Before we dive into what is actually causing your pain, we need to define exactly what we’re talking about when we refer to “disc herniations”. A “slipped disc” and a “bulging disc” are other, commonly used terms that are synonymous with a “herniated disc”. These conditions are separate to ruptured discs (a topic that we will not be covering). Slipped or herniated discs are when some of the inner “goo” (called nucleus pulposus) of the disc protrudes through a small tear in the outer layer of your disc (called annulus fibrosus).
So Why Do Some Of Us Experience Pain?
Pain is a very complex series of interactions in the body – and that’s just based on what we know! There is so much about pain that we simply don’t know yet. In saying that a herniation itself doesn’t hurt, what I mean is the tear in the annulus fibrosus and the protrusion of nucleus pulposus doesn’t actually hurt. What could be causing pain, are the following things:
Our most common visual of a disc herniation reflects this exact phenomenon. If the bulging disc protrudes far enough to press up against a nerve root, we can experience copious amounts of pain. In this situation you may find that particular positions provide relief; resulting from that direct pressure on the nerve being alleviated.
When our body experiences damage, inflammation is part of the process of healing. The cascade of inflammation produces an increase in local inflammatory mediators, which attract certain healing cells to the region and support the removal of wastes. Many of these chemical mediators also happen to cause pain when they come into contact with nerves. If the local inflammation is far enough away from major nerves (or is not significant enough), pain will be reduced or not present. If you notice a decrease in pain from taking anti-inflammatory drugs, then your pain is likely driven by inflammation.
To understand trigger points better, I’ve previously gone into greater detail on another post. Within the context of disc herniation (or perceived disc herniation), trigger points may be responsible for all or most of the pain you’re feeling. These nasty little packages of waste can create such disproportionately high pain sensations, and yet they can be so small and difficult to find. In this scenario, effective massage treatment can produce a significant reduction in pain (reference).
If you’re one of the 25% of people who experience pain with disc herniation, keep these things in mind when it comes to selecting your treatment options! Our body is extremely good at healing itself. Use the above understanding of pain-causes to help select the best ways of supporting your body’s natural healing capacity. Also, remember that the body is a complex organism and that these pain-causes may all be showing up in concert with one another!
It’s important to know that a lot of low back pain is misdiagnosed as lumbar disc herniation. The reason this occurs is because many physicians often uses the “common” pain profile of a herniated disc to diagnose it (instead of getting clear diagnostic imaging). Knowing what we now do about low back pain, we understand that there is really no such thing as a common pain profile of a herniated disc… and in many instances pain is not present in herniation (and conversely, pain is often present without herniation – see here: a story where 31 athletes had significant low back pain, but only half had structural issues of any kind).
Read related articles: “Tendinosis Is Far More Common Than Tendinitis” & “Does Massage Release “Toxins”? And What Actually Are “Toxins”?“