Spine Disorders

of the disc prolapse, therefore of the lumbar pain symptomatology, precisely because of its mechanical characteristics and the relationships with the adjacent anatomical structures, which are at this level highly represented from the nociceptive point of view.

Most disc protrusions occur in the posterior region of the intervertebral disc, causing pain - central to the spine - resulting from mechanical and / or inflammatory stimulation of the nerve endings present in the external annulus and posterior longitudinal ligament.

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A consequent analgesic blockade of the extension of the rachis, accompanied by an increase in torsion and flexion movements, develops a progression of the lesion which - hindered by the massive posterior longitudinal ligament - moves laterally. This results in painful symptoms lateral to the rachis, often associated with involvement of the dura mater and nerve fiber sleeves, resulting in the appearance of an extra-segmental reflex pain perceived in the buttock and / or the ipsilateral thigh.

; consequently, the pain spreads throughout the territory corresponding to the nerve filaments involved;

At the lumbar level, for example, irritation of the sciatic nerve (root L4, L5) is typical.