A herniated disc typically presents as a sudden onset of intense pain in the lower back with intermittent radiation of the pain into the legs. The back pain is typically characterized as a sharp stabbing pain. The leg and foot pain is often described as an electric shock sensation. This may often be accompanied by areas of numbness or tingling in the legs or feet. Many times a specific event is identified as the cause of these symptoms, but this may be as minor as picking up a piece of clothing off the floor.
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The Anatomy of Spine
The spine is composed of a vertical column of alternating bones and discs. The bones are stacked one on top of another like a block tower. Between each pair of bones is a disc – a cushion or shock absorber. This creates an alternating sequence of bone – disc – bone – disc from the base of the skull to the top of the pelvis.
The block portion of the bones is known as the vertebral body. This is the front half of the bony portion of the spine. This front half supports the weight of the spine and the upper body and provides the majority of the spine’s strength. This is also the portion of the bony spine that lies above and below each disc. The back half of the bony spine is composed of thin bony projections, like fins or wings. These serve as attachment sites for ligaments and muscles up and down the spine. Two fins project from the back portion of the vertebral body, and then slant to connect to one another in the middle. This creates a tunnel surrounded by bone. This tunnel is known as the spinal canal since this is where the spinal cord runs as it travels from your brain, down the spine, to the pelvis.
The discs of the spine are circular when viewed from above. They are similar to a jelly-filled doughnut. There is a firm, but slightly flexible, outer ring that is tough and strong. The middle of the disc is soft and squishy, like jelly. When pressure is applied to a normal, healthy disc the pressure in the central jelly portion increases and the firm outer ring is stressed but contains the inner contents.
There is no Extra Room in Spinal Canal…
As mentioned earlier, the spinal cord runs behind the column of vertebral bodies and discs, in the spinal canal. The bony walls surrounding the spinal cord provide protection from injury but also contribute to one of the problems caused by a herniated disc. This bony perimeter around the nerves does not offer much additional space. If things start to get crowded in the spinal canal, there is no extra room. At each disc level there is an opening between the different pieces of bone. This opening is known as a spinal foramen. The individual nerves that make up the spinal canal exit the spinal canal through these spinal foramen. Like the spinal canal, the spinal foramen is surrounding on all sides by bones, so there is no extra space and no ability to stretch or expand.
A sudden load applied to the disc may generate enough pressure within the disc to tear or rupture the outer ring. This can happen from a fall, a motor vehicle accident, or lifting a heavy object. This tear in the outer ring is often painful. The secondary problem that can develop, however, is that the disruption in this outer ring may allow the inner, jelly-like contents to escape. Depending on the location of the tear and the nearby structures, this escaping material can lead to additional problems.
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