Intervertebral Disc Damage (Discopathy): Causes

Pathogenesis (development of disease)

In a herniated disc (BSP; intervertebral disc prolapse), the inner part of the intervertebral disc (discus intervertebralis), the nucleus propulsus (internal gelatinous nucleus), is forced backward by the annulus fibrosus (connective tissue ring of the intervertebral disc) toward the spinal canal (spinal cord canal) out of the bed of the intervertebral disc between the vertebral bodies. In most cases, the nucleus enters the canal laterally in the process, so that individual outgoing nerve roots are compressed and lead to the symptoms described. The prerequisite for a disc prolapse is given by a degeneration of the intervertebral disc with formations of small tears in the annulus fibrosus.

The most common locations (95%) of disc prolapse are:

  • Between LWK (lumbar vertebral bodies) 4 and 5 → root irritation syndrome L5 (medial BSP), L4 (lateral BSP).
  • Between LWK 5 and SWK 1 (sacral vertebral bodies/cruciate vertebrae) → root irritation syndrome S1.

Etiology (causes)

Biographical causes

  • Age of life – older age
  • Professions – professions with
    • Work activities that are performed in a seated position and where vibrations act on the whole body (e.g., due to older and unsprung agricultural and transport vehicles).
    • Lifting or carrying heavy loads or activities in extreme trunk bending posture.
    • Predominantly vertical exposure to whole-body vibration while seated.

Behavioral causes

Medication

Caution. Three months or longer of systemic glucocorticoid therapy increases the risk of osteoporosis by 30-50 percent. In the case of therapy with metered dose inhalers, such as bronchial asthma, this side effect does not occur.

Other causes

  • Pressure increase in the abdomen such as sneezing or coughing.