Posted by: Wagner IT | March 22, 2009

Can Just a Small Disc Bulge Cause Pain?

by J. Adam Wagner, DC

by J. Adam Wagner, DC

Absolutely!! A disc is made of tough crisscrossed collagen fibers called the anulus. These fibers surround a “jelly like” substance called the nucleus pulposus. The posterior one third of the intervertebral disc (anulus) is innervated by a nerve called the sinu-vertebral nerve. This nerve can send impulses to the spinal cord/brain as pain and this pain is commonly called discogenic pain. This type of pain can be mild to severe,sometimes poorly localized and can also refer to an extremity, shoulder blade, buttocks, in the form mild to severe “tooth ache”,”hot poker like” or “pressure” like pain. Therefore, any disruption , inflammation or improper distortion of the disc anulus has the potential to generate discogenic pain. The common misnomer is to think that a disc must be herniated and touching a nerve to cause pain…absolutely NOT. Disruption of the anulus, even microscopically, can cause pain via the sinu-vertebral nerve (discogenic) and also the disc bulge can cause local pro immune/inflammatory mediators to coalesce and “chemically irritate” a nerve root that is adjacent to the disc without the disc actually touching it!. This second form of irritation may cause something called “radicular” (nerve root pain) pain such as “sciatica”. It is common to have both of these or just one. Key factors to short circuit this phenomenon are decreasing inflammation (anti-inflammatories, Epidural, ice etc) and decreasing the intradiscal pressure thus decreasing inflammatory coalescence and mechanical disruption. How can we decrease disc pressure? One of the most effective non surgical methods is to “decompress” the area using a spinal decompression machine. I use the Triton DTS at Wagner Integrative Therapies, (formerly Vital Link). I must also point out that studies also show many of us have herniated or bulging discs with no pain whatsoever! Wow!! We don’t know exactly why this is so but have good working models to help us explore and understand and explain. Did you know that the exact cause of mechanical low back pain is 85% unknown? Wow!!


Responses

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  2. Thank you “hallmursah”!! Welcome aboard and thank you for your kind words!

    Sincerely

    J. Adam Wagner, D.C.

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