Disc Disease
In order to understand disc diseases, you must first understand what a disc is and how it functions in the body. Discs are located between all of the vertebrae, or bones, of the spine from the base of your skull to the sacrum, or bottom of your low back. The disc functions to allow the discs to act as a cushion between the bones to absorb the shock and stress associated with everyday movements and activities.

Intervertebral discs are comprised of two main parts, the annulus fibrosus and the nucleus pulposus. The annulus fibrosus is the tough, outer-most part of the disc that is composed of criss-crossed fibrous tissue links that form rings that contain the gel-like inner portion of the disc, which is called the nucleus pulposus. As we perform different activities the pressure inside the disc increases and places pressures on the outer fibers. Over time, these increased pressures can weaken the structure of the discs leading to disc injury or disease.

Herniated or Bulging Discs
(a.k.a. "Slipped" Discs)
A disc bulge or herniation occurs when the integrity of the outermost portion of the disc is compromised. The outer fibers may become weak or develop partial or complete tears. Any of these conditions will allow the gel-like inner portion of the disc to protrude out of the disc spa
ce. The pain associated with a disc bulge or herniation can be caused by various mechanisms. In some cases pain may result from the increased pressure that the bulge places on the nerve endings of the outer fibers of the disc. In other cases chemical irritants are released and create inflammation and pain. A bulge or herniation can also result in pain when the protruding disc material puts pressure on the spinal cord or the nerves that go to the arms or legs. When a nerve is compressed or irritated by an object, it will respond by sending pain signals to the brain that are then interpreted as pain. When this mechanism occurs it may also create the sensation of pain down the arm or leg (sciatica). It may also result in tingling, electricity, cold, hot, or numbness in the arms and legs.

Degenerative Disc Disease
Degenerative disc disease describes a condition in which there is loss of the fluid content of the disc. Up until age 18 or 21 the intervertebral discs receive their nutrients and fluid by direct blood flow. Between the ages of 18 to 21 this direct blood flow stops and the discs begin receiving their nourishment through a sophisticated diffusion process and mechanical pumping action resulting from movement and weight-bearing activities. Unfortunately this system is not as effective as direct blood flow. Therefore, as we age our discs slowly begin to dry out. For most people, this degeneration results in some minor neck or back stiffness as we age but may never really causes pain. However, some people are more vulnerable to this degenerative process than others and it occurs more rapidly in these people resulting in a pathological condition, or disease process.

When a disc loses fluid it results in decreased disc height. Because these discs provide the cushion between the vertebrae or bones this decreases the space between the bones. This decreased space can lead to narrowing of the foramen (hole) where the nerves exit the spinal cord to carry impulses to our arms and legs. This may result in neck pain or back pain with or without pain down the arm or leg (sciatica) or result in numbness or weakness of the arm or leg.

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