What is disc protrusion? Symptoms and treatment
Approximately 80% of the consultations to the doctor for low back pain are due to diseases or disorders related to the intervertebral discs.
The spine is a hinged structure located in the middle back of the trunk, running from the head to the pelvis. Its main functions are structural and protection of the spinal cord. It is composed of vertebrae articulated together by cartilaginous joints in the posterior part and the intervetebral discs in the anterior part. The vertebral discs are nuclei of lax connective tissue that act as cushions that prevent friction between the different vertebrae and distribute the load supported.
During childhood, human beings have 33 vertebrae (7 cervical + 12 thoracic + 5 lumbar + 5 sacral + 4 coccyx). In adulthood, the sacral and coccyx vertebrae join together to form solid structures in continuity.
The vertebral (or intervertebral) discs protect the vertebrae, their joints and nerves, and are found between each of them. Over time, especially when repeatedly subjected to inadequate movements or excessive load, the vertebral discs may suffer degeneration. To understand this we must know the structure of these discs.
Structure of the vertebral discs
It consists of two distinct parts:
- The central part is known as the nucleus pulposus and is composed of a water-based gelatinous substance in which we find collagen fibers and cartilaginous cells among other compounds.
- The peripheral part, known as the annulus fibrosus, is composed of concentric layers of fibers that intertwine between one layer and another to give the annulus fibrosus greater strength. This ring prevents, under normal circumstances, the substance of the nucleus pulposus from escaping to the outside.
The thickness of the vertebral discs varies according to the level of the spine at which they are found; starting at 3 millimeters in the discs located between the cervical vertebrae and increasing in thickness as we go down the spine, reaching up to 9 millimeters in the discs of the lumbar region.
What is disc protrusion?
If the inner fibers of the annulus fibrosus rupture, the nucleus pulposus inside is displaced into the fissure, pushing and exerting pressure on the damaged area. When this happens we speak of disc protrusion.
Are disc protrusion and disc herniation the same thing?
When the lesion or rupture of the fibrous ring of the vertebral disc is greater, the gelatinous substance that is in the internal part can become externalized. In this case we speak of disc herniation, which is a more important and serious degeneration of the disc than in the case of disc protrusion.
Main symptoms of disc protrusion
The risk of developing disc protrusion increases with age, and is relatively common after the age of 40. Although other factors such as obesity, lack of physical activity or having a job that involves repetitive physical tasks can increase the risk.
Disc protrusion can be more or less severe. If the damage to the annulus fibrosus is small, the affected person may not even feel any symptoms, but if the damage is greater, it can cause severe pain and even muscle spasms due to the narrowing of the channel through which the nerves and spinal cord pass.
Treatment of disc protrusion
The spinal column protects the spinal cord, which is responsible for transmitting nerve impulses between the brain and the rest of the body in both directions. It is therefore an extremely delicate area and surgical intervention is reserved for cases of extreme necessity.
Treatment for disc protrusion is usually based on medication and guidelines for gentle exercise and physical therapy. Generally, with these measures, the affected person experiences a marked improvement in their symptoms and can lead a normal life.
It is very important that once the origin of the problem is located, measures are taken to prevent the disc protrusion from continuing to evolve, as it could eventually lead to a herniated disc, causing greater pain and even a disability to perform certain actions. Prevention is very important, especially if you have an added risk of developing the disorder due to your daily activity.
References:
- Mateo, J. A. T. (2008, December 30). Aging of the nucleus pulposus: true cause of disc herniation (m51.8 of the cie-10). Bibliographic review | Tomalá Mateo | Medicine . Medicine. https://rmedicina.ucsg.edu.ec/index.php/ucsg-medicina/article/view/223
