Herniated Disc
The importance of the intervertebral disc
The 23 discs of the human spine, of which the highest are situated between the 2nd and 3rd cervical vertebrae and the lowest between fifth and lumbar vertebrae and the sacrum, are there to serve as a cushion and shock absorber of the body axis of the spine.The required elasticity is due to the functional interaction of the fibrous ring (annulus fibrosus) and nucleus pulposus (nucleus pulposus).As the result of the upright posture the people, the disc is exposed to a particular pressure, and in early infancy is still supplied by blood vessels. Later, these blood vessels shut and nutrition of the disc is done by diffusion from the vertebral base plates.
What causes disc disease?
The daily stresses lead to wear and tear on the discs, strictly speaking, rather than a tear, it is an adaptation of the general body spine to the load conditions, i.e. when there is a lot of pressure, the structure will become firm and hard and a cushioning is lost.
Consequence of the processes is functional disorders that can lead to pain. This is primarily due to the elasticity and dehydration of the intervertebral discs and the formation of cracks in the fiber ring (visible in the picture, where tissue sections are compared with MRI images). This instability arises because the various parts such as vertebrae, spinal discs, muscles and ligaments no longer fit together smoothly. Therefore the spine can no longer exercise its support and holding functions to the full extent. When muscular power reserves are exhausted, it can lead to fatigue, pain. This process of wear is associated with a local inflammatory reaction and the release of different mediators that have the task to initiate the healing process. At the same time these chemical messengers irritate the pain nerve fibers and cause the classic back pain. This is a warning symptom and should tell the body to take a rest period to assist the healing process and to relax the muscles. An additional burden often leads to reflex muscle tension which increases the pain. The so-called pain spiral turns up. If not intervened, a chronicity of symptoms may impend. All therapeutic measures (drugs, physiotherapy) are designed to break this spiral of pain.
Due to the close spatial proximity of the intervertebral discs and facet joints on one hand, and the spinal cord and nerve roots on the other hand, perturbations in the area of the discs can also have an effect on the spinal cord and nerve roots. It can also come to various deformities, as intervertebral discs can move each other and exert additional stress / pressure on the facet joints.
Read more on specific issues on a herniated disc in the cervical or lumbar spine.
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