Bulging Disc | Degenerative Disc | Herniated Disc
The shock-absorbing discs that separate the bones in
the spine are probably the most common reason for spine surgery. The disc
is much like a jelly doughnut, in that there is an outside wall to the
disc and a soft center. The “jelly” is the inner spongy portion
of the disc, called the nucleus pulposus. Encircling the jelly nucleus
are hard bands of fibrous tissue called the annulus fibrosis, or disc
With age, the disc can become more brittle and susceptible to herniation
or rupture. Years of strain, and poor body lifting form, can take a toll.
One day, a sudden stress from lifting can cause this weakened disc to
rupture, allowing the jelly center to squirt out of the disc space. This
jelly contains chemicals which are extremely irritating to the nerves,
which can also cause swelling.
Because the nerve roots act as telegraph lines to other parts of the body,
a common complication of disc herniation is that it can cause pain that
is felt in other parts of the body, like the leg. In fact, leg pain below
the knee is a common herniated disc symptom. This radiating pain is called
radicular pain or radiculopathy.
Your physician will request diagnostic testing to help determine the best
- X-rays are usually the first step in diagnostic testing
methods. X-rays show bones and the spaces between the bones.
- MRI (Magnetic Resonance Imaging) uses a magnetic field
and radio waves to generate highly detailed pictures of the inside of
your body. Because X-rays only show bones, MRIs are needed to see soft
tissues like spinal discs. These images help your doctor provide a more
accurate diagnosis. MRIs are very safe and usually pain-free.
- CT scan/myelogram - A CT scan is similar to an MRI because
it provides additional diagnostic information about the internal structures
of the spine. A myelogram is used to diagnose a bulging disc, tumor
or changes in the bones surrounding the spinal cord or nerves. A local
anesthetic is injected into your low back to numb the area. A lumbar
puncture (spinal tap) is then performed. A dye is injected into the
spinal canal to reveal where problems lie.
- Electrodiagnostic - Electrical testing of the nerves
and spinal cord may be performed as part of our diagnostic workups.
These tests, called Electromyography (EMG) or Somato Sensory Evoked
Potentials (SSEP), assist your physician in understanding how your nerves
or spinal cord are affected by your condition.
- Bone scan - Bone imaging is used to detect infection,
malignancy, fractures and arthritis in any area of the body. Bone scans
are also used to find lesions for biopsy or excision. Click here to
learn more about bone scans.
- Discography - Discography is used to determine the internal
structure of your disc. It is performed with a local anesthetic by injecting
dye into the disc under X-ray guidance. An X-ray or CT scan is performed
to determine if the disc’s structure is normal or abnormal and
if the injection causes pain. A benefit of a discogram is that it enables
the spine surgeon to determine the disc level that is causing pain.
This ensures that surgery will be more successful by reducing the risk
of operating on the wrong disc.
- Injections - Pain-relieving injections can act as a
bridge to physical therapy by relieving back pain and providing the
physician with important information about your problem.
Unlike muscles which can heal somewhat quickly, a torn or degenerated
disc heals more slowly. The good news is that in many cases, the pain
and inflammation originating from damaged discs can be treated nonsurgically
by reducing the inflammation and by strengthening the musculature surrounding
the damaged disc to give it more support.