Herniated Discs or Bulging Discs
A Cause of Low Back Pain and Neck Pain
1. What is a Disc?
The intervertebral discs are part of the spinal column. The bony part is called the vertebral body. The disc is a fibrocartilaginous cushion in between each vertebral body. The disc is composed of an outer annulus fibrosus and a nucleus pulposus. The annulus fibrosis is a strong circular structure that encloses the disc. The nucleus pulposus is a gel-like substance on the inside that resists compression. Problems with bulging discs or herniated discs cause a great majority of chronic low back pain and chronic neck pain.
2. How does a disc cause back pain or neck pain?
There are several mechanisms of injury caused by discs. Initially the disc will push out which compresses the nerves as they exit the spinal chord. This is called a bulging disc. Next, a disc extrusion occurs when part of the nucleus pulposus breaks through the annulus fibrosus but still remains within the disc. Finally, a disc sequestration happens when the nucleus pulposus breaks through the annulus fibrosus and lies outside the disc. These structures can manually compress nerves in the spine or cause a chemical irritation of the nerves. That is what causes the pain.
3. Symptoms of a Bulging Disc or Herniated Disc
The pain from a bulging disc or herniated disc could range from mild to severe. The pain may occur in any disc from the neck to the low back. The pain may be localized to the spine. It may radiate down the arm for problems with bulging discs or herniated discs in the neck. It may also radiate down the leg for problems with bulging discs or herniated discs in the low back. This is also known as sciatica. The pain may be sharp or dull. It may be associated with numbness or tingling in the affected extremity. In serious cases, some loss of motor function may occur.
4. How is a Bulging Disc or Herniated Disc Treated?
Initially, treatment is conservative in nature. This may include bedrest, physical therapy, non-steroidal anti-inflammatory medications or narcotics. If these interventions are not successful in treating your back pain or neck pain, then the next step may be epidural steroid injections. Epidural steroid injections are performed by an interventional anesthesiologist who specializes in pain treatment. They place a potent anti-inflammatory next to the nerve and reduce inflammation and thereby reduce the neck pain and back pain.