FAQ

The pain associated with a herniated disc is felt along the compressed nerve down the leg. A herniated disc may appear on an MRI, but if the imaging doesn't align with your symptoms, it may not be significant. Many people can have an incidental finding of a herniated disc on an MRI without experiencing any symptoms, and this is not clinically relevant. However, a proper diagnosis requires a physical examination. A diagnosis should not be based solely on an MRI image.

Herniated disc is typically a concern observed before advanced age. The frequency decreases as age progresses. With aging, the disc loses water content and becomes stiffer. The gel-like center of the disc hardens, making it more challenging for the disc to rupture and protrude outward.

Herniated discs can still occur in older age, but at this stage, leg pain is more commonly associated with issues like a spinal stenosis or bony protrusions in the spine irritating the nerves.

Sciatica is a major nerve formed by the convergence of several nerves that emerge from the lower back, extending down to the leg and foot. It provides sensation and movement control for a significant portion of the leg. Sciatica pain occurs when one or more of the nerves composing this nerve are compressed or damaged anywhere along their course, typically due to the compression of disks within the spine. However, it can also result from the compression of the piriformis muscle or spinal stenosis. The term commonly used in the community, "I have sciatica," refers to pain originating from this nerve.

Before explaining a herniated disc rupture, it's necessary to describe the shape and structure of the disc. The disc, located between two vertebrae, is a flat, round, rubbery tissue. Its role is to act as a shock absorber between the two vertebrae during movement. It consists of two parts: an outer structure resembling a rubber tire and a central part that is more gelatinous, resembling a round ball (see figure). When weight is applied to the lower back, it compresses this disc between the two vertebrae. If the compressing force is too strong, it can force the inner core within the disc and attempt to push it outward. This process leads to cracking and tearing in the surrounding tissue, followed by the outer gel-like core trying to protrude. This event is colloquially referred to as a disc or herniated disc rupture. When the protruding core moves outward, it puts pressure on the nerves exiting the spinal cord at that location, leading to symptoms of a herniated disc.

English: The spinal cord passes through a tube formed by the merging of holes in the middle of the vertebrae, which are stacked from the neck to the tailbone. As it descends, at each level, two nerves emerge from the spinal cord to the right and left, responsible for essential functions like touch, pain, and movement throughout the body.

Normally, there is sufficient space in the central canal of the spine for the spinal cord and the exiting nerves, allowing them to progress without compression. However, as age advances, the tissues within the bony structure of the tube begin to calcify and thicken. Additionally, bony protrusions start forming in the spine. The shapes of the discs between the vertebrae distort, thinning, and bringing the vertebrae closer together. All these changes lead to a narrowing of the tube through which the spinal cord passes. Nerves that easily passed through in younger years become disturbed and compressed to varying degrees. This condition, known as spinal stenosis, particularly causes increasing pain while walking. Individuals experiencing pain when walking can cover the same distance after resting for five to ten minutes. The narrowing of the spinal canal, resulting in the need to rest and resume walking, is referred to as spinal stenosis.

English: A significant portion of back pain is attributed to lumbar osteoarthritis (facet joint pain), especially as age progresses.

Lumbar osteoarthritis or facet joint pain involves two small joints, one on the right and one on the left, located between adjacent vertebrae. These joints allow for bending and straightening, as well as twisting movements of the spine. Disruption of the structures of these joints due to aging, strain, or trauma can lead to pain during movement. In colloquial terms, "osteoarthritis" refers to the deterioration of the joint structure, degeneration, and consequently, the joint's inability to move as freely as before. This phenomenon is also observed in larger joints such as the knee and hip joints.

In a person with lumbar osteoarthritis and associated pain, the pain is felt in the lower back. The pain from a herniated disc, on the other hand, radiates down the leg towards the foot. A key characteristic of lumbar osteoarthritis is that the pain is more pronounced in the morning upon waking and gradually decreases with movement. Additionally, osteoarthritis pain may radiate slightly down the leg but does not extend below the knee.

The sensitivity of the immobile joint between the pelvic bone and the sacrum, which descends toward the coccyx, is called sacroiliac joint pain. The complaint of pain is felt on the right or left side of the hip. Symptoms are more pronounced in the morning after waking up. This condition can occur at any age and may be attributed to various causes.

Inflammation is a reaction that occurs in the body either against an external threat (such as microbes, foreign objects, or trauma) or against its own tissues (autoimmune). The body transports inflammatory substances to the region where this reaction occurs, carrying the substances that cause inflammation in that area, called inflammatory mediators. Initially, the blood vessels in the area widen, increasing blood flow to the region. Some of the blood inside the vessels, specifically the colorless liquid part called serum, exits the vessel. This is known as edema, meaning the colorless liquid part of the blood exiting the vessel causes swelling in the area. Therefore, the region becomes swollen. Additionally, due to vessel dilation, the color of the area turns reddish, and its temperature increases. As a result, redness, swelling, and increased temperature are observed in that area. Another fundamental characteristic of inflammation is the onset of pain. Yes, pain occurs because there are substances in the serum that exits the vessel and causes swelling, making the pain receptors in that area more sensitive. Therefore, when you bump your arm, when your joints swell due to conditions like rheumatism, when joints strain due to osteoarthritis, or when you cut or burn a part of your body, that area swells slightly and starts to hurt; it becomes sensitive when touched. This whole condition is referred to as inflammation. In other words, inflammation is a reaction caused by the body itself. If you get an infection in any part of your body, inflammation will occur around it. However, in the absence of an infection, it causes only swelling and pain.