Herniated Disc

What is a herniated disc?

The human spine is comprised of 24 vertebrae separated from each other by discs that serve as shock absorbers and provide flexibility of the spine. In addition, they serve to allow adequate space for spinal nerves to exit, providing sensation and movement to all parts of the body.

The disc is composed of a thick, tough outer annulus fibrosus - constraining ring primarily composed of collagen and a soft inner core known as the nucleus pulposus which consists of a proteoglycan. A tear in the annulus may cause the nucleus to rupture. If the nucleus pours out through the tear in the annulus, the disc is said to be herniated. Nuclear material, which is displaced into the spinal canal, is associated with a significant inflammatory response. The vertebrae between which the disc lies may press against each other and against the nerves that extend from either side of the vertebra. Compression of a motor nerve results in weakness, and compression of a sensory nerve results in numbness. In this instance, one may experience both back pain from the herniation or tear of the annulus, as well as pain from that part of the body served by the nerve. Radicular pain results from inflammation or compression of the nerve, explaining the lack of correlation between the actual size of a disc herniation with that of clinical symptoms.

What are some symptoms of a herniated disc?

Patients usually feel pain in the lower back and pain or numbness in the legs. The classic presentation of a herniated disc includes the complaint of sciatica (an intractable radiating pain), with associated objective neurological findings of weakness, reflex change or dermatomal numbness.

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