What Happens Anatomically to Cause a Herniated Disc?

A herniated disc, often referred to as a slipped or ruptured disc, is a common cause of back pain and discomfort. Understanding what happens anatomically to cause a herniated disc involves discussing the structure of the spine and the changes that lead to this painful condition. This article explores the anatomy of the spine, the role of intervertebral discs, and the specific processes that result in a herniated disc.

The Anatomy of the Spine

The human spine is a complex structure composed of 33 vertebrae, which are categorized into five regions: cervical, thoracic, lumbar, sacral, and coccygeal. These vertebrae are stacked on top of one another, creating a flexible and strong column that supports the body’s weight and protects the spinal cord.

Between each pair of vertebrae lies an intervertebral disc, which acts as a cushion and shock absorber. These discs allow for movement and flexibility while preventing the vertebrae from grinding against each other. The intervertebral discs are crucial for maintaining the spine’s structural integrity and function.

Structure of Intervertebral Discs

Intervertebral discs have a unique structure that enables them to absorb shocks and provide flexibility. Each disc consists of two main parts:

• Nucleus pulposus – This is the soft, gel-like center of the disc. It is composed primarily of water, collagen, and proteoglycans, which help the disc absorb shock and maintain its elasticity.
• Annulus fibrosus – Surrounding the nucleus pulposus is a tough fibrous ring called the annulus fibrosus. This ring is made up of several layers of collagen fibers arranged in a crisscross pattern, providing strength and stability to the disc.

Causes of Herniated Discs

A herniated disc occurs when the nucleus pulposus pushes through a tear or weak spot in the annulus fibrosus. This can happen due to several factors:

• Disc degeneration – As people age, their intervertebral discs naturally lose some of their water content, making them less flexible and more prone to tearing or rupturing. This degeneration process is a primary cause of herniated discs in older adults.
• Trauma or injury – Sudden trauma, such as a fall or car accident, can cause the annulus fibrosus to tear, allowing the nucleus pulposus to herniate. Repetitive motions or lifting heavy objects improperly can also contribute to disc herniation.
• Genetic predisposition – Some individuals may be genetically predisposed to disc degeneration and herniation. If a family member has experienced herniated discs, there may be an increased risk for others in the family.
• Lifestyle factors – Obesity, lack of exercise, and poor posture can all increase the risk of developing a herniated disc. These factors place additional stress on the spine and can accelerate the degeneration of intervertebral discs.

Anatomical Changes Leading to a Herniated Disc

The process of disc herniation involves several anatomical changes:

• Annulus fibrosus tear – The initial step in disc herniation is often a tear or rupture in the annulus fibrosus. This tear can result from degeneration, trauma, or excessive strain on the spine.
• Nucleus pulposus protrusion – Once the annulus fibrosus is compromised, the nucleus pulposus can push through the tear. This protrusion can compress nearby nerves, leading to pain, numbness, or weakness in the affected area.
• Nerve root compression – The herniated disc material can press against spinal nerves, causing nerve root compression. This compression is responsible for the radiating pain, tingling, and muscle weakness often associated with herniated discs.

Symptoms and Diagnosis

The symptoms of a herniated disc can vary depending on the location and severity of the herniation. Common symptoms include:

• Back pain – Often localized to the area of the herniation
• Radiating pain – Pain that spreads to the arms or legs, depending on the location of the herniated disc
• Numbness and tingling – Affected nerves can cause numbness or tingling in the extremities.
• Muscle weakness – Compression of nerves can lead to weakness in the muscles served by those nerves.

To diagnose a herniated disc, healthcare providers typically use imaging tests such as MRI or CT scans to visualize the spine and identify the herniated disc’s location and extent.

Treatment Options

Treatment for a herniated disc often begins with conservative measures:

• Rest and activity modification – Avoiding activities that worsen symptoms can reduce pain and inflammation.
• Medications – Pain relievers, anti-inflammatory drugs, and muscle relaxants can provide relief from symptoms.
• Physical therapy – Exercises and stretches can strengthen the muscles supporting the spine and increase flexibility.
• Epidural steroid injections – These can reduce inflammation and provide pain relief in more severe cases.

If conservative treatments fail to alleviate symptoms, surgical options such as a discectomy, laminectomy, or spinal fusion may be discussed and potentially recommended.

Understanding the anatomical changes that cause a herniated disc highlights the importance of maintaining spinal health through proper posture, regular exercise, and avoiding excessive strain on the spine. By recognizing the factors that contribute to disc herniation, individuals can take proactive steps to prevent this painful condition and maintain a healthy, functional spine.

If you have a herniated disc that is not responding to conservative treatment, a discectomy may be discussed and potentially recommended. Although this is generally a very successful procedure, having a large hole in the outer ring of the disc more than doubles the risk of needing another operation. A new treatment, Barricaid, is a bone-anchored device that closes this hole, and 95 percent of Barricaid patients did not undergo a reoperation due to reherniation in a 2-year study timeframe. This treatment is done immediately following the discectomy—during the same operation—and does not require any additional incisions or time in the hospital. 

If you have any questions about the Barricaid treatment, ask your doctor or contact us today.

For full benefit/risk information, please visit: https://www.barricaid.com/instructions.