Herniated and Bulging Disc
Designed to act as shock absorbers for the spine, discs are located between the vertebrae (bones of the spine). The outer ring of the disc (light blue in this diagram), known as the annulus fibrosis, surrounds a jelly-like center (darker blue in this diagram) known as the nucleus pulposus. Unfortunately, with years of wear and tear, exposure to vibration or pounding, slips or falls, perhaps coughing or sneezing, bending, lifting and twisting or maybe something as seemingly harmless as bending to pick up a piece of paper, weakening of the disc wall can occur allowing for a bulge or tear. Then the gelatinous central portion (nucleus pulposus) of the intervertebral disc may be forced through the injured, damaged, and weakened portion of the annulus fibrosis portion of the disc, perhaps resulting in back or neck pain and nerve root irritation.
Degenerative Disc Disease (DDD)
This is side view of the low back (lumbar spine) as seen in a T2 MRI. Degeneration of the disc over time produces low-grade inflammation and irritation and is a major cause of chronic low back pain. Because the discs in the spine do not have a dedicated blood supply, the discs must rely on a process called diffusion to receive their supply of water, nutrients, and oxygen. If the flow of these elements is disrupted, the vertebral discs can degenerate. This is a state of dehydration. Degenerative discs become more susceptible to injury from physical stress and day-to-day activities which can play a contributing role to serious conditions such as disc herniation, osteoarthritis, and spinal stenosis.
Degenerative changes in the lower back also can diminish the ability of the spine to carry the load of the upper body. This can lead to forward slippage of one vertebra on another, a painful condition called spondylolisthesis.
Sciatica refers to pain felt along a portion of the length of the sciatic nerve. The pain is usually felt in the buttocks, where it radiates down the leg. If you suddenly start feeling pain in your lower back or hip that radiates to the back of your thigh and into your leg, you may have a protruding (herniated) disc in your spinal column that is pressing on the roots of the sciatic nerve. This condition is known as sciatica.
Quite often, leg pain or foot pain does not mean that there is a problem with the leg or foot, but rather that there is a problem in the lower back, causing pain and possibly other symptoms to radiate, or be referred to, the leg or the foot.
An important thing to understand is that sciatica is a symptom of a problem – of something compressing or irritating the nerve roots that comprise the sciatic nerve – rather than a medical diagnosis or medical disorder in and of itself. This is an important distinction because it is the underlying diagnosis (vs. the symptoms of sciatica) that often needs to be treated in order to relieve sciatic nerve pain.
Your spine, or backbone, protects your spinal cord and allows you to stand and bend. Spinal stenosis causes narrowing in your spine. The narrowing can occur at the center of your spine, in the canals branching off your spine and/or between the vertebrae, the bones of the spine. When the spine narrows, it puts pressure on your nerves and spinal cord and can cause pain.
Spinal stenosis occurs mostly in people older than 50. Younger people with a spine injury or a narrow spinal canal are also at risk. Diseases such as arthritis and scoliosis can cause spinal stenosis, too. Symptoms might appear gradually or not at all. They include pain in your neck or back, numbness, weakness or pain in your arms or legs, and foot problems.
The wear-and-tear effects of aging can also lead to narrowing of the spinal canal. Narrowing of the lumbar spinal canal pinches the nerves that go to the skin and muscles of the legs. Sometimes, the pinched nerves become inflamed, causing pain in the buttocks and/or legs.
Spinal facets were designed to function as guides to align the vertebrae of the spine. Facet Syndrome can result from injury or degeneration of the disc(s). Facets are bony protrusions extending from the back of the vertebrae.
Facet Syndrome of the back occurs when the back of the spine which interconnects to one another (the facets) compresses and irritates the soft tissue in between. This can inflame the nerves exiting the spine and cause the same type of symptoms commonly seen with pinched nerve conditions. When a nerve is compressed, it may cause symptoms of numbness, tingling, burning, and achy soreness along the nerve path.
The facet joints are the areas where the vertebrae actually join together. They are designed to impart strength, flexibility, and spinal integrity, as well as offer a range of defined movement for each vertebral level.
Awareness that one has a condition such as herniated disc, bulging disc, degenerated disc, spinal stenosis, sciatic or arthritis of the facet joints in the spine, often comes as a surprise. But these conditions rarely spontaneously occur, but rather at some point in time they are initiated, maybe with an accident or trauma or as a consequence of simply putting too much pressure on an area of the body. Genetics almost certainly also play a role.