Intervertebral Discs: Its Causes, Symptoms, Diagnosis, & Treatment

QI Spine Clinic, 6 days ago

Understanding Intervertebral Discs Anatomy

• A Central Nucleus Pulposus (NP): Much of the spine’s strength and flexibility are derived from this gel-like material located in the middle of the intervertebral disc called the nucleus pulposus. Type II collagen and proteoglycans comprise the majority of its composition, comprising 66% to 86% water.
• A Peripheral Annulus Fibrosus (AF): consists of concentric layers of collagen fibres called “lamellae.” Each layer of lamellae has alternating fibre orientations, which effectively prevents multidirectional movement. 
• Two Vertebral Endplates (VEPs): The endplate serves as the disc’s primary source of nutrients and allows diffusion. During severe disc degeneration, the hyaline endplate is also the last component to wear through.

Symptoms of Intervertebral Discs

• Increased and continuous back pain
• Difficulty in movement like bending or prolonged sitting
• Increased back pain while coughing, sneezing, laughing or straining
• Pinching pain or numbness in the arm, leg or other region affected by the disc.

Risk Factors & Causes of Intervertebral Discs Pain

• Elevated body mass index (e.g. obesity)
• Lack of fitness or active lifestyle
• Cigarette smoking
• Older age
• Poor posture
• Diabetes
• Lifting heavy loads.

Type of IVD Problems:

• Sprain or Strain: an injury to a ligament or muscle that might occur due to twisting or lifting weights, resulting in back pain.
• Herniated or Ruptured Disc: The disc acts like a cushion for protection. If it is compressed, it can create pressure and irritate nearby muscles, resulting in acute back pain. 
• Sciatica: Pain can also travel from the spine to the back of the leg, causing sciatic pain. Sciatica pain is caused by discomfort, compression, or irritation of the sciatic nerve. It travels along the nerve’s path from the buttocks to the bottom of the leg and into the foot and toes. Sciatica typically affects only one side of the body but can cause inflammation, pain & often some numbness in the affected leg or foot.
• Spondylolisthesis: Between each of the movable vertebrae is located the intervertebral disc. Spondylolisthesis is a common lumbar spine problem when the disc is unstable and allows the upper vertebral body to slide forward. The most common type of spondylolisthesis is group 4, which is degenerative. Degenerative spondylolisthesis can occur due to wear and tear of the intervertebral discs and ligaments, also known as the process of “degeneration”. Instability and slippage can also be significantly influenced by facet joint osteoarthritis.

Treatment of Intervertebral Discs

Among the Methods used to Relieve Pain are:

• Heat treatment (for example, hot packs and heat wraps).
• Gradually increasing activity levels within pain limits.
• An exercise program designed to improve strength, fitness and flexibility.
• A short-term (less than 12 weeks) trial of massage, spinal mobilisation or manual therapy.
• Non-steroidal anti-inflammatory drugs (NSAIDs) or steroids.
• Pain-relieving medications, such as paracetamol.