These are just a few of the common names used to describe an injury to the disc that is causing pain. They all relate to a disruption of the internal workings of the disc that cause pain and/or limitation of function. Depending on the degree of disruption symptoms may vary from the mild low back stiffness and discomfort right through to severe debilitating lower back pain and sciatica.
However it is important to realise much of the disruption that occurs within the disc over our lifetime is due to normal wear and tear and doesn’t cause symptoms. We know this from studies where scans of the spine are performed on people who had never experienced pain. These scans still identified changes occurring in all the tissues of the spinal joint.
The spine is made up of individual bones that are stacked one above the next to form a column. The disc sits between the main blocks of bone (the vertebral body) and acts as a shock absorber while still allowing movement in the spine.
The disc is made up of 2 parts. In the centre there is a softer, semi fluid tissue called the nucleus. This is surrounded and contained by a wall named the annulus. The wall is layered like the rings of an onion.
When we move we cause pressure to build up on one side of the disc and the soft nucleus is forced to move away from the pressure (like a bar of soap between wet hands). The longer we stay in one position the more the nucleus moves. The surrounding wall limits the amount the nucleus moves.
The structure of the disc changes during our life. These changes are normal but they can impact on the ability of the disc to cope with the stresses of our lifestyle.
The disc wall gradually develops fissures or cracks and the central nucleus gradually looses water content (dehydrates). Problems arise if the pressure exerted on the disc wall cause it to fatigue and bulge outwards and has the potential to cause symptoms.
For instance when sitting for a prolonged period pressure is placed on the front of the disc resulting in the nucleus moving backwards. The movement of the nucleus should be restrained by the back wall of the disc. If there is sufficient weakening of an aspect of the back wall it can yield and allow extra displacement of the nucleus resulting in a focal bulge in the disc wall. This can often be painful and restrict movement in the short term.
Where the disruption inside the disc is smaller and the outer wall remains strong the displaced nucleus can be returned to its normal position. In this case symptoms can be rapidly reversed with self treatment. This is usually achieved by movements in the opposite direction to those that caused the displacement.
If the pressure on the outer wall becomes too much the wall fails and this is what we term a disc prolapse ...(learn more).
A thorough evaluation of the kind offered at Spine Care Clinic has been shown to be effective in identifying the specific problem affecting the joint and thus the appropriate management plan.
Due to the high rate of recurrence the greater understanding and independence each person has in treating their problem the greater their ability to minimise this risk of recurrence and self manage future episodes.