What you Should Know About 4 stages of Disc Herniation

A herniated disk is a common spine problem. A spinal disk has a soft, jellylike nucleus encased in a tougher outer cover, an annulus. Sometimes called a slipped disk, a herniated disk occurs when some nuclei push out through a tear in the annulus.

Treatment procedure and recovery time of herniated disc depend upon the stage of the problem. 

4 stages of disc herniation

We can classify slipped disc into four stages. With each classification, the severity of pain and disability increases. The treatment also changes with different stages.

The 4 stages of disc herniation are:

    1. Bulging disc.
    2. Disc Protrusion.
    3. Extrusion.
    4. Disc sequestration.


Bulging disc

 As mentioned before, the intervertebral disc has a central soft jellylike nucleus surrounded by a tough exterior. In this stage, this nucleus pulposus bulges out slightly and mildly pushes the fibrous annulus.

But the disc’s outer covering is still intact. There’s no wear and tear in it yet. 

It very mildly compresses any nerve that passes through, and if you have a disc bulge problem in your low back, it will most probably press the lumbar nerves; if it is in the cervical region, then it will press the cervical nerve. 

Disc protrusion

The second stage is disc protrusion. The bulging of the disc further exceeds and forces the outer layer to come out slightly from its parameter. The outer fibrous annulus is still intact, but the nucleus pulposus pushes it further to bulge out.

This causes greater pressure on the exiting nerves, and obviously, it’s slightly more painful than the first stage.

 Disc extrusion

The next stage is called disc extrusion. Extrusion means ‘to come out. Until this stage, the gel is inside the fibrous annulus. But, in this stage, it cracks the outer layer, and the nucleus pulposus comes out, so this is a slightly severe condition. It compresses whatever nerves pass through here, and you feel very sharp pain.

Disc sequestration

In the third stage, the nucleus pulposus comes out, but in the 4th stage, it gets detached from it. The bulging part gets detached and can create many problems by dislodging into the spine canal and severely compressing the nerve that passes by. 

This is the most severe condition, where the only treatment option is surgery. Exercises will not be able to help you at this stage.

Recognizing the four stages of disc herniation is very important as the treatment method depends upon it. In addition, it helps to answer whether going for conservative treatment or surgery is the right option. Doctors can diagnose the stage of a disc hernia by signs and symptoms, but an MRI investigation is recommended to confirm it.

The first two stages can be managed conservatively with exercises and physiotherapy. The third stage, i.e., disc extrusion, can also manage conservatively if proper steps are taken. However, it is still advised to visit the doctor to get the issue properly diagnosed, and then a treatment path can be planned depending on the stage.  Contact us if you are looking for the best doctor in Mumbai.

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