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The Ultimate Back Pain Relief Tips Blog

3 Things to Look for in an MRI of a Herniated Disc

Posted by Dr. Jeff Winternheimer D.C. on Tue, Aug 27, 2013 @ 08:06 AM

Herniated disc MRIHerniated discs can happen to anyone, whether you’re a seasoned athlete or weekend warrior, if you work in an office or on a construction site. Aging is a contributing factor to discs problems and back pain, so most of us will not escape it entirely. If you’ve been diagnosed with a herniated disc or discs after having an MRI of your lumbar (lower back) and/or cervical (neck area) spine, you many be wondering how the determination was made. The MRI images will show various views, including cross-sectional views, of soft tissues, nerves and bones of your spine.

The MRI offers detailed images of your vertebrae and the cushioning discs between them, along with the spinal canal, spinal nerves, muscles, tendons, ligaments and other soft tissues. The MRI views show 3-dimensional cross sections, which enable your doctor to see the spine in thin layers. The MRI scan can also help reveal the severity of your condition and help rule out other causes of pain and related symptoms.

Looking at MRI images: Profile and axial views

In a side/profile view of your back, normal discs appear to be roughly horizontally-oriented oblong shapes, which are lighter in the plump center area. The outer “edges” of the flat oblong discs, or outer cartilage, look dark gray. One or more of the discs may show a herniation or bulge toward the back, bulging into the light gray area running vertically behind the vertebrae. The tougher outer cartilage of the disc is has been weakened, becoming less flexible over time. The thinned or weakened area allows the softer inner material to partially extrude. As the disc material expands against/through the weakened spot, it may begin to crowd the nerves.

  1. Bulging discs: A herniated disc will look different than the rest of the spinal discs, often in a subtle way. Your physician will often see a bulge in one or more of the cushioning discs between your vertebrae. Nearly half of all bulging discs occur in the lower back in the lumbar area described as L5 S1, but can occur in any disc. This bulge is the result of the tougher cartilage, which forms the outer layer of the disc, stretching or giving way. This allows the softer inner cartilage material to distort the shape of the disc, bulge or leak. Eventually discs can "dry out", losing flexibility and ability to cushion the vertebrae--and can cause pain. Pain also occurs due to crowding of the nerves (nerve compression) by the bulging disc.

  2. Flattened/deflated discs: Herniated discs may also appear flatter (not as plump) as the surrounding discs--they may appear a little “deflated”--and the center area may be darker in color. 

  3. Nerve crowding: The nerve area behind the spine appears as a light gray column with the edge of the disc bulging into its space. If you look at the axial view (cross section) the light gray column running behind the spine now looks like a light gray circle since it’s being viewed from the top. Within that area, the nerves look a bit like black dots, with some dots reaching around the sides of the spine. On one or both sides, crowding may be visible as a dark gray area almost covering the dots, which shows the disc bulge blocking the nerve pathway, viewed in cross-section from above.

If you've got back pain from a herniated disc, talk to the experts at the Illinois Back Institute. The Institute was founded by Dr. Jeff Winternheimer, D.C., developer of the innovative, all-natural herniated disc treatment called Functional Disc Rehydration™. Contact the Illinois Back Institute for your free consultation today.

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Topics: herniated disc, Back Pain, MRI, Bulging Discs, lumbar, cervical