A vertebral disc is composed of a thick, fibrous outer layer called the annulus and a softer inner portion called the nucleus pulposus. A disc herniation happens when the nucleus pulposus migrates through a tear in the outer layer, the annulus. A good mental picture of this is to imagine squeezing the jelly out of a doughnut. The tear itself may bring about inflammatory changes producing pain, which is why some patients respond favorably to corticosteroids. If however the tear allows the herniated nucleus to come into contact with a spinal nerve the patient will experience great pain and typically does not improve with medications.
Physicians may also refer to a disc herniation as an extruded disc, an extrusion, a prolapsed disc or a prolapse. A disc herniation should not be referred to as a “slipped disc”. Discs do not slip as they are adhered to the vertebrae above and below.
Disc herniation should always be managed conservatively first. We have a number of different treatment options here at the Atlantic Spine & Joint Institute for individuals suffering from disc symptoms. We have had great success at managing these conditions without the need for risky, invasive surgical procedures.