Comprehensive Guide to Herniated Disc

A disc becomes herniated when an annular tear is created due to disc degeneration or injury, allowing the nucleus pulposus to expand outside of its normal bounds. Tears in the annulus fibrosus weaken the structure of the disc, compromising the disc’s ability to act as a shock absorber between vertebrae. Meant to facilitate movement in the spine as well as countering load, intervertebral discs play an important role in everyday actions like sitting, standing and walking.

Annular Tears that give way to disc herniations come in several different forms. While even the slightest tear is recognized as disc herniation, not all herniations are symptom causing. Typically a herniated disc is formed due to one or more of the following types of annular tears.

• Concentric Tears. Typically caused due to injury, Concentric Tears affect the disc by creating separation in the lamellae or membrane layers protecting the disc.
• Peripheral Tears. Peripheral Tears, while similar in orientation to concentric tears, occur on the outside of the disc and are not limited to separation of membrane layers. Frequently known to cause disc degeneration.
• Radial Tears. Spanning the height of the disc and extending from the center outward, Radial Tears occur naturally with aging and are the most common cause of disc herniation in patients.

Herniated discs can occur in the cervical and lumbar regions of the spine. When herniated discs occur in the cervical region of the spine — the neck — they occur in the following areas:
• C4 - C5 disc herniation
• C5 - C6 disc herniation
• C6 - C7 disc herniation

Symptoms associated with herniated discs vary greatly from minor lower back pain to severe and radiating down an arm or leg. What often impacts the severity of the pain, numbness, or weakness associated with the herniated disc is whether it is pressing on a nerve. An early warning sign of possible herniated disc issues is reoccurring low back pain issues over time with increasing regularity.

Herniated discs in the lower back that press against nerves can cause radiating pain, tingling, numbness and even burning as the pain moves from the buttock down the leg and sometimes into the foot.

Herniated discs in the neck area are often related to nerve compression and include a wider range of symptoms. These symptoms may include dull and sharp pains, tingling, numbness, and radiating pain that can be associated with specific movements of the neck.

When looking at an MRI, herniated discs are often fairly easy to spot. Normally appearing as a cleanly contained disc between two vertebrae with a well formed center or nucleus, herniated discs often exhibit signs of degeneration which may include deformed centers, dehydration and/or actual nucleic spillage into the spinal cavities surrounding the disc. Through the use of a physical exam to determine the extent of discomfort and pain and a discogram to validate pain causing discs, our doctors are able to safely pinpoint the source of discogenic pain in the spine

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