What has caused my disc to herniate or bulge?

There are many ways a disc can be damaged. For example, truck drivers have this problem because of that constant vibration or pounding they experience while on the road. It could also be something as simple as years of wear and tear, repetitive lifting. You might slip and fall on your rear end, fall flat on your face, or flat on your back. You may cough or sneeze or lift or twits – even as little as to pick u a piece of paper. Or, you may do a combination of all of these incidents to cause disc damage. Basically, the liquid substance on the inside of the disc is put under a great deal of pressure. The cartilage around it can’t hold it back any longer and (snap) it just tears. So we get a little tear that forms in there. Now this is a problem, because the liquid substance squeezes out into the tear and spreads it apart. That causes a bulge to form.

The disc works very similar to a water balloon. If we put a water balloon on the edge of a table, you would see the sides push out a little bit. When we push down on top of it, it expands out in all directions, and when we let go of it, it goes back to normal. That’s exactly the way that these discs work.

What you should know about a herniated disc

According to the North American Spine Society (NASS) and the American Society of Neuroradiology (ASNR), a herniated disc is 1. Localized and displacement of disc material beyond the normal margins of the intervertebral disc space. 2. (Non-Standard) [Any displacement of disc tissue beyond the disc space]. Note: Localized means, by way of convention, less than 50% (180 degrees) of the circumference of the disc. Disc material may include nucleus, cartilage, fragmented apophyseal bone, or fragmented annular tissue. The normal margins of the invertebral disc space are defined, craniad and caudad, by the vertebral body end-plates and peripherally by the edges of the vertebral body ring apophysies, exclusive of osteophytic formations. Herniated disc generally refers to displacement of disc tissues through a disruption in the annulus, the exception being intravertebral herniations (Schmorl’s nodes) in which the displacement is through vertebral end-plate. Herniated discs in the horizontal (axial) plane may be further subcategorized as protruded or extruded. Herniated disc is sometimes referred to as “herniated nucleus pulposus,” but the term herniated disc is preferred because displaced disc tissues often include cartilage, bone fragments, or annular tissues.

The term “ruptured disc” is used synonymously with herniated disc, but is more colloquial and can be easily confused with violent, traumatic rupture of the annulus or end-plate. The term “prolapse” has also been used as a general term for disc displacement, but its use has been inconsistent. The term herniated disc does not infer knowledge of cause, relation to injury or activity, concordance with symptoms, or need for treatment.

We’re here to help you with your pain

Wilkins Spinal Care is located on Rt. 31, just one mile east of Mt. Pleasant.

372 E. Main Street
Mt. Pleasant, PA 15666
Phone: (724) 547-3377
Wilkins Spinal Care sees patients by appointment:

Monday through Thursday: 8:00 AM – 5:00 PM
Friday: 6:30 AM – 9:30 AM

Special appointment times are available outside of these hours by calling:
(724) 547-3377

For driving directions click here.

Let us help you get on the road to recovery!
Visit our Main Web site at www.WilkinsSpinalCare.com
Learn how you can eliminate back pain.

What percent of intervertebral disc herniations are missed on MRI reports?

The answer may perplex you, but 30% of patients with a disc herniation do not show that herniation on traditional MRI studies. This came from a study published in Radiology in 1995, which stated that in cases of acute lumbar radiculopathy, only 70% of the patients that were diagnosed with a lumbar disc herniation based on clinical examination had a lumbar disc herniation confirmed by MRI, which also means that 30% did not show the herniation.

There is an article that went into a lot of reasons why MRIs miss this condition. It was published in Spine and was a collaborative effort between the Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow, China, and the Department of Orthopedic Surgery, UCLA, Los Angeles, CA. Everyone that participated in this study is starting to realize that you must load the disc and put it under pressure to get a true picture of how it is functioning. You do this by standing and sitting, and when they do most MRIs, you are put in a tube and you are laying down with no weight bearing on it.

What our patients are saying about us

“After nine treatments… I arose on a Saturday morning to NO PAIN! Life is good, no – GREAT!!! How do you thank someone for giving you back your life? I call Dr. Larry “God’s assistant” and his machine a gift from God!”
– Audrey, -, PA

“Because of this treatment, I am able to live life with little or no pain. It is amazing what this new technology can do to help us all. I feel better than I did in the past 20 years!”
– Ronald, Connellsville, PA

What is it that causes a disc to herniate or bulge?

The disc works very similar to a water balloon. If we put a water balloon on the edge of a table, you would see the sides push out a little bit. When we push down on top of it, it expands out in all directions, and when we let go of it, it goes back to normal. That’s exactly the way that these discs work.

There are many ways a disc can be damaged. For example, truck drivers have this problem because of that constant vibration or pounding they experience while on the road. It could also be something as simple as years of wear and tear, repetitive lifting. You might slip and fall on your rear end, fall flat on your face, or flat on your back. You may cough or sneeze or lift or twits – even as little as to pick u a piece of paper. Or, you may do a combination of all of these incidents to cause disc damage. Basically, the liquid substance on the inside of the disc is put under a great deal of pressure. The cartilage around it can’t hold it back any longer and (snap) it just tears. So we get a little tear that forms in there. Now this is a problem, because the liquid substance squeezes out into the tear and spreads it apart. That causes a bulge to form.

What you should know about a herniated disc

According to the North American Spine Society (NASS) and the American Society of Neuroradiology (ASNR), a herniated disc is 1. Localized and displacement of disc material beyond the normal margins of the intervertebral disc space. 2. (Non-Standard) [Any displacement of disc tissue beyond the disc space]. Note: Localized means, by way of convention, less than 50% (180 degrees) of the circumference of the disc. Disc material may include nucleus, cartilage, fragmented apophyseal bone, or fragmented annular tissue.

What causes the disc to herniate or bulge?

The disc works very similar to a water balloon. If we put a water balloon on the edge of a table, you would see the sides push out a little bit. When we push down on top of it, it expands out in all directions, and when we let go of it, it goes back to normal. That’s exactly the way that these discs work.

There are many ways a disc can be damaged. For example, truck drivers have this problem because of that constant vibration or pounding they experience while on the road. It could also be something as simple as years of wear and tear, repetitive lifting. You might slip and fall on your rear end, fall flat on your face, or flat on your back. You may cough or sneeze or lift or twits – even as little as to pick u a piece of paper. Or, you may do a combination of all of these incidents to cause disc damage. Basically, the liquid substance on the inside of the disc is put under a great deal of pressure. The cartilage around it can’t hold it back any longer and (snap) it just tears. So we get a little tear that forms in there. Now this is a problem, because the liquid substance squeezes out into the tear and spreads it apart. That causes a bulge to form.

Another reason for the formation of herniations is the bio-mechanical behavior of the intervertebral disc is related to its hydration status. Generally, a well hydrated disc is able to withstand the compressive forces of weight bearing better than a dehydrated disc. The fluid of the nucleus pulposus (the liquid part of the disc) acts not only to resist compression, but also to distribute forces in a radial fusion through the anulus fibrosus (cartilage part of the disc). As the discs water-binding capacity decreases, it becomes fibrous and rigid; ultimately resulting in a functionally impaired disc that exhibits altered load distribution through its individual components (the liquid part and the cartilage part).

What is a herniated disc?

In order to answer this, I am going to give you the definition which was written for doctors, and then I’ll explain it in layman terms.

According to the North American Spine Society (NASS) and the American Society of Neuroradiology (ASNR), a herniated disc is 1. Localized and displacement of disc material beyond the normal margins of the intervertebral disc space. 2. (Non-Standard) [Any displacement of disc tissue beyond the disc space]. Note: Localized means, by way of convention, less than 50% (180 degrees) of the circumference of the disc. Disc material may include nucleus, cartilage, fragmented apophyseal bone, or fragmented annular tissue. The normal margins of the invertebral disc space are defined, craniad and caudad, by the vertebral body end-plates and peripherally by the edges of the vertebral body ring apophysies, exclusive of osteophytic formations. Herniated disc generally refers to displacement of disc tissues through a disruption in the annulus, the exception being intravertebral herniations (Schmorl’s nodes) in which the displacement is through vertebral end-plate. Herniated discs in the horizontal (axial) plane may be further subcategorized as protruded or extruded. Herniated disc is sometimes referred to as “herniated nucleus pulposus,” but the term herniated disc is preferred because displaced disc tissues often include cartilage, bone fragments, or annular tissues.

The term “ruptured disc” is used synonymously with herniated disc, but is more colloquial and can be easily confused with violent, traumatic rupture of the annulus or end-plate. The term “prolapse” has also been used as a general term for disc displacement, but its use has been inconsistent. The term herniated disc does not infer knowledge of cause, relation to injury or activity, concordance with symptoms, or need for treatment.

The disc has two points to it – the liquid part and the outer part, which is cartilage. Now, the liquid portion has a job and it’s your shock absorber. It also gives you the ability to move in all directions. The cartilage’s job is to protect the liquid part. When you put the liquid part under pressure, it starts to compress and squeeze down. When it does this, it elongates and presses on the cartilage until a crack appears. The fluid pushes on the crack until you have a bump or herniation on the disc. That is basically what a herniation is.

What is a discectomy?

Dorland’s Medical Dictionary provides a concise definition of the term “discectomy” where it explains that it is an excision (which means removal of a portion or all of an organ or other structure) of an intervertebral disc.

I usually explain to patients that they usually do this surgery two different ways. The first is that they cut off the portion of the disc that’s herniated (or pushing outward against the nerve) or they use a laser and burn off the portion of the disc that’s herniated (again the part pushing against the nerve.)

Sources: Dorland’s Medical Dictionary

Let us help you get on the road to recovery! Learn how you can eliminate back pain – Visit our Main Web site at www.WilkinsSpinalCare.com