a physical therapist who will develop a customized exercise program involving specific stretches and extension movements for you.
Dr. Michael Rohan, Jr. is fellowship-trained in spine surgery, the highest level of medical education in the U.S. Over the past 10 years, Northwest Florida Spine has been referred back and neck pain patients from across the Gulf Coast region for the most advanced minimally invasive spine surgery and artificial disc replacement surgery. Responding to its regional reputation in spine care, in early 2018, the spine center transitioned its name from Panama City Spine to Northwest Florida Spine which reflects the regional draw of patients.
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