Overview of Intervertebral Discs

What are Intervertebral Discs and What do They do? – Anil Kesani MD

Dr. Anil Kesani explains that the spine consists of several vertebrae aligned on top of one another to create the spinal column. Between each of these vertebrae is an intervertebral disc.  Dr. Kesani is a spine doctor that practices as an orthopedic and spine surgeon at SpineMD in North Richland Hills, Texas. Possessing upwards of a decade of medical experience, Anil Kumar Kesani, MD, has been a part of numerous research projects and publications, including one that examined how intervertebral disc cells were affected by nicotine.

Intervertebral discs serve as shock absorbers and protect the vertebrae within the spinal column from becoming impacted as a result of activity. At the same time, they enable the spine to extend and flex so that it can move normally. These discs also protect the nerves running down the middle of the spinal column from damage.

There are 24 intervertebral discs in the human body, all of which normally consist of an inner and outer layer of fibrocartilaginous material. The inner layer is soft and made of mucoprotein gel, a substance that resembles jelly. Known as the nucleus pulposus, this soft, inner layer is protected by the disc’s outer layer, called the annulus fibrosus. When pressure is put on the spine, the hard annulus fibrosus takes the pressure and pushes the nucleus pulposus around to absorb the pressure.

Unfortunately, both layers are affected by a person’s age. Moisture is lost in the nucleus pulposus over time, just as strength is lost in the annulus fibrosus. This results in deterioration of the intervertebral discs, and may cause chronic back pain.  This is what is commonly referred to as disc degeneration and results in discogenic back pain.

If on the other hand the annulus fibrosus or outer layer degenerates and gets weak it can lead to disc herniation resulting in pinched nerves.  Slipped discs or disc herniation can lead to a combination of low back pain and radiating leg pain.

Anil Kesani MD Spine Doctor Intervertebral Disc
Anil Kesani, M.D.
Anil Kesani SpineMD Intervertebral Disc

Painful Sciatica, what is it?

Sciatica Symptoms & Treatment – Anil Kesani MD

Dr. Anil Kesani explains that sciatica is a lay term used to describe radiating pain from the lower back and down the legs or radiating leg pain.  A fellow of the American Academy of Orthopaedic Surgeons, fellowship trained in spine surgery and board certified by the American Board of Orthopaedic Surgery, Anil Kumar Kesani MD is the founder of SpineMD.  Dr, Anil Kesani is experienced in providing operative and non-operative  treatments for various spine problems, including disk herniation, stenosis, and sciatica.

Sciatica or lower extremity radiating pain is caused by irritation of lumbar spinal nerves within the lumbar spine leading to radiating pain down the legs.  While it is commonly mistakenly referred to as irritation of the sciatic nerve, this is incorrect, it is actually irritation or pinching of the nerves within the lumbar spine that causes this radiating leg pain.  In fact, pain that is caused by irritation of the sciatic nerve by the piriformis muscle is the pelvis is referred to as piriformis syndrome.

Radiating leg pain can affect only one side of the body or both sides. Intensity can range from a mild ache to excruciating pain or sharp burning sensation. In some cases, the pain can be aggravated by cough or sneezing as this increases pressure within the abdomen that is transmitted to the already irritated or pinched nerves. 

Depending on where the nerves are pinched position really affects the intensity of the leg pain.  If the nerves are getting pinched centrally within the spinal canal or ” lumbar stenosis ” this leads to the leg pain worsening with standing and/or walking and improves with sitting versus if the nerves are getting pinched peripherally in the foramen or ” foraminal stenosis ” this leads to the leg pain worsening with sitting and improves with standing. 

Pinched nerves in the lumbar spine can also result in numbness and/or tingling of the affected area supplied by the nerve or if the pinching is severe enough it can also result in muscle weakness as well as bowel and/or bladder incontinence.

Sciatica or radiating leg pain can be treated by non-operative therapy such as medication, physical therapy and spinal injections.  In cases where nonsurgical treatment fails then surgical treatment can be an option.  In rare case where patients experience severe leg weakness or changes in the bowel or bladder function, a patient may have to undergo surgery on an urgent basis.  Please let you spine specialist or surgeon immediately know if this is the case.  Learn more about Dr. Kesani and how he treats conditions such as sciatica at myspinemd.com/physicians.  Also, check Dr. Kesani youtube videos out at SpineMD youtube channel here.

Anil Kesani MD Spine Doctor Sciatica
Anil Kesani, M.D.

Neck Pain

Neck Pain – Anil Kesani MD

Dr. Anil Kesani explains that about 80% of people will experience neck pain in their lifetime. Why? Simply put, because the neck is one of the most mobile and complex parts of the body, with multiple moving parts and delicate structures that are constantly in use. Humans are inherently predisposed to suffering from neck pain.  Sometimes we sleep in the wrong position or crack our neck too hard or lift too much or sometimes, things just happen. You fell off your bike on your morning ride or you got a cut on the back of your neck and now it’s infected or maybe you’re just getting old.  

Life happens and as it happens, our spine and neck start to deal with more and more issues including frustrating neck pain. That’s why SpineMD and Dr. Anil Kesani are dedicated to making sure that your neck and spine are always receiving the best care, whether that’s nonsurgical checkups and maintenance or surgery. Not all neck issues are going to need surgery, so let’s discuss how to know whether it’s serious or not.

First, let’s talk about how the neck and spine deal with each other. The neck and spine are very closely related and are connected. The part of the spine that is present within the neck is referred to as the cervical spine. The cervical spine has several critical functions including connecting the skull to the thoracic spine, which is the part of the spine in the upper and mid back. The cervical spine protects the spinal cord and serves as a conduit for the spinal cord to send signals from the brain to your arms and legs. Basically, it’s the most important part of the body concerning movement and you should treat it that way!

Let’s talk about some common causes of neck pain. Let’s start with the most common and least serious of conditions: short-term soreness or tightness in your neck or upper back. Although neck pain is felt in the neck, it can originate from other sources, such as the upper back. You can feel soreness or tightness in your neck or upper back after a hard workout or even sleeping wrong, so unless it persists for a long period of time, I wouldn’t worry. At the most, you might have a neck strain, which means you tore a fiber in your neck. While this sounds serious, it generally isn’t. It can hurt a lot and it can hurt for a few days or a week, but they usually heal on their own.

Something a little more serious would be pinched nerves in the neck. How do you know you have a pinched nerve? When a nerve is pinched, it can’t send signals to your brain, so generally you either feel shooting pain, some sort of numbness or tingling, “pins and needles” or muscle weakness. These let the brain know that something is putting pressure on the nerve and that there needs to be something done to fix it.

If you think you have a pinched nerve, there’s a few things you can do before visiting a doctor. For one, you need to get some extra sleep or at least rest more than usual because a pinched nerve needs time to recover. You should also use ice packs so as to reduce any possible inflammation or swelling, and after the inflammation has mostly settled if needed, you can use a warm compress, get a light massage so as to help relieve tension or sources of stress that may be causing the issue to worsen. If it hasn’t been fixed or if it’s worsened within a few days, visit a doctor ASAP.

Finally, let’s move onto some serious causes of neck pain, starting with fractured or broken neck bones. If you have been part of a major trauma involving your neck, go the doctor or hospital immediately! You may not feel it at first but delaying can cause serious life-altering conditions such as paralysis or death. Some other serious albeit rare causes of neck pain are tumors and autoimmune diseases.

Not all the symptoms of a neck tumor are serious, but if you think you have a neck tumor, then you need to get an immediate attention. Some common symptoms of a neck tumor are a lump in the neck or throat, trouble swallowing, frequent coughing, sudden headaches, ear pain or a persistent sore throat. Lastly, some autoimmune conditions such as arthritis, lupus or type 1 diabetes can cause serious neck pain. Each condition can affect your neck and bodily function in some way, but there are no surefire symptoms to detect them.

Now, before you check WebMD and decide you have a neck tumor or an autoimmune condition, we would recommend visiting an actual doctor. These conditions aren’t always readily diagnosable based off a variety of symptoms (in fact, they rarely are), some which can’t be confirmed without imaging and bloodwork. If you think you may be suffering from any of these conditions or are concerned with your overall neck and spine care, make an appointment with Dr. Kesani at SpineMD today.

About SpineMD

SpineMD is a clinic based in North Richland Hills serving DFW that focuses on spinal care. Our highly trained and experienced providers specialize in the treatment of all types of spine problems including back pain, neck pain, slipped or herniated disc disease, disc degeneration, pinched nerves and many more conditions. Our physicians are experts in the latest nonsurgical and surgical care including minimally invasive spine surgery, disc replacements, stem cell use among others as well as complex/redo spine surgery.

Anil Kesani MD Spine Doctor Neck Pain
Anil Kesani, M.D.
Anil Kesani, M.D. gives a summary of neck pain.

Safe Exercises for Back Pain

Exercises for Back Pain – Anil Kesani MD

Dr. Anil Kesani  from SpineMD recommends nonoperative pain-relief methods such as safe exercises for back pain when appropriate.  Exercises for back pain can be effective in treating back pain from back problems such as disc degeneration, disc herniation and even lumbar strains or soft tissue low back injuries.

An expert in minimally invasive spinal surgery, Dr. Anil Kesani takes the time to understand each of his patients’ specific problems through obtaining a detailed history, examination and if necessary imaging studies.  Imaging studies such as X-Rays, CT and MRI maybe necessary depending on the situation.

Back exercises can be used to help relieve some of the pain associated with back pain:


  1. Lie on the floor face down with your hands near your face. Press down with your hands, and gently push yourself upward. Finish by resting on your elbows and forearms. Hold this position for 30 seconds if you are able. As you become more comfortable, extend the duration up to five minutes.
  2. For the second exercise, lie face down and spread your arms in front of you. Squeeze your midsection as you lift one arm and the opposite leg as far as you can. Hold for three seconds. Lower your arm and leg and then repeat with the other arm and leg. Perform this exercise five to 10 times on each side.


  1. Lie on your back with your knees bent and hands next to your face with your elbows bent.  If necessary have someone stabilize the bottom of your feet on the floor.  Then sit up by contracting your abdominal muscles and touch your elbows to you knees.  Hold this position for three seconds and then gradually lie down.  Perform this exercise 5 to 10 times.

For more information, visit Dr. Kesani’s YouTube site here. 

Anil Kesani MD Exercises for Back Pain
Anil Kesani, M.D.
Anil Kesani SpineMD Exercises for back pain