Herniated Disc
The intervertebral disc consists of an outer
fibrous body called the annulus fibrosus and an
inner gel-like substance called the nucleus
pulposus. It acts as a shock absorber and spacer
for the spine giving room for the intervertebral
neural foramina which are the portals for the
exit of the spinal nerves. The nucleus pulposus
contains noxious chemicals which can be
irritating to nerves.
The intervertebral discs lie between the
vertebral bodies. In front, they are bound by
the anterior longitudinal ligament and behind,
by the posterior longitudinal ligament. Behind
the posterior longitudinal ligament lies the
spinal cord.
Wear and tear can cause the annulus fibrosus to
weaken allowing bulges. These blulges may
protrude out enough to touch the spinal cord
causing irritation to the nerves. These large
disc bulges are termed disc herniations. With
extreme forces, these disc bulges may tear the
annulus fibrosus and allow leakage of the
nucleus pulposus. This may be observed as sudden
sharp pains radiating down the leg. The
chemicals of the nucleus pulposus can cause
swelling of the nerves resulting in constant
burning pain. These pains are termed lumbar
radiculopathy or commonly sciatica, which is
usually described as pain radiating from the low
back down the legs to the feet.
The pain from the herniated disc may be
treated with lumbar epidural steroid
injections. Surgical intervention may be
indicated for repair of the disc herniation
or removal of the entire disc. Disc
herniations may sometimes heal on their own
without intervention
