A Herniated Disc is a condition whereby the outer annulus Fibrosis is torn and the soft nucleus migrates through the annulus causing a deformity of the disc. This tearing and migration process can cause a great deal of pain which is perceived most often by the patient as a broad and diffuse back pain.
If the herniated disc deformity is compressing a nerve root, the patient may feel intense pain into their leg or arm depending on which disc is herniated.
There is an overwhelming amount of research that indicates the lumbar intervertebral disc is responsible for a great deal of chronic back pain and or leg pain.1,2 One of the most prestigious journals concerning the spinal column is entitled Spine, appropriately. The inaugural issue was published in March of 1976.3 An internationally recognized orthopedic surgeon named Alf Nachemson, M.D., published a detailed review of the literature citing 136 references pertaining to the state of knowledge on the topic of lower back pain. The time, Dr. Nachemson’s article was considered to be the most comprehensive and authoritative review available on the tope of low back pain, and it remains extensively cited in contemporary publications. His article is entitled, “The Lumbar Spine: An Orthopedic Challenge.” He basically concludes that, “The intervertebral disc is most likely the cause of pain.”
He presents 6 lines of reasoning and cites 17 references to support his contention that the disc is the most likely source of lower back pain. Interestingly, one of the studies he cites was completed by Smyth and Wright in 1958.4 Regarding the work by Smyth and Wright, Dr. Nachemson notes:
“Investigations have been performed in which thin nylon threads were surgically fastened to various structures in and around the nerve root. Three to four weeks after the surgery these structures were irritated by pulling on the threads, but [lower back] pain resembling that which the patient had experienced previously could be registered only from the outer part of the annulus of the disc”
Herniated Disc on MRI
I could go on an on about how the disc is most common source of chronic low back or leg pain, however I think I would loose you! Suffice it to say, if you have a chronic problem with your back, it is more likely than not that your it is coming from your disc.
Herniated, Bulging, Protruded, or Ruptured?
There are medical definitions as it relates to herniated, bulging, protrusion or rupture. I talk about these definitions specifically in some of the additional free information we provide. Basically, as it relates to your back pain, each of these cause back pain and depending on where the disc problem is located, will cause leg or arm pain as well. If you must know the actual definitions of these terms, feel free to request the additional information. I explain this in great detail.
Common Disc Symptoms?
Certainly at the top of the list of common disc symptoms is BACK PAIN. Leg pain is another top symptom. However, more than just the back and leg pain is how it affects quality of life. It is common for disc pain patients to have limitations in standing and walking. The longer you stand the more your back hurts. This is due to increased pressure in the disc. Also sitting for too long makes more pain, again due to an increase in disc pressure. Anything that increases disc pressure usually causes more pain. That’s why it hurts to lift objects, sometimes as light as 10-15 pounds. Any repetitive lifting will also cause additional pain and sometimes that additional pain can last multiple days before calming to the baseline level of pain. This all translates to a patient who can’t:
- Work in the yard
- Go shopping
- Play with children/grandchildren
- Play sports
- Stand in a line
- Enjoy life
And the list goes on and on. Intervertebral discs are something you would normally never think about, until just one gets injured and won’t heal. Then it’s all you think about and sometimes for years.
Traditional Treatments for Disc Problems
This is where the rubber meets the road for a disc pain sufferer. The problem lies with the treatments that are commonly administered for disc pain patients. Since the disc has been established as the primary cause of most patients chronic back or leg pain, then the disc must be treated effectively for the pain to stop. There has traditionally been a very large disconnect for disc patients leading up to surgery for disc problems.
There are certainly situations where surgery is the most appropriate treatment. I talk about surgery indications in the additional free information I provide. Most patients don’t want surgery and are looking for effective long term treatments. Some treatments that provide temporary relief of disc pain include:
- Spinal Injections
These treatments have a hard time promoting permanent healing when the disc herniation gets to be a certain size. So what does a patient do when the disc problem is not bad enough for surgery but too bad to respond to normal traditional treatments? Usually they just live with the pain until the disc herniation worsens. Unfortunately this amounts to years of reduced quality of life and wasted time. Who has years to waste on Back Pain?
Why Do Herniated Discs Have Difficulty Healing?
Well, the short answer here is that intervertebral discs are not vascular. Since there is no blood supply, the disc does not bleed even when you cut into it during surgery. As a result, the disc tissue is a poor healer. The fibers of the annulus (outer part of the disc) do not mend well. As your muscles tighten and spasm as a result of your body trying to protect itself from more damage, the disc pressure actually increases which further complicates the healing process. That is why reducing pressure from the disc and restoring the normal biomechanics of the spine is so important in obtaining lasting relief of the disc pain.
Restoring the normal biomechanics of the spine is accomplished by practitioners with a keen eye for spine dysfunction as well as an extensive “bag of tools” both high tech and low tech to achieve the goal of treatment. I the level of expertise and tools necessary to truly help herniated disc sufferers is why there are so many people living with the effects of disc pain all over this great country. I talk more about treatment options in the additional free information I provide for those who request it.
Exercises For Disc Problems
There are some exercises that can be helpful for herniated discs. I will discuss 2 exercises here. The first exercise is for disc herniations that cause leg pain. The goal of this exercise is the get the pain that is in your leg to “centralize.” Centralize is a medical term we use to describe the pain lessening in the leg and centralizing to the back. If you can find a position (by extending and leaning left or right) that relieves the leg pain, then you can hold for 5-10 seconds and then repeat. If the pain increases in the leg then this is not the right exercise for you. Even if the pain reduces in the leg during the exercise but then increases in the leg afterwards and lingers for longer than 20 minutes, then this is not the right exercise for you.
You may already be familiar with this exercise. The reason it is important is because it is so important to restore normal movement of the spine to help discs to heal. Smaller 1-3 millimeter disc herniations can heal with these types of exercises and/or conservative treatments. The larger herniations have difficulty healing but this is still a good activity to perform for herniated discs. If you have leg pain while performing this activity, then discontinue as you are likely affecting your nerve.
I hope this information has been useful for you. We offer a great deal of additional FREE information including some videos that I did, concerning Herniated Discs, Low Back Pain, Nerve Pain, Degenerative Disc Disease, and other topics as it relates to the very frustrating journey of seeking relief from these conditions.
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- Mooney, V, “Where Is The Pain Coming From?” SPINE. April 1983; 8(3): pp. 286-93
- Ozawa, Tomoyuki MD; Ohtori, Seiji MD; Inoue, Gen MD; Aoki, Yasuchika MD; Moriya, Hideshige MD; Takahashi, Kazuhisa MD; “The Degenerated Lumbar Intervertebral Disc is Innervated Primarily by Peptide- Containing Sensory Nerve Fibers in Humans”; SPINE, Volume 31(21), October 1, 2006, pp. 2418-2422
- Nachemson, AL, Spine, Volume 1, Number 1, March 1976, pp.59-71