Discopathy

Discopathy is a condition of the intervertebral disc (discus intervertebralis). Literally translated it means 'disease' (pathy) of the 'intervertebral disc'. As a result of wear, cracks occur in the fibres of the disc and that causes pain. With a large tear the contents of the disc can protrude. In that case there is a hernia.

What is an intervertebral disc?

As the name suggests, intervertebral discs lie between the vertebrae. There they provide shock absorption during movement and prevent vertebrae from touching each other.

An intervertebral disc is made up of two parts, an outer rim and a soft core. The outer rim, a cartilage layer also called the annulus fibrosus, ensures that forces are distributed evenly over the entire disc.

In addition, the outer rim is important for containing the soft core. The soft core is the nucleus pulposus. This consists of a gel-like mass and is important as a shock absorber during, for example, walking.

What causes an abnormality of the intervertebral disc?

Discopathy is almost always the result of ageing. This process of degeneration causes the outer rim to become less elastic and sometimes even to tear. A sign of ageing of the soft core is that it dries out. A tear in the outer rim can lead to a hernia (protrusion) of the intervertebral disc. The soft core then protrudes from the disc and hardens.

A discopathy itself can be asymptomatic, meaning 'without symptoms'. If there is pain, it is due to nerve irritation. This arises from compression (pressure) of the disc on nearby nerve roots.

What are the symptoms of discopathy?

Recognisable symptoms are sharp local pain and a possible worsening of pain with flexion and/or extension movements of the spine. Static loading such as prolonged sitting and standing, or dynamic loading such as walking can also provoke symptoms.

Stiffness and a feeling of instability in the lower back are common in discopathy. In the case of a hernia of the intervertebral disc there may also be specific symptoms such as radiating pain, tingling and muscle weakness.

How is the diagnosis 'discopathy' made?

Often the patient's story and the physical examination show that it is a problem with the intervertebral disc. Additional tests are therefore not always needed. If symptoms are severe or do not resolve, imaging may be necessary. This is usually done by means of an X-ray. The distance between the vertebrae can be clearly seen on this. If the distance has become smaller, there is something wrong with the discs.

If there is still doubt, or suspicion of more serious symptoms, an additional MRI scan can be made.

What does treatment of discopathy look like?

With discopathy, a conservative treatment method is preferred. This comes down to dosing the load and physiotherapy. The physiotherapist can guide and advise on posture and movements, give exercises to train mobility and muscle strength, or perform treatments that relieve pain. In exercise therapy, particular attention is paid to building muscle strength of specific trunk muscles.

When conservative treatment does not produce sufficient results, or in worsening symptoms, surgery may be chosen. In the case of a hernia this is done by means of a hernia operation.