Also called a herniated, slipped, ruptured, or torn disc, a prolapsed disc is a spinal disc whose center has extended beyond its normal barriers. This condition is experienced by people of all demographics, but it is most common in those 30 – 50 years old. For many people, it doesn’t produce any symptoms and heals on its own in a number of weeks or months. For others, however, the symptoms can become so severe that they’re life-changing and long-lasting, leaving those unfortunate sufferers wondering, “Just what is a prolapsed disc?”
The scientific name for a herniated disc is prolapsus disci intervertebralis. Prolapsus refers to the fact that the interior of the disc has moved out of place, while disci intervertebralis is the scientific name of an intervertebral or spinal disc. Similarly, the word “prolapsed” in “prolapsed disc” literally means that the organ or structure has fallen or slipped down and out of place. However, this name, along with other misnomers like “slipped disc,” can be misleading. In the case of the spinal discs, “prolapsed” means that the interior of that disc has come out of place. The disc as a whole does not move.
Many people use the term “prolapsed disc” interchangeably with “herniated disc,” “ruptured disc,” and “slipped disc.” While this is good enough for everyday usage, “prolapsed disc” can also refer to a specific stage of disc herniation – one in which the interior of the disc has not fully escaped. The path to a fully ruptured disc consists of four stages: disc protrusion or degeneration, prolapse, extrusion, and sequestration. Disc protrusion occurs when the intervertebral disc is weakened, but there are no visible external changes. Prolapse is when the form of the disc actually begins to change, and it bulges or pushes out into the spinal canal. Extrusion occurs when the gel-like core, nucleus pulposus, finally breaks through the outer layer, but it doesn’t extend beyond the disc. The final stage, sequestration, involves the core actually leaving the disc and oozing elsewhere in the spinal canal.
The first of the two steps are considered incomplete herniations, since the inner layer has not actually escaped into the spinal canal. The last two are complete herniations. “Prolapsed disc” can be used to refer specifically to the second stage in this process, but in most cases, it is simply used as a synonym for herniated disc.
The Anatomy of Prolapsed Disc
To understand a prolapsed disc, and why such severe symptoms can result from it, it’s necessary to know the spinal structures involved in its formation. The spine is an extremely complex system with many interrelated parts, but the most relevant ones to understanding prolapsed discs include:
· Vertebrae – The basic building blocks of the spine, vertebrae are the bony structures that create the framework for this system. There are 33 vertebrae, and they protect the spinal cord as well as stabilize the spine. Each vertebra has two openings called foramina, through which nerve roots pass to get from the spinal cord to the rest of the body. Between the 24 articulating, or moving, vertebrae lies an intervertebral disc.
· Intervertebral or spinal discs – These cushion-like structures connect the vertebrae and help hold them together, and also act as shock-absorbing pillows. They allow the vertebrae to move slightly without rubbing against one another, and they absorb pressure to reduce stress on the bones. They are made up of two distinct layers:
o Annulus fibrosus – The exterior layer of intervertebral discs is a tough “skin” made up of many layers of fibrocartilage, which allows it to be flexible yet strong. It is this layer that splits or tears in the case of a prolapsed or herniated disc.
o Nucleus pulposus – The interior filling of spinal discs, this is a gooey, jelly-like substance composed of collagen, water, and other materials. As a person’s body ages, it loses some of this water and collagen, making it thinner and more brittle.
· Spinal canal – Each vertebra has an opening between the front and back, and when the vertebrae are stacked on one another, these openings line up to form a hollow column known as the spinal canal in which the spinal cord resides. A ruptured disc can leak into this spinal canal and put pressure on the spinal cord.
· Spinal cord – The “superhighway” of the nervous system, the spinal cord transmits electric signals to and from the brain and the nerve roots. If it is compressed by disc tissue, the effects can be severe and widespread.
· Nerve roots – Nerve roots are the base of the body’s peripheral nerves. They sprout out of the spinal cord and go through small openings in the vertebrae to get to the rest of the body. A prolapsed spinal disc can put pressure on this nerve tissue.
Causes and Risk Factors
While certain factors increase your risk of developing a prolapsed disc, none guarantee that you will develop the condition. The following are risk factors for developing a prolapsed disc:
· Poor posture – Slumping puts uneven pressure on the spine and the spinal discs, which can unduly stress them.
· Family history – If others in your family have suffered from a ruptured or prolapsed disc, then you have a higher risk of experiencing it yourself.
· Age – As the body gets older, the spinal discs lose water content and collagen. This makes them more brittle and less able to perform their duty of cushioning the vertebrae. Because they are more fragile, the outer layer is more likely to rip.
· Physically demanding jobs or hobbies – The more stress placed on your spine, the faster spinal discs can break down. If you have a job that requires heavy lifting and other strenuous activity, or you participate in rough sports, then you have a higher chance of experiencing a herniated disc.
· Excess body weight – Obesity is another indicator for a prolapsed disc because carrying extra body weight puts more pressure on your spine. Again, the more pressure and stress on your spine, the higher your likelihood of a torn disc.
· Smoking – In addition to the plethora of other detrimental effects it has, smoking can also increase your chance of experiencing a herniated disc. The chemicals in cigarettes can diminish nutrient absorption by discs, compromising their integrity.
· Prior injury – Even if a previous injury didn’t immediately result in herniation, it could have weakened your spinal discs, making them more likely to rupture in the future.
A prolapsed disc can be caused by many factors, and it can be difficult to determine the true culprit behind it. Adding to this difficulty is the fact that there can be multiple contributors to its development. For example, a car accident could damage the disc, and then extra body weight could continue to break it down until it becomes prolapsed. Only a doctor can provide a professional diagnosis, and even then he or she will most likely need to perform diagnostic tests. However, most cases of prolapsed discs are due to:
· Age-related degeneration – Far and away the most common cause of a prolapsed disc is degeneration of the spinal discs. As mentioned earlier, they change and become weaker as the body gets older, and oftentimes, this is all that’s needed for a disc to become prolapsed.
· Injury – Sudden trauma like a car accident or sports injury can stress the spinal disc to the point that it breaks.
· Lifestyle-related wear and tear – Whether from carrying extra body weight, a rough job, or a hobby, extra wear and tear can cause the spinal discs to break down so much over time that the outer layer tears.
Symptoms of Prolapsed Disc
In the vast majority of cases, those with a prolapsed disc don’t experience symptoms, and many are unaware they even have one. That’s because the disc has not extended far enough, or into the right area, to compress a nerve root or the spinal cord. When it does put pressure on these structures, however, the symptoms can be significant and can include:
· Localized and radial pain
· Tingling
· Numbness
· Muscle spasms
· Inhibited reflexes
· Problems walking
· Muscle weakness
These symptoms are usually experienced in the part of the body relating to the nerve tissue being compressed. For example, if a nerve root in the cervical spine is pushed upon, symptoms are felt in the head, neck, shoulders, and/or arms because the nerves in this region of the spine extend to those parts of the body. Alternately, nerve roots in the lumbar spine reach to the lower back, buttocks, legs, and feet, so when they are impacted, the symptoms of a prolapsed disc will be felt in these areas.
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