Damage to the intervertebral discs.
Throughout life discs wear out.
Imagine a moist bath sponge. If you press it hard then as soon as you let go it immediately returns to its former shape. It is elastic and flexible. Put a heavy stone on the sponge and let it dry in the sun, the sponge is a) pressed flat and stiff and b) no longer springs back into its original shape. It is hard, porous and its shape can no longer be changed. A similar thing happens to your intervertebral discs throughout life as with the sponge.
Damaged intervertebral discs are a phenomenon of wear and tear. The ageing process starts as soon as as a human being is able to walk. Even in 4 year olds age-related changes to the intervertebral discs can be detected.
Back pain from wear and tear.
In our youth the discs bulge with fluid and act as excellent buffers between the spinal vertebrae. They divert pressure and protect the vertebral bones from wear and tear. Because of the intervertebral discs the vertebrae sit stably on each other and are held together as if by chewing gum. At the same time the vertebrae can move easily without rubbing painfully against each other.
Over time discs lose fluidity and elasticity. So when put under pressure they are pressed together more forcefully – and are no longer able to return to their original shape. Overall the discs lose height and like everything that dries out a disc too can develop slight cracks and become damaged. Those affected then complain about severe back pain.
Symptoms & causes of intervertebral disc degeneration.
Definition. What is intervertebral disc degeneration?
What is meant by damage to intervertebral discs?
Damaged intervertebral discs are a phenomenon of wear and tear. As soon as a human being stands upright and walks, the intervertebral discs forfeit a little of their original perfection each day.
Intervertebral disc damage and its consequences.
Intervertebral discs consist of a firm external outer layer known as the annulus fibrosus. This annulus fibrosus [fibrous ring] is filled with a jelly-like substance and a firm nucleus. Over time the discs constantly lose fluidity and forfeit elasticity and flexibility. So when put under pressure they are pressed together more forcefully – and are no longer able to return to their original shape. Overall the discs lose height.
When discs dry out.
The disc slowly dries out and the over time the fibrous ring develops fissures. These develop predominantly in the posterior part adjoining the spinal canal through which the nerve paths travel. Parts of the soft, jelly-like contents of the disc may escape into these fissures. The disc changes shape and bulges out towards the spinal canal. If the external layer tears completely and a hole develops in the fibrous ring, the jelly-like contents as well as the firm nucleus escape into the spinal canal – the classic prolapsed disc. Then nerves in the spinal canal threaten to become compressed. In this case patients complain about symptoms of paralysis. Then a doctor must be consulted immediately.
Most frequently there is painful arthritis.
The most frequent consequence of damage to intervertebral discs is not a slipped disc but painful wear and tear (arthritis) on the surfaces of the vertebrae. Because of the defective 'shock absorbers' the vertebrae have to clearly take more pressure and are exposed to greater stress. In addition they can also become inflamed because of constant overloading.
Symptoms. Signs of intervertebral disc degeneration
What are the symptoms of intervertebral disc damages?
Severe back pain and sometimes even feelings of numbness in arms or legs – these symptoms bring patients with intervertebral disc problems to us. What in colloquial language is described as „lumbago“ also describes the symptoms of an acute onset of pain resulting from intervertebral disc damage.
Backache with involvement of nerve paths.
If the pain emanates directly from the intervertebral disc it usually increases when standing or sitting – if more pressure is caused by a static load on the spine and therefore on the intervertebral discs. If those suffering from damaged intervertebral discs lean forward or rotate their upper body in a circular motion to relieve their back, this movement too can be very painful. Coughing and sneezing increase lower back pain.
If damaged discs press on the nerve paths running through the spinal canal, pain frequently radiates down the neck and arms or legs and feet. Sensations of numbness along with restricted function in the affected areas are also frequently observed with compressed nerves. Patients' arms and fingers are frequently getting numb.
Backache with involvement of the vertebral joints.
If the pain also radiates from the vertebral joints then the affected person experiences a different kind of pain. In this case back pain increases when sitting or standing and especially when bending backwards. Sitting slightly bent forward on the other hand seems to give relief. Circular movements or a sideways tilt of the upper body are painful. If the spine of the affected person is tapped along its length, this also causes pain.
Headaches from damaged intervertebral discs.
Patients with damaged intervertebral discs frequently show signs of painful and extremely tense back musculature because the spinal column is unstable. Tension in the neck region can radiate into the back of the head and produce symptoms of headaches. Sometimes damaged intervertebral discs in the cervical spine trigger headaches rather than backache. So it is not unusual for patients with severe headaches at the back of the head to have the cause diagnosed as damaged intervertebral discs.
Causes. How intervertebral disc degeneration develops
What factors lead to intervertebral disc degeneration?
Damaged intervertebral discs are a phenomenon of wear and tear. Like everything that is used on a daily basis, over time there are signs of overuse. In principle the signs of wear and tear begin as soon as a human being can stand on two legs and starts to walk. So even in 4-year old children the beginnings of age-related changes can be observed in the discs. Damage to intervertebral discs is a genetically pre-programmed condition and generally runs in the family.
Risks: Incorrect weight bearing & heavy strain.
Being overweight, sedentary work and a lack of abdominal and back muscles can considerably hasten wear and tear. Likewise heavy strain or frequent poor postures. This is what we observe in our patients: For instance long-distance drivers or builders strain their backs particularly severely or nursery nurses in the Kindergarten frequently stoop and so have poor posture. Many also lift heavy objects incorrectly or carry weights that are too heavy, something which can trigger an acute prolapsed disc.
Pregnant women are at greater risk of developing intervertebral disc degeneration.
Pregnant women also have a greater risk of damaging their discs. During pregnancy the body's centre of gravity is displaced forwards. This puts more weight and pressure on the spine in the posterior region of the back. In addition the intervertebral discs store more water and lose stability because of hormonal changes.
Deformations of the spine accelerate wear and tear.
Patients with congenital deformations of the spine or deformations caused by accidents also show accelerated signs of wear and tear. By constantly incorrectly putting weight on the spine the discs in affected people are more heavily loaded and also constantly deformed and put under immoderate strain.
Diagnostics & Therapy
When treating damaged intervertebral discs, pain relief and muscle training are the most important therapy measures.
These clinics and hospitals have doctors and therapists qualified in treating damage to the intervertebral discs and diseases of the spine.