Clinical term
Intervertebral disc disease
Intervertebral disc disease (discopathy) refers to an alteration of one or more intervertebral discs, most often degenerative (degenerative disc disease): dehydration, loss of height, tears in the annulus fibrosus. Common on imaging, it is not always painful.
Scientific basis
With age, the disc gradually loses part of its water and its cushioning properties. The changes described include: dehydration of the disc; disc space narrowing (loss of height); protrusion, a broad and diffuse bulging of the disc; tears in the annulus fibrosus; changes in the adjacent vertebral endplates, visible on MRI (known as "Modic" changes).
The L4-L5 and L5-S1 levels are the most often involved. Genetic, mechanical (loads, vibrations, microtrauma) and age-related factors play a role.
These signs are very common in people without pain: their prevalence increases with age and concerns a large majority of asymptomatic individuals after age 60. The presence of degenerative disc disease on imaging is therefore not enough to explain pain.
Blue Portance / SBNFA™ reading
In SBNFA™, intervertebral disc disease is placed back within the system that surrounds it. An altered disc is part of a whole — vertebrae, joints, muscles, fascia, pelvis, hips — that may or may not continue to distribute stress.
The question is therefore not only "is the disc damaged?" but also "does the system retain possibilities for redistribution?". Two people with the same image may thus have very different margins of adaptation.
Contribution to the analysis of sitting
Prolonged sitting can hold the same lumbar spine configuration for a long time. The analysis looks at the orientation of the pelvis, how long the position is held and whether support can be varied over time.
Not to be confused with
Herniated disc, a localized displacement of the nucleus that can irritate a nerve root; segmental instability, abnormal mobility between two vertebrae, not to be confused with the global postural micro-adjustments described in SBNFA™; facet joint osteoarthritis.
Related terms
Sources and scope
- Adams and Roughley (2006): what is intervertebral disc degeneration, and what causes it?
- Brinjikji et al. (2015): imaging features of spinal degeneration in asymptomatic individuals
- Fardon et al. (2014): lumbar disc nomenclature, version 2.0
- Société française de rhumatologie (French Society of Rheumatology): low back pain and lumbar radicular pain (in French)
Established pathological anatomy and imaging data. An image of degenerative disc disease does not, on its own, identify the origin of pain.
Further reading
- Learn more — Article: Back Pain With a Normal MRI: Why Do I Still Hurt?
