The Link Between Herniated Discs and Spinal Stenosis

Your spine keeps you upright and protects your spinal cord, which is filled with nerves that connect with almost every area of your body. But, for all its importance, your spine is a rather delicate structure and prone to injury, especially as you age.

If you have lower back pain or neck pain, you may wonder why. Brian Fuller, MD, founder of Mountain Spine & Pain Physicians in Denver, Colorado, here discusses two common sources of back pain — herniated discs and spinal stenosis  — and how they’re related.

The anatomy of your spine

Your spine consists of a stack of vertebral bones that encase and protect your nerve-rich spinal cord. Your spinal cord starts at the base of your neck and runs down the center, hollow portion of the stacked vertebrae — an area known as the spinal canal — and ends in your lower back. 

All along the spinal cord, nerves branch out and exit through holes in the vertebrae so that they can connect with muscles throughout your body. The nerves carry messages from your brain to the muscles, and back again.

The stacked column of vertebrae also allows your spine to move in many directions, so that you can bend and twist without injuring your spinal cord. Each pair of vertebrae is separated from one another and cushioned by a spongy structure called a vertebral disc. The discs keep your bony vertebrae from grinding together, which would cause pain, and also act as shock absorbers.

The anatomy of your discs

The flat, round, rubbery vertebral discs are about half an inch thick. The discs consist of a jelly-like interior, known as the nucleus pulposus, and a flexible outer covering called the annulus fibrosus. 

When you exert pressure on your spine — by walking, running, or jumping — the nucleus expands from the added weight. When your discs are healthy, the annulus keeps the nucleus contained. Thanks to the annulus, the nucleus expands and moves, so that it can absorb and distribute shocks, yet maintains its position in between the vertebrae.

How and why a disc herniates

Just as your skin begins to lose structure, shape, and moisture over time, so do your vertebral discs. The constant pressure on your discs from your body weight also contributes to the breakdown of both the nucleus and the annulus.

As you age, the nucleus loses its high moisture content and begins to flatten and shrink. The annulus also starts to degrade and may develop small tears. Now, when the nucleus expands, the annulus may not be able to contain it. Instead, the nucleus pushes through a rip in the annulus and bulges into the spinal canal. 

When your annulus can’t contain the nucleus, the disc is considered to be herniated. Herniated discs are also called ruptured, slipped, or bulged discs.

How a herniated disc narrows your spine

When a disc herniates into the spinal canal, it presses against the nerves, causing pain and other symptoms. The presence of the herniated nucleus narrows the space in your spinal canal and may press against your spinal cord, a condition known as spinal stenosis. Symptoms of spinal stenosis include:

  • Neck or back pain
  • Numb or tingling hand, leg, or foot
  • Weakness in hand, leg, or foot
  • Trouble walking
  • Difficulty keeping your balance

If you have spinal stenosis in your lumbar spine (i.e., lower back), you might also experience pain or cramping in your legs when you walk or stand for a long time. The pain may diminish when you bend forward or sit.

Treating spinal stenosis and slipped discs

Dr. Fuller first conducts an examination and may order imaging studies to determine the source of your back or neck pain. Factors other than slipped discs can also cause back pain and spinal stenosis, including bone spurs that develop as a result of osteoarthritis.

Depending on your case and your needs, Dr. Fuller tailors an effective treatment plan. Options include:

  • Corticosteroid injections
  • Platelet-rich plasma (PRP)
  • Physical therapy
  • Laminectomy
  • Laminotomy
  • Laminoplasty

You don’t have to suffer from back pain or rely on ineffective pain medications. Contact us by phone at 303-355-3700 or use our online booking form to book a spinal stenosis or herniated disc evaluation today.

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