Disc narrowing: definition, symptoms and treatment

Also called disc collapse, disc pinching correspond to the decrease in the height of a disc located between the vertebrae (intervertebral disc). The disc is pinched, thinned, which leads to the appearance of pain in the back or neck. It is often one of the manifestations of thehas degenerative disc disease. Is a pinched disc serious? What is the difference with a herniated disc? How to treat it?

Definition: what is a narrowed disc?

Disc narrowing, also called disc collapse correspond to decrease in the height of an intervertebral disc. It is usually one of the manifestations of degenerative disc disease. The pinching can be at the cervical, dorsal or lumbar level and can concern one or more discs.

What is an L5-S1 disc narrowing?

The discs most often subject to disc pinching are the discs located between the L5 and S1 vertebrae (L5-S1 pinch).

What is an L4-L5 disc narrowing?

The discs located between the L4 and L5 vertebrae are also very affected. This is called an L4-L5 pinch.

What is a global disc narrowing?

When the whole disc is thinned, we speak of overall pinch.

What is a local disc narrowing?

When part of the disc is thinned, it is called local pinching. Disc deterioration causes the disc to sag.) It can also be asymmetrical. It is disc degeneration which causes it to collapse.

Is disc pinching serious?

No, this is a common and normal problem as it is often age-related. However, to relieve symptoms and avoid complications, a doctor should be consulted.

What are the symptoms of a narrowed disc?

“In the long run, it is not uncommon for disc pinching to lead to root conflicti.e. with a neurological root, explains Dr Steffen Queinnec, orthopedic surgeon at Clinique Geoffroy Saint-Hilaire. Depending on the affected area, the symptoms boil down to strong and frequent pain in the lower back or neck. The affection can also have a more global repercussion, also muscular“.

What are the causes of disc pinching?

The causes can vary, in particular depending on the area where the pinched disc is located. The main causes are:

• There dehydration
• The iinsufficient oxygen supply,
• The poor evacuation of carbon dioxide which causes the drying and aging of the intervertebral disc. The phenomenon then promotes the loss of the damping properties of the disc and its progressive deterioration resulting in what is called degenerative disc disease.
• Any disorder of an intervertebral disc can lead to disc pinching:
• Certain degenerative diseases, such as osteoarthritis or herniated disccan lead to disc wear at different levels of the spine;

• Inflammatory and infectious diseases can also cause inflammation of the intervertebral disc.

Other causes are more related to lifestyle and bad habits:

• Often lifting and carrying excessively heavy loadsespecially if you go about it the wrong way;
• Physical inactivitythat is, sitting all day, especially with poor posture;
• Excessive sport : train intensively and at high frequency.
• Mechanical stresses at work, at home or in the car; stress and fatigue which aggravate the symptoms.

When and who to consult in case of disc pinching?

► In case of pain, the patient first consults his attending physician who, initially, will prescribe painkillers or anti-inflammatories.

► If the pain does not yield after 10 or 15 days of treatment, the doctor will refer him to a rheumatologist. This specialist, consulted in the event of chronic or recurrent low back pain, may prescribe extensive examinations in order to find out the origin of the back pain. He may in particular prescribe a postural assessment. “A first assessment will often include X-rays and an MRI, specifies the doctor. In case of doubt about a possible surgical indication, the patient can be referred to a spinal column specialist (orthopedist or neurosurgeon) who can, depending on the case, ask for the indication.“.

► The patient can also consult a massage therapist for acts of massage

► an osteopathwhich can relieve lumbar pain through gentle and non-traumatic bone or muscle manipulations

► A chiropractor who practices manipulation exclusively at the level of the back

► an acupuncturist, which can relieve back pain thanks to needles pricked on certain specific points, in particular along the spine. “However, it is always advisable to have a medical opinion before considering manipulations, to eliminate contraindications.“, insists our interlocutor.

What exams to diagnose a narrowed disc?

The diagnosis is clinical. The doctor first proceeds to back flexibility assessment as well as its mobility. X-rays of the back then an MRI are performed – and then perfectly show the difference in disc height and that of the thickness of the space between the vertebrae – in order to highlight the disc disease and a possible complication such as a herniated disc.

Can a pinched disc be cured? What treatment?

The treatments will be adapted according to the cause, but the best solution is still prevention. We therefore recommend:

• Taking anti-inflammatories (rather cortisone) to relieve pain, especially in the case of pinching l5 s1;
• Physiotherapy, which makes it possible to strengthen the muscles and harmonize their functioning and to compensate for the insufficiency of the disc; the massage performed by a physiotherapist can reduce pain, relaxing the muscles and fighting against painful postural attitudes, but not in acute periods.
• Infiltrations under radiological control are sometimes considered.
• Once the treatment of the acute phase has been completed, it is necessary to work postural readjustmentsheathing by doing exercises

When to consider an operation?

Surgery is the last resort in severe cases which can no longer be relieved with other solutions. “Surgery is one of the remedies, but rarely the first, notes the specialist. It is particularly essential that the patient has attempted a good physical rehabilitation“. Depending on the case, the intervention can range from the simple root releaseto heavier interventions, such as placement of disc prostheses or arthrodesis. “These are not trivial interventions, presenting risks like any surgery, but in fact requiring good reflection and respect for the usual care process.“, concludes Dr. Queinnec.

Thanks to Dr Steffen Queinnec, orthopedic surgeon at Clinique Geoffroy Saint-Hilaire (Paris 5th).