The article is part of a series written by Dr. Kevin Pauza
It’s difficult to get the proper treatment for a medical condition when the cause of it is misunderstood, which is often the case with herniated discs. There is a great deal of misinformation about herniated discs that has begun to be treated as fact, making it important to lay out the truth about this condition.
Facts About Herniated Discs
The correct term when referring to this condition is “herniation.” Some incorrect and misused terms include “disc protrusion,” “prolapse,” “slipped disc,” or “pinched nerves.” These terms are incorrect due to the nature of herniated discs, which will be explained later.
The second fact, that few doctors know, is how to differentiate between herniated discs and bulging discs. Most doctors are surprised to learn that the difference between these two conditions is not related to how far the disc extends from beyond where it belongs.
It may help to remember the difference between bulge and herniation this way:
A disc bulge is when more than 50% of a disc’s normal outer circumference, or ring, extends outward. Think of a bulged disc as a fat man with a large girth extending outward, all the way around his entire belt-line.
In comparison, a disc herniation is when less than 50% of a disc’s normal outer circumference extends outward. Using the same analogy, think of a disc herniation as a pregnant woman whose focused area of her baby extends outward only on her front, making up less than 50% of her body’s girth.
Herniated discs do not cause symptoms. It is their associated leaking liquid gel nucleus pulposus that causes symptoms and weakness. The nucleus pulposus leaking out of discs alongside herniations inflame spinal nerves, causing sciatica pain and weakness. This means that pain is not caused by the nerve being physically pinched, but by irritation and inflammation of surrounding nerves. This is why the MRI appearance often does not correlate with symptoms.
When the herniated disc level seen on the MRI image matches up with the patient’s symptoms, it’s usually coincidental. Recall that the herniation is not causing symptoms, but instead, it is the herniation’s associated nucleus pulposus leakage. The MRI appearance of the herniated disc levels is usually coincidental, and not necessarily reflective of herniated discs causing symptoms.
Disc herniation almost always occurs in the bottom one or two discs, the L4-5 disc and L5-S1 disc, more than all the other discs combined and we can predict it with a high degree of certainty for the following reasons.
Remember that humans have only 5 lumbar discs, and over 80% of the time, the disc herniation is only the bottom one or two discs. These two discs are more prone to develop annular tears because almost all damaging spine forces affect mostly these two discs. This makes sense because these two discs separate the pelvis’ movements from the upper body’s movements. Scientifically, we can say that these two bottom discs are the fulcrum of two major force vectors, so damaging forces cause annular tears leading to herniated discs in this area.
Most disc herniations improve on their own. Specifically, 89% of disc herniations resolve on their own within 20 months. It’s valuable knowing that nothing causes herniations to improve faster than their natural course. Not physical therapy, not chiropractic therapy, not epidurals, not traction, and not medicine. Epidurals may provide temporary relief from pain caused by the inflammation of the nucleus pulposus leakage through the associated annular tears, but epidurals do not heal herniated discs. Because herniation is caused by annular tears, only sealing and healing annular tears can heal herniations.
It’s not the herniated disc’s pressure pinching on the spinal nerve that causes sciatica symptoms, as most doctors once thought. Instead, it’s the inflammation of the spinal nerve caused by the associated leaking nucleus pulposus. This liquid causes all symptoms, and yet is unseen by MRIs and CTs. This is why the annulogram test was developed to identify the symptom-causing annular tears.
The Discseel® Procedure
Because herniated discs are, for the most part, caused by annular tears, and because annular tears can only be effectively treated by being sealed and healed, the best treatment is the Discseel® Procedure.
The Discseel® Procedure is the only procedure in the world that uses FDA-approved Fibrin for off-label use to repair annulus tears in the herniated disc, preventing the continued seeping of the torn disc’s nucleus pulposus. The biologic may restore the tears by instigating regrowth of torn tissue and stopping the leaking from the spinal disc, thus eliminating back pain, sciatic pain, and other pain caused by herniated discs.