Ask A Specialist: How Does a Disc Rupture?

Patients often ask me how their disc ruptured. In most cases, this event does not occur with a bang, but rather a ‘whisper’.”

A ruptured disc is one that has ‘herniated’ meaning the disc contents have protruded through an opening in the wall of the disc. A Herniated Disc is categorized as a Non-Contained Disc.

A disc is basically two parts; (1) a circular outer layer termed the Annulus Fibrosus and (2) a Nucleus Pulposus, the gel-like center of the disc. The annulus fibrosus is made from sturdy bands of fibrous cartilage to encase the nucleus. If the annular wall weakens, cracks, or opens the nucleus may leak out from the disc.

In the following illustration we see four variations of disc disorder.

The first drawing indicates a crack in the annular wall. Number two is a Bulging Disc. Notice the annular wall has been compromised but has not broken open. A bulging disc (categorized as a Contained Disc) may be a precursor to a herniation. The last two drawings represent true disc herniations.

Throughout the cervical, thoracic, and lumbar spine discs sit anchored in between vertebrae. Vertebral endplates made from cartilage along with a system of ligaments hold each disc in proper position. Therefore, discs cannot ‘slip’ out of place.

These small cushions slightly bend and twist while absorbing stress from body movement. Some types of body movement create more disc pressure such as jumping or lifting a heavy object. The way a disc absorbs stress and pressure is similar to a tube of toothpaste. Squeezing the tube places the contents under pressure. If the tube encasing the paste has a weak spot or a hole, the paste leaks out through the opening.

Certain herniations can be very painful while others cause no symptoms. Often when a disc herniates the nucleus spreads into the spinal canal compressing sensitive nerve roots. In addition, the nucleus releases a chemical agent that temporarily irritates surrounding nerve structures causing inflammation and pain.

Why do discs herniate?

A number of factors contribute to the deterioration of discs. The dynamics of normal wear and tear, injury, and aging all can affect the structural integrity of discs. Fortunately, the majority of herniated or ruptured discs do not require surgical intervention. In many cases, over time the invading nucleus pulls back toward the disc eliminating associated pain.