What is a disc herniation? What are the facts and what are the myths?

Here is what occurs in a herniation:

• As a result of excessive pressure on one part of the disc, the nucleus pulposus penetrates through one or more layers of the annular fibrosis, often posteriorly and lateral.

• This bulging causes an increase in inflammatory chemicals to be released around the disc, spinal cord and nerve roots, which is a contributor to the pain you feel.

• Not all herniations are the same. We stage them and it is essentially a picture of a process in motion.

• A prolapse is when the nucleus penetrates through just a few layers of annulus, but not fully out of the confines of the disc.

• An extrusion is when the nucleus penetrates through the entirety of the annulus and exists outside of the disc.

• A sequestration is when the nucleus material breaks off in the spinal canal.

This may sound scary, but oftentimes these are completely asymptomatic. In other words, people can have disc herniations and have absolutely zero pain. The statistics are roughly 20% of young adults and 75% of those older than 70 years of age have asymptomatic disc herniations.

Further, you can have low back pain without any evidence of disc herniation on an MRI. The majority of disc herniations spontaneously regress (move back into place) after 2 years, so the disc can indeed heal. Herniations do not necessarily need to regress for someone to be pain free. Finally, the bigger the herniation, the more likely it is to heal. 

If you are struggling with low back pain, or have a disc herniation, hopefully this information can help calm your fears.

If you are struggling with low back pain, and potentially a disc herniation, the first thing to do is to stay optimistic! The second step is to find a quality clinician to bring you through a rehab protocol that includes movement, lifestyle changes and education.

What to take from this post: 

• Disc herniations are in fact normal parts of aging and can be asymptomatic.

• The majority of disc herniations heal in time, and even if they don’t you can still be pain free.

• The bigger the herniation the more likely it is to heal.