The disc is the cushion between the bones of the spine. They are made up of a fibrous outer ring called the annulus fibrosus, and a jelly-like inner material called the nucleus pulposus. It is the nucleus pulposus that acts as the primary shock absorber within the disc. Over time, or because of a traumatic accident, the annulus fibrosus becomes torn and the jelly-like inner material will start to leak out towards the edges. If the material reaches the outer edge and pushes the annulus fibrosus out, it is called a disc bulge. If the last layer tears and the inner material leaks all the way out into the open space, this is called a disc herniation. The outer third of our disc has nerve innervation, which means the disc itself can be a source of pain. If the nucleus pulposus leaks out and the nearby nerves become irritated or compressed this can cause pain, numbness/tingling, which can be local or radiate along a dermatomal pattern.
The lumbar spine is the most common area in the spine to experience a disc bulge/herniation. This is because the disc in this area have the most amount of compression from the weight above, and from the longer lever that is created when the spine is bent. It is usually not one incident that causes the disc to become damaged, but repetitive bending/twisting, especially under increased loads that cause the disc to fail.
Although disc herniation has long been associated with the need for surgery, conservative care can often reduce and manage the symptoms. With the proper care and activity modification the nucleus pulposus can be resorbed by the body’s natural mechanisms, reducing the stress to the surrounding tissues, most importantly the nerves. The therapist at Portland Physical Therapy has years of experience treating the spine, including disc bulges and herniations, and will discuss your options with you.
