Disc Issues & Treatment: Aspire for a Pain-Free Life

This blog is about disc problems and their therapeutic options.

Information about the structure and function of our intervertebral discs can be found in our previous blog Disc – Structure & Function.

Diseases and Problems

The biggest problem with our discs is probably chronic underuse. Due to our European-Western affluent society, most people suffer from a lack of movement, which also leads to insufficient load on our spine and its structures in daily life. Once you start school, you sit for most tasks, and we spend most of our time in this position.

Constant unilateral loads, as well as permanent overloading, have negative effects on the discs and the spine: if the pressure changes are absent, so are the stimuli acting on the tissue. As a result, the transport processes of diffusion and osmosis decrease, nutrients are insufficiently transported, and the cells no longer produce enough base substance (among other things, due to the lack of piezoelectric stimuli).

Due to the decrease in the base substance, the tension of the fiber network in the disc is also reduced. The greater deformability of the disc leads to increased stress on the collagen fibers and structures!

Henry Vandyke Carter Henry Gray, Gray301, marked as public domain, details on Wikimedia Commons

The weakened collagen network can no longer withstand the intradiscal and mechanical pressure sufficiently, often resulting in injuries to this fiber network. These injuries can lead to a bulge in the disc (protrusion) or even a leakage of disc material (prolapse). As a result, anatomical conditions can lead to very sensitive and painful compressions and pinching of surrounding nerve tissue, with radiations and paresthesias, sometimes leading to sensitivity loss and paralysis symptoms.

In middle age (between 30 and 40), one is most susceptible to this problem. This is because the body still has the capacity to bind a lot of water, but the quality of the collagen structures has already decreased.

Bulging

As mentioned in our Blog on Structure & Function the base substance cannot fully exploit its maximum water absorption capacity, as this is prevented by the collagen network. In the clinic, we often see middle-aged individuals with significant back discomfort in the morning, with pain, stiffness, and some radiation. With some movement and time, the discomfort improves, only to potentially increase again towards the evening.

An explanation could come from the so-called bulging effect: due to the hydration of the disc while lying down at night, there is an increase in pressure in the disc. The fibers, however, cannot sufficiently withstand the pressure, especially when standing, causing a bulge that can cause the complaints. Through movement and time, water is expelled from the disc (dehydration), reducing intradiscal pressure and bulging, thus decreasing the discomfort. Towards the evening, when dehydration has become too significant and the fiber network is again subjected to higher mechanical stress, the discomfort increases accordingly. Often these are the first signs of an overstrained disc that tend to be ignored.

The extent of the water-binding capacity of the disc is particularly evident in young people: they are measurably taller in the morning after complete hydration of the disc than in the evening.

Henry Vandyke Carter Henry Gray, Gray661, marked as public domain

Discs in Age

Due to normal aging processes, often associated with reductions in activity and increasing lack of movement, a natural degeneration of the disc occurs. The decrease in cell synthesis activity also reduces the amount and quality of the base substance.

As a result, the disc can bind less water with age and dries out over the years. The disc thus transforms into a more homogeneous fibrous cartilage structure without clear structural division.

Henry Vandyke Carter Henry Gray, Gray313, marked as public domain, details on Wikimedia Commons

This is associated with a decrease in elasticity and mobility. However, the stability also increases as a result! In advanced age, fewer or almost no protrusions (bulges) and no prolapses (leakages) occur due to this desiccation. Due to the anatomical conditions of the facet joints of the vertebral bodies, which form part of the spinal canal, arthritic or degenerative osseous changes increasingly come into focus, which, with effects on surrounding tissue (bony narrowing, spinal canal stenoses), can also painfully compress the neural structures.

Therapy

Whether and to what extent a disc can regenerate and thus heal is still the subject of research. Recent studies do show a regeneration and healing capability. Crucial to this is targeted and adequate rehabilitation – and significant cooperation and discipline of the patient, as the (consider the turnover time of collagen structures!) complete renewal of an injured disc takes a long time. Even though pain relief occurs sooner! This is also where the problem of chronicity lies, as most patients do not carry through this lifestyle change and exercises and training long enough. Once the pain has subsided, they often fall back into old patterns – with familiar and frustrating consequences.

The sometimes lengthy rehabilitation should be oriented to the physiologically occurring phases of wound healing. Recurrent and constant damage to the newly formed tissue through overuse or misuse should be avoided.  Frequent position changes for regular loading and unloading, as well as an active posture of the spine with possible posture correction, promote physiological stimuli for the discs. Additionally, strengthening the musculature and improving coordination is often necessary, as these also worsen or weaken from unilateral loads or poor posture.

The physiotherapists and osteopaths at BodyLab are familiar with the anatomical and physiological conditions and know what therapeutic options exist in case of injuries, complaints, or problems. We are happy to advise and instruct you about training and exercise possibilities. If this is not (after surgeries or injuries) or no longer possible, the quality and function of the disc and spinal joints as a functional unit can be improved, and thus pain and complaints reduced, using passive joint techniques, partially under compression or traction.

Once again, the principle holds true: Life means movement!

If you need us, we are gladly here for you!

Your BodyLab Team - Your Connective Tissue Specialists

Osteopathy and Physiotherapy | Rehabilitation and Training

 Zurich Altstetten

Cover Image Credit

Henry Vandyke Carter Henry Gray, Gray301, marked as public domain, details on Wikimedia Commons

All images used here are marked as public domain, further details on Wikimedia Commons.