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Putting a Chemical Halt to the Flames of Disc Herniation

There is new research information about herniated discs. It seems that disc herniation may be the result of inflammation. In fact, the sciatica and low back pain that are symptoms of disc herniation may really be caused by a chemical process.

Disc material, present between the bones of the spine, may be able to respond to damage or injury with an inflammatory response. One substance in the center of the disc, called PGE2 may be able to cause pain. It does this by irritating the nerve roots leaving the spinal cord. PGE2 may be linked to sciatica and low back pain.

Scientists in Japan studied the disc material taken from patients with disc disease. In some cases, the disc had herniated or pushed into the spinal canal. Other discs included in the study had broken off and were floating in the spinal canal. These samples were compared to normal disc material taken from patients with vertebral bone fractures.

This was just one of several studies to confirm the idea that inflammation is part of the herniated disc process. It's a bit more complicated than just an increase in PGE2 causing herniated discs. There's also an enzyme called COX-2 that helps the PGE2 along. The more COX-2 is present, the greater the amount of PGE2 that becomes part of this inflammatory process.

Researchers think that keeping COX-2 levels down will reduce the use of PGE2. This, in turn, means less inflammation, less irritation of the nerve roots, and fewer symptoms for disc pain patients. Antiinflammatory drugs designed to stop COX-2 have recently begun being used to treat the symptoms of disc herniation. It seems that these drugs are effectively limiting the effect of COX-2 and thereby helping to reduce the symptoms and the underlying cause of the problem.

Hiroshi Miyamoto, MD, et al. The Role of Cyclooxygenase-2 in Lumbar Disc Herniation. In Spine. November 15, 2002. Vol. 27. No. 22. Pp. 2477-2483.


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