What is a Prolapsed Disc?

Prolapsed disc explained by Denver, Golden, Aurora, Boulder, Broomfield, Jefferson, and Littleton Colorado’s top pain doctors

Prolapsed-DiscProlapsed disc is a condition involving the intervertebral discs that separate the vertebrae. Vertebrae are individual bones that are stacked on top of one another to make up the spinal column. In between these bones are spaces in which pads of cartilage, or intervertebral discs, act as shock absorbers. These intervertebral discs are relatively soft and compressible, which aids in the flexibility of the spine.

The construction of intervertebral discs is what aids in their shock absorbing capabilities. These discs contain an outer layer that is strong and fibrous, called the annulus fibrosus. Its tough and fibrous texture is due to fibrocartilage that allows it to maintain the inner contents of the disc. The inner portion of the disc is known as the nucleus pulposus. This part of the disc is made up of a mucoprotein gel, which is soft and pulpy. Loose annular fibers, suspended within this jelly-like substance, are what help maintain its shape and resistance.

Owing to typical aging or injury, intervertebral discs can become damaged. When this occurs, the inner nucleus pulposus can protrude, or herniate, out through a weak portion in the outer annulus fibrosus layer of the disc, thus placing pressure on other structures within the area of the spinal column. Prolapsed disc can also be known as a disc herniation or rupture. It is also sometimes referred to as a slipped disc, however this is not an entirely accurate description of the condition.

Herniated Disc DiagramGenerally, compression of nearby nerves and other structures surrounding the spinal column are to blame for the pain associated with prolapsed disc. Additionally, inflammation that occurs around the affected area is believed to contribute to the pain associated with the condition. In general, this condition can occur anywhere along the spine, though a majority of instances of prolapsed disc occur within the lumbar region.

The pain associated with prolapsed disc can be described as constant and persistent. This is generally because once the inner layer of the disc protrudes out through the protective outer layer, it is not able to retract itself. Thus, the herniated disc material remains compressed against the nerve, causing pain. Further, the pain can be experienced as a highly specific and very sharp stabbing pain, or it can be described as a more widespread and general pain. In some cases, the pain can be experienced as nerve root pain, which travels along the area of the spinal column. The onset of pain does tend to occur rapidly, and in some instances, the pain can be quite severe. Patients with prolapsed disc may also complain of numbness and painful tingling sensations. These symptoms may be alleviated somewhat when the patient is lying down.

Causes of Prolapsed Discs

Disc Herniation - XRAYThere are a number of reasons to explain why an individual may develop a prolapsed disc. While a some instances can be attributed to the typical wear and tear from aging, some cases of prolapsed disc can be the result of a congenital weakness in the fibrous layers of the disc, making it more prone to herniation. Nonetheless, the daily pressure placed upon the structures that make up the vertebral column can cause them to become dehydrated, smaller in size, and to gradually lose their ability to absorb shock. This can wear down the outer ring of the disc by weakening the annulus fibrosus that acts to hold in the inner pulpy material.

Prolapsed disc can also occur by improperly bending, causing injury to the disc. While most typical daily movements do not place a lot of strain on the spine, when the spine is forced to lift something heavy or move sharply, a significant amount of pressure is applied to the intervertebral discs. This can place the intervertebral disc at risk for tearing or other damage.

Aging is a common factor known to be related to an increased risk for developing prolapsed disc. Other known factors include, bending awkwardly, frequent heavy lifting, a sedentary lifestyle, smoking, being overweight, weight-bearing sports, or a traumatic back injury.

Treatments for Prolapsed Discs

Patients are encouraged to speak with their physician regarding their condition, as a number of treatment options are available. Should the patient not be experiencing severe and debilitating pain associated with their condition, it is recommended that they first attempt conservative, at-home treatment for managing their pain. If it is known that the patient’s condition is related to an acute injury, then it is generally recommended that the patient avoid placing any undue strain on the muscles within the back or joints for several days. This can allow the intervertebral disc time to begin the healing process and avoid the risk for any additional injury.

Physical therapy may also be recommended. This would include targeted exercises and several types of routine stretches that are believed to be helpful in reducing the pain and inflammation associated with prolapsed disc. Swimming is a great exercise and is highly recommended for patients with prolapsed disc. This exercise is low impact, thus it places very little strain on the individuals joints.

Over-the-counter pain relievers with anti-inflammatory qualities (such as non-steroidal anti-inflammatory drugs) can be very beneficial for patients with prolapsed disc. These medications are believed to be effective because of their anti-inflammatory characteristics. Other medications, such as oral corticosteroids like prednisone and cortisone, may be recommended in instances where the patient’s pain was not significantly reduced using an over-the-counter pain reliever.

In terms of patients who report that their pain has not been responsive to over-the-counter pain medications, it may be recommended that they try more aggressive pain management techniques. For instance, opioid medications, such as codeine, may be prescribed for patients needing short-term relief from the pain of a prolapsed disc. These medications act by binding to the opioid receptors within the brain and have received extensive support for their effectiveness in reducing pain. The risks of using opioids include the potential for addiction; in other words patients may become psychologically or physically dependent on them.

Epidural Steroid Injection - XRAYProlapsed disc can also be associated with chronic or severe pain. Patients with these more significant symptoms may wish to try the more aggressive forms of pain management available. For instance, a highly effective and almost immediate option for managing neuropathic pain associated with a prolapsed disc is epidural injections. This procedure involves the injection of an anaesthetic medication, generally corticosteroids, into the area near the nerve that is primarily responsible for transmitting pain signals to the brain. Other methods, including the use of a TENS unit or spinal cord stimulation have also been shown to be highly effective in relieving pain associated with prolapsed disc.

Alternative and complementary pain management techniques are also available. These can include biofeedback training, relaxation training, and acupuncture. These methods have received some support in terms of their effectiveness in helping patients manage the pain of a prolapsed disc, particularly when used in conjunction with other therapies.

Conclusion 

Prolapsed disc is a condition affecting the structure of the intervertebral discs that make up the spinal column. This condition can result from either injury or a weakness due to aging. Bulging disc material places compression on nerves and other surrounding structures within the area, causing a significant amount of pain. There are a number of treatment options available for individuals with protruding disc. It is generally recommended that patients with mild to moderate pain attempt to manage their pain first with conservative, at-home treatment methods. Should these interventions be ineffective, however, other interventions are available. It is recommended that patients with prolapsed disc speak with their doctor about the specific treatment options available to them for managing the pain and discomfort associated with their condition.

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