Spinal (intervertebral) discs make it possible for the backbone to support daily movements. These natural “shock absorbers” consist of a solid outer shell called an annulus and a softer inner portion referred to as a nucleus. If a disc’s outer shell becomes weak due to age-related changes or damage, inner material can shift or push outward. When this happens, it’s known as a herniated disc. How disc herniation affects your spine and adjacent nerves depends on several factors, including the specific type of herniation that has occurred. The trusted Santa Monica spine surgeons at The Spine Institute have put together a list of three common possibilities.
1. Protrusion (“Bulging” Disc)
A bulging disc is a contained type of herniation where the shape of the disc is changed when the inner nucleus is flattened. The inner material doesn’t break through the outer shell. However, the flatter or misshapen disc can protrude enough to press on nearby nerve roots. If this occurs, symptoms experienced may include:
- Little or no noticeable discomfort if the protrusion isn’t significant
- Mild discomfort affected by movement
- Radiating pain felt in the legs, thighs, shoulders, or arms (depending on where the affected disc is located)
- Increased discomfort as the deformed disc shifts
2. Disc Extrusion
With this non-contained type of disc herniation, the disc’s soft inner material pushes outward with enough force to break through the outside shell of the disc. Disc extrusion can occur because the outside shell has weakened, or as a result of a sudden trauma like a hard impact or fall. Symptoms tend to be more painful and noticeable than what’s normally experienced with a bulging disc. The leaking inner disc material may result in:
- Sciatic nerve compression and related lower back and radiating nerve pain (90 percent of herniated discs affect the lower back area)
- Direct compression on the spinal cord itself from leaking disc material
- Reduced sensation or numbness and tingling due to nerve compression
3. Sequestered Herniation
Symptoms tend to be more severe with sequestered herniation, a type of disc herniation where the inner disc material pushes outward and moves elsewhere. For instance, you might have a disc extrusion where the inner disc material becomes loose and moves to another part of the spine, which then becomes a sequestered herniation. The odds of experiencing a sequestered herniation can increase if a non-contained herniated disc remains untreated. A free-floating piece of inner disc material can contribute to many possible spine-related issues, including:
- Nerve compression in other parts of the spine as the disc material travels
- Spinal stenosis if the material gets into the spinal canal and narrows the space
- Debilitating pain and severe localized and/or radiating symptoms
- Reduced mobility that may include difficulty walking, running, or performing normal daily activities
Sometimes, the discomfort that results from a herniated disc will gradually become less noticeable over time, which usually happens when disc damage is due to age-related spinal changes. Some patients respond well to therapeutic techniques such as massage therapy, epidural steroid injections, or chiropractic manipulations. When surgery is necessary, there are a growing number of minimally invasive procedures that can ease nerve compression with fewer risks and shorter recovery periods. For instance, you may want to consider vertebroplasty surgery. Santa Monica residents should reach out to Dr. Hyun Bae at The Spine Institute today. Give us a call at 310-828-7757 to schedule an in-person evaluation.