3 Basic Types of Disc Herniation
The Skinny on Herniated Discs
When people first hear the term hernia, they envision thick, abdominal belts and a painful diaphragm or injured groin. And, to their credit, hernias do form in these areas. However, in reality, herniations can occur in many locations throughout the body. For instance, typical hernia hotspots include the stomach, intestines, groin, umbilical cord—and yes—even the spine. Particularly vulnerable, our intervertebral discs can suffer herniation (or rupture) from sudden injury or gradual wear-and-tear.
In essence, your intervertebral discs ensure your spinal stability and enable pain-free movement. Very few of our actions avoid using the spine. Walking, lifting, standing, twisting, sitting, and lying down… Your spine makes all of these actions possible. When a traumatic event compromises the spine, however, it can render everyday actions extremely difficult—even excruciating. In fact, when discussing spinal pain and degeneration, the verdict often points toward a damaged intervertebral disc.
The Design Of The Disc
Located between your vertebrae, intervertebral discs provide your spine with shock absorption, protective cushioning, and lubrication. Similar to the anatomy of a jelly donut, a rubbery outside called the annulus composes the “pastry” of the disc. In addition, a thick, jelly-like substance called the nucleus supplies the internal filling for the disc.
As such, the ideal anatomy of an intervertebral disc provides your spine with a great deal of protection. However, this protection comes at a cost. Advancing age, accidents, heavy lifting, and disease can easily injure an intervertebral disc. And, consequently, a damaged intervertebral disc can result in nerve compression, loss of height between vertebrae, and bone-on-bone friction. In severe cases, a bulging disc can even block nerve signals, leading to a loss of sensation and reduced mobility!
More specifically, disc herniations can occur in the cervical, thoracic, or lumbar regions of spine. However, a majority of herniations occur in the ultra-movable cervical spine and the weight-bearing lumbar spine. Although disc damage can occur at all levels of the spine, not all herniations display the same symptoms. Varying degrees and locations of damage will cause symptoms to differ. And, general prognoses can vary depending upon the type of herniation that occurs. However, orthopedists usually classify spinal herniations into 3 major types:
- Contained Herniation: Also known as a protrusion, orthopedists typically refer to a contained herniation as a bulging disc. A bulging disc occurs when damage to the nucleus of the disc causes outward pressure and distension of the annulus. Think of a jelly donut that has accidentally been flattened in the donut box. None of the jelly seeps out, but a flatter, wider donut is left behind. When your disc suffers from this form of herniation, the disc can protrude outward from its home between your vertebrae. For many, the mild symptoms of a disc bulge will go unnoticed. However, for others, this type of herniation can cause mild to moderate pain, as the flattened disc pushes on adjacent nerves.
- Non-Contained Herniation: Also known as a disc extrusion, this type of herniation involves the nucleus breaking or rupturing through the annulus. If we visualize that jelly donut again, think of squishing the jelly donut in your hand. However, this time, the amount of applied pressure resulted in the jelly leaking outside of the pastry crust. When non-contained herniation occurs, painful symptoms inevitably result. A leaking nucleus can compress adjacent nerves roots, and sometimes, even the spinal cord itself. A main contributor to back pain, nerve compression can cause tingling or loss of sensation in the limbs.
- Sequestered Herniation: The third—and arguably most problematic form of herniation—is the sequestered hernia. When this occurs, a piece of the nucleus breaks through the exterior of the disc, separating completely from the main nucleus. One last look at our poor jelly donut. If you were to squish a jelly donut so forcefully that the jelly actually spurted out and landed on the chocolate-frosted donut next to it… This extreme scenario would represent the sequestered herniation. In particular, this form of herniation usually occurs when a non-contained disc goes long-untreated. As a result, the ruptured disc material may migrate, moving into the spinal cord canal and sequestering (or trapping) itself. Spinal stenosis (or compression of the spinal cord), reduced mobility, and excruciating pain may result.
What can we do About a Damaged Disc?
For some, the answer to treatment lies in pain management, physical therapy, and time. Damaged discs have the potential to improve and heal on their own through the use of proper treatments and monitoring. For some, however, more invasive routes must be taken. Surgical interventions can be the ticket, especially when the herniated disc material encroaches on nerves or causes debilitating symptoms. However, to find answers and customizable solutions to your individual situation, seek the support of a spine specialist. Don’t wait any longer to fix those flattened jelly donuts!