What is a herniated disc? Disc herniation or bulged disc
Ruptured disc or herniated disc – what is the difference?
The freely moveable bones (vertebrae) that make up the backbone (spinal column) are separated and cushioned by small flat pieces of cartilage (discs). Each spinal disc is shaped somewhat like a hockey puck, and has a jelly-like filling (nucleus pulposus) in them almost like a jelly donut. Each disc is constructed of a tough but flexible outer ring of fibrous material (annulus fibrosus), arranged in layers like a ball of string. A normal healthy disc is somewhat soft and compressible to absorb shock and to provide flexibility to a spine made up of bone.
As a person gets older the discs tend to lose water and become denser and more brittle as they dry out, and this makes the discs more easily compressed and susceptible to damage. As a disc ages and compresses, the tough outer ring begins to weaken. In this weaker state the jelly-like nucleus pulposus inside the ring is able to push against the ring and cause the disc to bulge out. This situation is called a bulging disc.
With continued age-related wear and tear that starts in the late 30s and continues all throughout life, or when a disc is damaged from injury, the ring of dense fibrous tissue can bulge out abnormally, or split open, or even break apart into several pieces if it is unhealthy and brittle, allowing the jelly-like material to escape. When any of this happens it is sometimes called a herniated nucleus pulposus, ruptured disc or slipped disc – they mean essentially the same thing.
Depending on the location and degree of a ruptured disc, or the location and amount of tearing that occurs the disc material is then able to irritate and press on the nerve roots that are located near the disc as they branch off from the spine. Again, depending on the amount and location of pressure and irritation applied to the nerve root, this can cause a variable amount of pain, weakness, numbness, or changes in sensation anywhere along the path of the affected nerve. The idea is that a weak disc bulges, the bulging presses on nearby nerves, and this causes pain and other complaints in the low back and leg where the nerve travels.
A disc herniation can happen in any area or level of the spine. However, most herniated discs occur in the lower back (lumbar spine), less so in the neck (cervical spine) and more rarely in the upper back (thoracic spine).
The great majority of spinal disc herniations happen at the lower lumbar spine, especially at the L4-5 and L5-S1 levels.
Conservative disc herniation treatment
In many ways spinal disc herniation causes the nerves to become pressed upon, or compressed, resulting in what some people would call a pinched nerve, whether in the low back or the neck. There are a whole series of simple and effective things a person with a pinched nerve can do that can be very helpful in many cases. Review some of these ideas for pinched nerve treatment to learn how to help yourself and reduce or eliminate the need for more aggressive medical or surgical treatment.
Can a herniated disc be prevented?
After the first injury to a disc in the lower back, a second injury is easier to happen and more likely to be worse than the prior occurrence because of a pattern of weakening of the supporting tissue around the disc as well as continued weakening of the disc itself.
The following ideas will help to minimize the chances of having another episode of a herniated or swollen disc, and to keep the back as healthy and strong as possible:
- Be careful when you lift: Protect your back by lifting with the large leg muscles, not the back muscles. Do not lean forward from the waist when lifting; squat by bending the knees as the back is kept flat and upright.
- Always use good posture when standing or walking. Stand tall. Keep the shoulders relaxed while they are allowed to stay back and down. Keep the chin tucked in. Keep the belly in.
- Get regular exercise at least three times a week.
- Keep body weight at a healthy level to reduce the load and impact on the lower back, as well as knees and hips.
- Do not smoke tobacco, especially cigarettes. Of all forms of tobacco, cigarette smoke destroys vitamin C which is critical for the formation of healthy connective tissue of all organs and areas of the body, like the discs.
What is lumbar disc disease?
Lumbar disc disease is a general medical term that means any abnormal and problematic change in the structure of the normal disc, as discussed above. It is a broad term that takes in not only age-related disc changes, but also injury-related disc rupture or bulging that happens for any reason, resulting in a medical problem.
Most often lumbar disc disease is a part of the aging process since this happens essentially to anyone who lives to be 40 years of age or more, when small disc degenerative changes start to occur. Disc disease is only an occasional problem that happens to only certain people when severe trauma causes a fairly normal disc to bulge or herniate. It should be noted that many times these different kinds of disc disease occur in the same person. Meaning, someone who is already has one or more spinal discs that are already weakened by age-related degeneration will also add the trauma of some heavy lifting or a fall or an automobile accident to the spine, so that the actual reason for the herniated disc that might occur is more than one cause – several causes going on at the same time, until the disc ruptures.