The center of the human disc, which is the nucleus pulposus, ruptures through the annulus fibrosus. Which is the woven structure containing the nucleus. The nucleus which has chemicals as well as a mass irritates the surrounding tissues, including the nerves.
This is like the jelly coming out of the side of the donut.
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| Herniated Disc |
Thus holding the center jelly or nucleus proposes. The cross
links of the fibers may break allowing a separation of the fibers, and the
nucleus can then push through that break. Once that weak spot allows an opening
the fibers themselves can also break causing a blowout of the nucleus.
The nucleus material then causes an inflammation of the
tissues and the nerves and the mechanical pressure of the jelly-like substance
also compresses the nerves and the tissues.
This causes the pain signals, numbness, and weakness. Ouch!
So, how does the body fight off the pain associated with the disc herniation?
The human body removes any foreign object by activating
special cells called macrophages and monocytes that attack and destroy the
foreign material. To use another analogy, these
cells are like small pac men that chomp away at all that stuff. Through the body a herniated
disc, which is the nucleus pulposus in the wrong location, is considered a
foreign object the macrophages and monocytes pac-man away the nucleus. In addition, the larger disc herniations
tend to have the most water content. With time this disc piece will dehydrate.
Over time the disc
herniation is removed, and shrinks back so it no longer irritates the nerves or
the tissues. The body also heals back the tear
in the annulus, and reties the annular fibers. That healed annulus is now associated
with a scar, and though it helps hold the nucleus back into its position it is
a weaker area and it has a small but increased chance of rereupture.
The disc will continue with the natural dehydration process,
and will bulge over time. That's why if you get
cereal MRI studies of large disc herniations you will see spontaneous
regression of the herniation, and longer term the findings of a disc bulge. The
most important thing you need to know is that the body does have its own way to
remove disc herniations.
If your patient enough, and do not have major nerve issues
that require surgery, most of the time, the body does remove the disc herniation
on its own. That is the reason why many people will
have disc herniations or bulges on MRIs, but no pain. If you are in severe
pain, please discuss this condition with your doctor to make sure you do not
have a situation that requires urgent or emergent care.
Fortunately, these situations are rare. On the other hand,
if you have truly lost muscle strength, and lost the ability to control your
bladder or bowels, you may need care right now. If your doctor determines
that's not the case, and if you can tolerate the current pain, allow your body
to start the process of removing the disc herniation. Let your body pac-man
away that disk. If you're in pain, but do not
have significant loss of body functions, you can wait to see if your body will
remove or improve that disk herniation.
That's why greater
than 90 percent of people with disc herniations do get better after six to eight
weeks - no surgery needed.
Take it home message is, if you can tolerate
the pain, and be patient, you can avoid disc surgery.
Wawo
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