At the area where bones meet cartilage, there is a structure known as the endplate (A), which has high elasticity and absorbs the impact on the disc.
The nucleus pulposus (B) and annulus fibrosus (C) do not contain blood vessels, making them unable to heal once damaged.
(A = Endplate, B = Nucleus Pulposus, C = Annulus Fibrosus)
When a disc is subjected to pressure, the part that typically gets damaged is the outer layer known as the annulus fibrosus.
Pain begins when the annulus fibrosus is compromised.
Continuously bending forward causes the annulus to thin and the nucleus pulposus to dehydrate.
Eventually, this leads to disc protrusion, as shown in the illustration below.
When the nucleus pulposus tears through the annulus fibrosus, it creates an injury, leading to the death of nucleus pulposus cells and the production of inflammatory substances.
This process results in pain, known as discogenic pain, which tends to be localized around the lower back.
When the limits of disc protrusion are exceeded, the dehydrated nucleus pulposus tears through the annulus fibrosus, resulting in a disc rupture.
A disc rupture can cause excruciating pain that is often unimaginable.
When the injury to the annulus fibrosus worsens, it becomes thinner, and the nucleus pulposus also dehydrates, causing the nucleus to tear through the annulus and escape.
This condition is referred to as a disc rupture. When a disc ruptures, it can compress the spinal cord or nerve roots, leading to leg numbness or weakness.
Additionally, the inflammatory substances released from the escaping nucleus can irritate the nerve roots. When these nerve roots are compressed or stretched, severe pain radiates down the leg, known as radicular pain.
Radicular pain typically starts in the lower back and travels through the buttocks, thigh, calf, and down to the foot. The intensity of this pain is often beyond imagination.
When the nucleus pulposus escapes through the annulus fibrosus, the inflammatory substances released from the damaged nucleus flow towards the nerve roots.
When the nucleus pulposus ruptures, it releases inflammatory substances.
However, while these inflammatory substances cause pain, they also play a role in healing the torn annulus fibrosus. This is similar to the natural healing process of skin wounds..
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