Herniated Nucleus Pulposus Explained — from Anatomy to Treatment | BEST

Herniated nucleus pulposus is a more complex term for the condition most people know as a herniated disc. It simply describes the pushing of inner disc material, called the nucleus pulposus, through a tear or weak spot in a spinal disc. 

A herniated nucleus pulposus can be a source of debilitating symptoms, including pain, tingling, numbness, and muscle weakness due to nerve root or spinal cord compression. Having a better understanding of the underlying causes and the treatment options is a critical step on anyone’s treatment journey. 

As you take some time to read the following helpful information, we invite you to reach out if you have any questions or would like to learn more. The BEST Health System team is here to help you find relief no matter what your situation is. 

Nucleus pulposus and spinal disc anatomy overview

There are 23 spinal discs in the main spinal column. These rubbery discs function to cushion the vertebrae in the spinal column. This allows for the wide range of motion we require to bend, flex and twist our neck and back. 

The discs themselves consist of two main layers. The annulus fibrosus is a tough outer layer made of cartilage. The nucleus pulposus is the softer inner material, consisting of water and collagen fibers. 

The nucleus pulposus helps absorb shock, specifically compression and twisting forces, that the discs withstand on a daily basis. 

How disc degeneration causes herniated nucleus pulposus

The single largest contributor to herniated nucleus pulposus is aging. While it can be related to injury, even significant trauma is not enough to cause tearing and herniation of a healthy spinal disc on its own. Herniated nucleus pulposus instead develops largely as a result of degenerative changes that weaken the discs. 

This process essentially follows these steps:

  • Over time, our bodies have a tendency to dry out and lose water content
  • This makes soft tissue, from the skin to cartilage to tendons, more brittle and less elastic
  • The spinal discs are particularly prone to this due to limited blood supply
  • Dry and brittle discs can cause small cracks and tears on the annulus fibrosus
  • These cracks and tears can grow, causing the discs to be less able to withstand stress
  • This pressure causes nucleus pulposus material to push out against these weak areas
  • A herniated nucleus pulposus occurs if inner disc material pushes outside the normal disc radius

A herniated nucleus pulposus is a fairly common condition, and it’s even possible to have it without symptoms. Most people with the condition complain of a number of specific symptoms that cause them to seek medical assistance. 

Herniated nucleus pulposus symptoms include pain, numbness, and tingling

A herniated nucleus pulposus can result in minor pain if disc material irritates the small amount of nervous tissue on the disc. More serious symptoms are usually related to displaced disc material causing nerve root or spinal cord compression. 

As part of the central nervous system, the spinal column is densely packed with nerves that travel from the brain to the rest of the body. Nerve compression, or a pinched nerve, can result in debilitating local and radiating symptoms that include:

  • Neck and back pain
  • Tingling in the upper or lower extremities
  • Numbness and muscle weakness

These symptoms can get worse over time without proper treatment and can even lead to long-term nerve damage and mobility problems. This is why it is so important to seek immediate care if you experience any of these issues, or for any pain that doesn’t improve in a short period of time. 

Diagnosis and treatment options for herniated nucleus pulposus

Doctors can diagnose a spine condition such as herniated nucleus pulposus through a physical exam, questions about symptoms, review of medical history, and imagery such as an MRI. MRI is usually used over X-ray for disc conditions because it can image soft tissue problems. 

Herniated nucleus pulposus symptoms are usually first treated with at-home therapies including:

  • Periods of rest to take pressure off the spine
  • Over-the-counter medication
  • Gentle stretching 
  • Hot and cold therapy 

In more severe cases, effective treatments can include physical therapy and pain-relieving injections. Although it is an age-related condition, individual cases can improve and many patients are able to find lasting relief through nonsurgical care.

Surgery can become a serious consideration if weeks or months go by and symptoms continue to disrupt the quality of life. With the development of minimally invasive spine surgery, it is now possible to treat herniated nucleus pulposus on an outpatient basis. This helps reduce the risk of complications and leads to a shorter recovery time compared to traditional open spine procedures.  

Herniated nucleus pulposus treatment at BEST Health System

At BEST Health System, our talented team can help patients with a herniated nucleus pulposus at any stage of treatment. From pain management injections to state-of-the-art minimally invasive procedures, we can help you develop a personalized treatment plan that is right for your health care needs and lifestyle. 

Contact us today to learn more.