Types of Herniated Discs Causing Back Pain

Do you suffer from chronic back problems, but your doctor says "it is just musculoskeletal?" Although most back pains assessed by doctors in the primary care setting are truly musculoskeletal in nature, there may be a more serious problem lurking if your pain does not improve in a few weeks - a herniated disc.

So what is a herniated disc? Well, simply put, it is a vertebral disc that has ballooned out from between your spinal vertebrae. Each disc consists of a soft center, the nucleus pulposus, and a tough outer rim or border called the annulus fibrosis. Trauma or any excessive stress on the back can cause the annulus fibrosis to tear, allowing the center nucleus to bulge outward from the vertebrae. The direction in which this soft center of the disc protrudes determines which type of herniated disc is present. Most herniated discs, in fact nearly 80%, are called "posterolateral" disc herniations, which simply means the ballooning has occurred mostly in the posterior direction (backward) and slightly toward the side (lateral). However, less commonly, discs can herniate in the "far lateral" direction, which means the center of the disc has ballooned mostly toward the side of the body, or laterally. In comparison to posterolateral disc herniations, far lateral disc herniations are more difficult to detect and diagnose. They can compress and damage critical neural structures, leading to permanent changes that may never fully resolve with treatment.

Symptoms associated with herniated discs could range anywhere from being nonexistent to very severe. Sometimes the associated pain is located only in the back, while at other times it may involve the back, hip and one leg. How bad the symptoms are and what types of symptoms one may have depends upon how much of the nucleus pulposus has herniated and what structures at that level of the spine, if any, have become compressed by the disc. Many people have herniated discs but may not know it because of a lack of symptoms. This stems from the fact that the portion of the disc that has herniated outward may not be compressing any structures, such as nerve roots, around the disc. However, such asymptomatic herniated discs could become problematic later in life if added stress or trauma to the back occurs, and caution should be taken to avoid aggravating factors.