Intervertebral disc protrusion – treatment, diagnosis and symptoms

Destructive processes in the disks impair their ability to perform the functions of shock absorbers efficiently. Healthy discs provide the spine with flexibility and freedom of movement.

The destruction of the structure of shock absorbers under the influence of negative factors can provoke the initial phase of a hernia – protrusion. It is important to detect this process in time in order to prevent the development of a more severe degree of the problem.

What is intervertebral disc protrusion

The outer shell of the disc forms a dense ring of cartilaginous tissue, it is also called fibrous. The disc nucleus is soft, gelatinous.

Thanks to this structure, the discs absorb the movements of the vertebrae relative to each other.

If the spacer between the vertebrae protrudes beyond its normal boundaries, but the outer shell is not torn, but stretched, then this phenomenon is called protrusion.

Formation stages

The protrusion of the squeezed part of the disk can reach dimensions in the range of 1 ÷ 5 mm. Protrusion is the very first manifestation of pathology that occurs with structural changes in the discs.

This phenomenon can be divided into stages:

  1. The nucleus protrudes and stretches the shell, but it is still uniform and intact throughout. This is how the initial degeneration of the intervertebral disc manifests itself.
  2. Further pressing of the soft nucleus leads to a significant thinning of the annulus fibrosus in this place. Cracks may appear. This stage is called protrusion.
  3. The progression of negative processes in the disc produces a breakthrough of the outer ring in a tense place and the loss of a part of the nucleus pulposus. At this stage, the pathology is already called a hernia.


  • Diffuse – this is the name of the pathological protrusion of the disc, which has an uneven and multiple character.
  • Ventral – the protrusion of a part of the disc occurs in the opposite direction from the spinal canal (towards the abdomen).
  • Lateral – the spread of pathology has a lateral direction.
  • Physiological – the minimum amount of disc protrusion. Does not require treatment and does not cause anxiety.
  • Posterior-lateral – it is also called paramedial. A common type of disease. Bulging of the nucleus is directed laterally with orientation to the posterior part.


Squeezing of a part of the nucleus without rupture of the disc membrane occurs to the back of the spine to the intervertebral canal, the spinal foramen – this pathology is called dorsal protrusion.

There are:

  • Foraminal – the direction of blowing out a part of the disc can be on the entire segment of the intervertebral canal.
  • Paramedian – the nature of pressing into the central part of the spinal canal along the line.
  • Extraforaminal – the same as foraminal protrusion, but the pressed part of the disc protrudes towards the outer side of the intervertebral canal.
  • Intraforaminal – the same as foraminal protrusion, but it is directed towards the inner part of the intervertebral canal.
  • Median – the protrusion occurs directly into the central part of the spinal canal. A very dangerous dislocation of a portion of the disc that can involve the spinal cord.


A large group of pathological changes in the spine is called circular protrusion. It takes place if there was a displacement of the inner part of the disc, which did not lead to rupture of its outer shell and has the character of a uniform protrusion in a circle.

This pathology manifests itself insidiously. The degree of danger depends on what feature a particular protrusion has.


  • Circular-foraminal In a separate group under this name, the phenomenon is highlighted when the inner part of the disc is pushed evenly towards the spinal canal. There are one-sided protrusions spreading on two sides.
  • Uniform circular This is the name of a violation in the disc, when the flattening of the nucleus leads to an even distribution of the protruding part. The walls of the shell stretch evenly and keep the same thickness.
  • Circular-dorsal This type of protrusion in its definition completely repeats the previous group – uniformly circular, but with the difference that most of the pathological protrusion is located on the side of the posterior wall. Experts attribute this subspecies of pathology to the most dangerous. If you do not stop the process, then the lesion spreads sequentially to adjacent vertebrae.

Size classification of protrusions:

The name of the protrusion by its size Size, mm
big 4 and more
average 2 ÷ 3
small 1

Causes of occurrence

Protrusion is the initial stage of a hernia and has the same reasons for the appearance of this pathology.

  • Excessive stress on the spinal column. It is especially dangerous to lift weights in a bent-back position and do it abruptly.
  • Poor posture creates inharmonious loads on the discs and predisposes to disorders in the spine.
  • A sedentary lifestyle contributes to inadequate nutrition of disc cells and contributes to their weakening.
  • Smoking also weakens the spine because the oxygen in the blood decreases and affects the metabolism.
  • Protrusion can occur as a result of osteochondrosis.

Symptoms of the disease

The signs of the disease depend on factors:

  • in which area there was protrusion,
  • a kind of pathology,
  • the size of the disc pushing beyond the boundaries of its dislocation,
  • Whether the protrusion is pressing down on the nerve roots or the spinal cord.

If the nervous tissue is not affected, then the pathology will not give pain signals.

Feelings are possible:

  • limitation of the range of motion due to painful manifestations,
  • projection of pain:
    • to the neck,
    • in leg,
    • in the back of the head,
    • in the hand,
    • in the gaps between the ribs;
  • discomfort in the limbs in the form of:
    • burning sensation
    • tingling,
    • weakness,
    • numbness.

Cervical spine

This area is susceptible to disturbance because it has a high degree of mobility. If the process of destruction begins in the discs, leading to protrusions, then this kind of discomfort may occur:

  • pain is projected along the arm;
  • manifestation of weakness:
    • in the muscles
    • in the elbow,
    • in the shoulder,
    • in hand;
  • systematic pain in the neck;
  • tingling and numbness in the hand.


This zone, by its physiological characteristics, is the most protected from the occurrence of anomalies. The vertebrae are connected by ribs in a rigid structure. And yet, about 2% of cases of protrusion occur in the thoracic region.

It causes:

  • pain between the ribs
  • muscle weakness in the abdominal area,
  • pain in the back
  • back stiffness
  • chest discomfort in the form of:
    • tingling,
    • pain,
    • numbness.


The l4 l5 intervertebral disc area is the most susceptible to disease. This is facilitated by its mobility and the fact that there is a center of gravity and significant loads fall on it. Most often, protrusions affect the disc between the fourth and fifth vertebrae.

In this case, there are:

  • weakness in the thigh muscles,
  • possible impaired urination function,
  • muscle weakness in the calf area of ​​the legs,
  • systematic pain in the lumbar region,
  • lower back sciatica,
  • lumbar stiffness
  • in the toes occur:
    • tingling
    • pain,
    • numbness.


The way in which protrusions are visible in the images is MRI. Soft and hard tissues with all the details, any slice and series of scans with a small step is able to show this method.

Advantage over other methods:

  • high information content,
  • ease of implementation,
  • painless method,
  • harmlessness.

How to treat

In most cases, with protrusion, a comprehensive treatment program is prescribed. It provides for the relief of an acute condition with the help of drug therapy.

  • NSAID drugs relieve pain, stop the inflammatory process and ensure that tissue edema passes.
  • Muscle relaxants act in a targeted manner and remove muscle spasms.
  • Chondroprotectors and vitamins strengthen the condition of the cartilage and improve their nutrition.

The second stage is carried out activities that the doctor will appoint:

  • acupuncture,
  • therapeutic exercises,
  • hirudotherapy,
  • manual therapy,
  • traction,
  • physiotherapy.

Prevention measures

You need to know the culture of spine health in order to avoid serious problems in it.

  • Correct posture must be developed and maintained at all times.
  • Try to carry weights, distributing them evenly in your hands, and preferably behind your back in a knapsack or backpack.
  • When lifting a load, it is necessary to bend your knees and keep your back straight.
  • Make sure that the food is complete.
  • If a person smokes, then this habit must be overcome.
  • Do special gymnastics or just walk and swim.
  • Do not overburden yourself with hard work.
  • At the first signs of osteochondrosis, consult a doctor to undergo an examination and receive an appointment.

Method of treatment with folk remedies

When choosing a recipe, you should consult a specialist.

Traditional medicine can only be an auxiliary method of treatment, but not the main one.

  1. The anti-inflammatory properties of Kalanchoe are used to improve the condition of the problem area with protrusion. The upper film is removed from the leaflet on one side and applied to the affected area at night. The leaf is fixed with an adhesive plaster and wrapped warmly.
  2. An alcohol tincture is prepared from garlic. Proportions: 300 g of minced garlic and 150 ml of alcohol or vodka. The bottle is kept for ten days in a dark place. The method of treatment is a warm compress on a sore spot for forty-five minutes. Use with caution to avoid skin burns; in case of discomfort, remove the compress earlier. Treatment with a tincture of garlic is best done every other day.
  3. A medicinal mixture of honey and crushed root is prepared from comfrey. Take ten days in the morning, one teaspoon.
  4. A very powerful regenerating agent is turpentine baths. Here you need to be careful – in case of vascular and heart diseases, it is better to abandon the method. They take baths with the addition of a turpentine mixture. The water temperature gradually rises from 37 to 40 degrees. For turpentine composition, mix:
    • a glass of turpentine,
    • ten grams of crushed baby soap,
    • salicylic alcohol (1% solution).


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