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

In this blog, we look at intervertebral disc problems and their treatment options.

You can find information about the structure and function of your intervertebral discs in our earlier blog Intervertebral Disc – Structure & Function.

Conditions and Problems

The biggest problem for your intervertebral disc is probably chronic underloading. Due to our European-Western affluent society, most of us suffer from a lack of movement and consequently also a lack of load on our spine and its structures in everyday life. As soon as you start school, you sit for most tasks, and we spend most of our time in this position.

Constant one-sided loading as well as permanent overloading have negative effects on the discs and the spine: if alternating pressure is missing, the necessary stimuli on the tissue are also absent. As a result, the transport processes of diffusion and osmosis decrease, nutrients are only insufficiently transported, and the cells (also due to the lack of piezoelectric stimuli) no longer produce enough ground substance.

Due to the decrease in ground substance, the tension of the disc's fiber network also decreases. The resulting greater deformability of the disc places a heavier load 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 then often no longer adequately withstand the intradiscal and mechanical pressure, leading to injuries of this fiber network. These injuries can lead to a bulging of the disc (protrusion) or even an extrusion of disc material (prolapse). For anatomical reasons, this can lead to very sensitive and painful compressions and pinching of surrounding nerve tissue, with radiating pain and paresthesia, sometimes even leading to loss of sensation and symptoms of paralysis.

In middle age (between 30 and 40), you are most vulnerable to this problem. This is because your body still has the ability to bind a lot of water, but the collagen structures have already decreased in quality.

Bulging

As already mentioned in our blog about structure & function, the ground substance cannot utilize its maximum water absorption capacity, as this is prevented by the collagen network. In the clinic, we frequently see in middle-aged people that back Conditions are often severe in the morning, accompanied by pain, stiffness, and sometimes radiating symptoms. With a little movement and time, the Conditions improve, only to possibly increase again towards the evening.

One explanation could be the so-called bulging effect: due to the hydration of the disc while lying down during the night, there is an increase in pressure within the disc. However, the fibers can only inadequately withstand the pressure, especially when standing, causing a bulge that can cause the Conditions. Through movement and time, water is pushed out of the disc (dehydration), which reduces intradiscal pressure and bulging, thereby easing the Conditions. Towards evening, when dehydration has become too pronounced and the fiber network is once again exposed to increased mechanical stress, the Conditions increase accordingly. These are often the first signs of an overloaded disc, which are easily brushed aside.

How large the disc's water-binding capacity is can be seen especially in young people: in the morning, after full hydration of the disc, they are measurably taller than in the evening.

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

Intervertebral Discs in Aging

Through normal aging processes, along with the frequently associated reduction in activity and increasing lack of exercise, a natural degeneration of the disc occurs. Due to the decrease in cellular synthesis activity, both the quantity and quality of the ground substance decline.

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

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

This is accompanied by a decrease in elasticity and mobility. However, stability also increases as a result! Due to this drying out, fewer to almost no protrusions (bulging) and prolapses (herniations) occur in advanced age. Due to the anatomical conditions of the facet joints of the vertebrae, which form part of the spinal canal, arthritic or degenerative osseous changes with effects on surrounding tissue (bony narrowings, spinal canal stenosis) then come to the fore, which can likewise painfully compress neural structures.

Therapy

Whether and to what extent an intervertebral disc can regenerate and thus heal remains the subject of research. However, more recent studies definitely show a capacity for regeneration and healing. Crucial to this is targeted and adequate rehabilitation—and significant cooperation and discipline on your part, as the complete renewal of an injured disc takes a long time (keep in mind the turnover time of collagen structures!). Even if you become pain-free much sooner! This is also where the problem of chronification lies, as most patients do not stick to this lifestyle change or the exercises and training long enough. Once the pain has subsided, you quickly fall back into old patterns—with familiar and frustrating consequences.

Rehabilitation, which is sometimes lengthy, should be guided by the physiological stages of wound healing. Renewed and continuous damage to the newly formed tissue through overloading or improper loading should be avoided. Frequent changes in position for regular loading and unloading, along with an active posture of the spine including any necessary postural correction, promote the physiological stimuli on the discs. Furthermore, strengthening the muscles and improving coordination is often necessary, as these have also deteriorated or weakened due to one-sided stress or poor posture.

The physiotherapists and osteopaths at BodyLab understand the anatomical and physiological conditions and know which therapeutic options are available for injuries or Conditions / problems. We are happy to advise and guide you regarding training and exercise options. If this is not yet possible (after surgery or injury) or no longer possible, passive joint techniques, sometimes under compression or traction, can improve the quality and function of the disc and the spinal joints as a functional unit, thereby reducing pain and Conditions.

Here, too, it holds true once again: life means movement!

If you need us, we are here for you!

Your BodyLab team, your specialists for disc and back Conditions

osteopathy and Physiotherapy | Rehabilitation and Training

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You can find more on this on our herniated disc page.

Cover Image Credits

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

All images used here have been marked as public domain; further details on Wikimedia Commons.