Disc Problems




Bulging Disc

A bulging disc can cause discomfort and disability in various parts of the body, depending on the location of the affected disc(s). A bulging disc occurs when one of the discs between your vertebrae develops a weak spot and pops out beyond its normal perimeter. Interestingly, many people might have a bulging disc and not even know it, as long as the bulging area does not press upon surrounding tissues. When the bulging disc impinges on the nerves of the spinal column, however, that’s typically when symptoms begin. In the lower back, the damaged disc can cause pain to travel to the hips, buttocks, legs, and feet. In the upper back, the pain would radiate from the neck down the arm and to the fingers.

Approximately 90% of bulging discs occur in the lower back, or lumbar area of the spine. The most common lumbar bulging disc is seen around levels L4-L5 (lumbar segments 4 and 5) or L5-S1 (lumbar segment 5 and sacral segment1), which causes pain in the L5 nerve or S1 nerve, respectively. If the bulging disc impinges on the sciatic nerve in the lower back, it can lead to a back problem called sciatica. On the other hand, if the bulging disc is located in the neck, it is called a cervical bulging disc.

A bulging disc can be very painful, but you can increase your chances of avoiding this condition by learning more about bulging disc causes. It is important to know what activities to avoid and which ones you should take precautions against. Some ways you might be able to avoid a bulging disc are by protecting your back when lifting, using good posture, maintaining a healthy weight, and getting regular exercise. You should also be aware that age is another risk factor for bulging discs, since discs tend to become weaker and less elastic over the years.

Collapsed Disc

A collapsed disc is an intervertebral disc that has lost its normal height due to degeneration within the annulus fibrosus, which is the fibrous outer wall. While this degeneration can be caused by traumatic injury, it is more frequently a result of wear and tear that is a natural part of the aging process. Loss of disc height is most common within the cervical (neck) and lumbar (lower back) regions of the spine, where the vertebrae bear significant body weight and are subjected to a wide range of stress-inducing motion. A collapsed disc won’t necessarily produce symptoms; only when diminished disc height leads to an impingement of a nerve root or the spinal cord itself will pain, tingling, numbness, or muscle weakness occur.

The Mechanics of a Disc Collapse

The term collapsed disc is often used interchangeably with “herniated disc,” but the presence of one does not necessarily indicate the presence of the other. A disc herniation is the leakage of a portion of the gel-like nucleus pulpous through tears or cracks in the annulus fibrosus. It is possible for a disc collapse to be present without the leakage of the disc’s inner material. It is also possible for a disc collapse to produce enough pressure on the nucleus to force the inner material out through a weakened section of the outer wall. The main way a collapsed disc produces pain and other symptoms is by reducing the space available for components of the central and peripheral nervous system – the spinal cord and nerves. Less space means a greater likelihood of nerve compression. In addition, the loss of disc height reduces the ability of the disc to act as a cushion between vertebrae, creating the potential for bone to grind against bone and for the development of osteophytes (bone spurs). This can begin to irritate nerve endings, particularly within intervertebral joints.

Degenerative Disc Disease (Spondylosis)

As we age, the water and protein content of the body’s cartilage changes, making the cartilage more fragile, thin and weak. Because both the discs and joints that stack the vertebrae (facet joints) are partially composed of cartilage, these areas are subject to wear and tear, or degenerative changes, over time. The gradual deterioration of discs between vertebrae is referred to as degenerative disc disease.

Degeneration of the disc is medically referred to as spondylosis. Spondylosis can be noted on an X-ray or MRI scan of the spine as a narrowing of the normal “disc space” between adjacent vertebrae. An MRI scan also may show the beginnings of a loss of water content in the disc.

When Degenerative Disc Disease Progresses

Disc degeneration can occur at any level of the spine, possibly causing pain in the affected area with radiating pain along the nerves emerging from the spinal canal at that level. When disc degeneration affects the neck, it is referred to as cervical disc disease.

Disc degeneration that affects the lumbar spine is referred to as lumbago, which causes pain that is localized to the low back. Symptomatic lumbar disc degeneration is most common in people of working age, usually between 30 and 50.

What Causes Degenerative Disc Disease?

Degenerative disc disease causes are rooted in the changes that occur in our spinal column as we age. Over the years, the water and protein content of the body’s cartilage changes. This change results in weaker, more fragile, and thinner cartilage throughout the body. In addition, daily life also puts stress on all of your body’s moving parts. Therefore, considering that both the discs and the joints in the spinal column are partly composed of cartilage – and that these areas are also subject to wear and tear over time – it becomes apparent that these cumulative changes will result in the gradual deterioration of the spinal column. The result of these changes is known as degenerative disc disease. Degenerative disc disease is sometimes referred to as spondylosis (spinal osteoarthritis) because the degenerative changes in both conditions are very similar.

By examining degenerative disc disease causes a little more closely, you will see that this condition progresses from the spinal discs to the spinal joints and also affects the nerves in the spinal column. Cartilaginous cushions known as intervertebral discs separate the spine’s vertebrae from each other. These discs provide structural support to the spine and act as shock absorbers, taking in the stress created by movement. The discs are mostly water, allowing them to be very elastic and absorb pressure. However, age and repetitive strain cause disc wear and tear.

This color enhanced sagital (lateral) MRI image of the cervical spine shows severe multilevel degenerative changes of the spine with spinal cord compression.

As the discs become thinner and harder, they are no longer able to protect the joints of the spine, called facet joints. Without disc protection, facet joints cannot move properly and this causes cartilage around the facet joints to break down. In response, the body tries to heal itself by adding extra bone to the spinal column. These new bony additions are called bone spurs, but instead of helping the situation, bone spurs can actually impinge upon nerves in the spinal canal, causing pain and disability.

Since disc problems are one of the most common causes of lower back pain, or lumbago, you may be interested in hearing about ways to prevent the degeneration from occurring in the first place. The best way to prevent this condition is to take good care of your body. Lifestyle choices such as maintaining a healthy weight, avoiding neck and back injury, sticking to a nutritious diet, and not smoking can potentially help you save your spine.

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