The Real Truth About Disc Herniations


A jelly donut.  Yum.  What does that have to do with a herniated disc?


Well, the jelly donut is a good analogy for the structure of your discs.  The outside doughy part is like the outside layer of your disc called the annulus fibrosis.  The jelly, or inside part is analogous to the nucleus pulposus, the part that herniates.  The spot that they inject the jelly into the donut is the weak spot in the wall, usually the back-left or back-right corner of the disc.  So there you have it -the disc / jelly donut analogy.


So if you have a herniated disc, are you doomed to a life of pain?  Step down from the ledge, and let’s take a look at some of the latest research about herniated discs and see what’s up:


This study in May 2011 looked at 78 patients with cervical radicuopathy, or neck pain that radiates down one or both arms.  In 73% of the patients, the clinically affected side nerve root was compressed on the same side as the symptoms.  Normal MRI’s were found in 13-15% of the subjects.  The authors concluded that MRI findings must be interpreted cautiously due to the high number of false-positives and false-negatives.  In other words, the MRI findings don’t always match up to the symptoms.


How can that be?  That wasn’t a real journal anyway, that’s how they got it published!!  Not quite, folks.  Read on…


This classic study was published in 1994 in the prestigious New England Journal of Medicine.  It looked at low back MRI’s of 98 people without any pain at all.  Why would they want MRI’s of people without pain?  Read on… They found 52% had a disc bulge on at least one level, 27% had a disc protrusion, and 1% had a disc extrusion.  38% of the subjects had more than one disc involved.  The authors concluded (and I quote from the abstract): “the discovery by MRI of bulges or protrusions in people with low back pain may frequently be coincidental.”


You want more?  I’ve got more…


In a study done in The American Journal of Sports Medicine in 2011, they looked at low back MRI’s of adolescent rowers.  None of these rowers complained of back pain, so surely their MRI’s would be perfect, right?  Plus, they’re only 15 years old or so, so what could they possibly find?  Surprisingly, they found that 9 of the 22 rowers (40.9%) had at least one abnormality detected in the lumbar spines.  Seven (31.%) had disc abnormalities – remember, with no symptoms.


The point I’m trying to drive home here is that if you have a herniated disc, don’t put all the blame on it as the source of the pain.  It is usually a lot more complex than that.  How many structures connect to the back and pelvis?  Nobody has ever counted, but it must be several dozen.  Simply taking a picture of your back with an expensive camera called an MRI will not cure you.  It is merely a picture, a moment in time.  There have been too many studies that show the MRI does not usually change the course of treatment, no matter what the findings.  Did they find any tumors or growths?  No?  Then you are probably in the clear.  Most abnormalities in your spine are actually normal for your age and activity level, and most conditions are manageable with conservative care.  Use your best resource – your body – to take control of your pain.


Hope this article gives you some hope and some perspective about herniated discs.


Has anyone managed to treat their herniated discs and get out of pain?  We want to hear about it!



Jamie Glick MS, PT
Jamie Glick MS, PT is a licensed physical therapist with an outpatient orthopedic practice in New York. He is a graduate of Columbia University's Program in Physical Therapy and has over 15 years experience. Jamie specializes in the treatment of all spinal disorders. He an 18 time marathon finisher. He also blogs regularly at