The neck and low back are the most common spinal regions where a disc herniates. A herniated disc is often referred to as a bulging disc, ruptured disc, or slipped disc. However, discs do not slip and there is a difference between a herniated and bulging disc. A herniated disc ruptures through the tough fibrous outer ring that contains the gel-like inner core—the nucleus pulposus. A bulging disc is a contained disc disorder, meaning none of the nucleus pulposus is shed outside the disc.
Neck pain is a common problem that may be accompanied by shoulder, arm, and/or hand pain. The neck — or cervical part of the spinal column is flexible and capable of moving in many directions (eg, rotate, nod). Cervical anatomy is quite different from other spinal regions. Vertebral bodies are the smaller; and despite stabilizing structures (eg, ligaments), the cervical spine absorbs and distributes forces incurred during motion while supporting the weight of the head.
Osteoporosis May be “Silent” Until a Spinal Fracture Occurs
Osteoporosis is a progressive bone disease that affects men and women (rarely children). It is a disease characterized by low bone mineral density, decreased bone mass, or deterioration of bone tissue. Bones become porous, thin, brittle, and more susceptible to fracture. Although it is highly preventable, and often manageable, some patients may not know they have osteoporosis until they break a bone. In the spine, the types of fractures related to osteoporosis include vertebral compression fracture and burst fracture.
Vertebral Compression Fracture
A vertebral compression fracture (VCF) occurs when a vertebral body in the spine is compressed and the bone collapses. A VCF happens when force exceeds the bone’s strength, such as during a traumatic fall or car accident. VCFs can be extremely painful and can lead to limited mobility, loss of height (stature), and spinal deformity. Osteoporosis increases the risk for vertebral compression fractures.
Spinal Stenosis Can Cause Neck and Back Pain
Spinal stenosis is a spine problem that may gradually cause neck and back pain. It may be accompanied by neurological symptoms, such as numbness, tingling sensations, or weakness. It occurs when the spinal canal and/or nerve passageways narrow, which squeezes nerve structures. When the spinal canal is affected, the disorder is called central stenosis. When the spinal nerves exiting the spinal canal are affected, it is called lateral recess stenosis or foraminal stenosis. Foramen is the term for the nerve passageways through which nerves exit the spinal canal. Basically, spinal stenosis is a nerve compression problem, and there are many spinal conditions than can cause or contribute to the development of stenosis.
Spondylolisthesis Occurs When a Vertebra Slips Forward
Spondylolisthesis is a lumbar (low back) disorder that occurs when a vertebral body slips forward horizontally over the one beneath. Spondylolisthesis may develop from stressful forces, degenerative changes in the spine, certain types of spinal fractures, and may even be found at birth (congenital). Some people are predisposed to this condition due to hereditary factors. Common symptoms include lower back and leg pain.