Schmorl's nodes are small protrusions of vertebral disk tissue that bulge through the ends of weakened vertebrae. They can emerge due to direct trauma to the spine, age-related disk degeneration, or an autoimmune condition that weakens vertebral tissue. In most cases, the nodes themselves are painless and unnoticeable to the naked eye. Pain, stiffness, and inflammation can occur around one, however, especially when a person suffers a major back injury. Most people can recover with bed rest and pain-relieving medications if there are no underlying injuries present.
Soft-tissue disks, which are found between each vertebrae, provide shock absorption for the spine. The interior of each disk is made up of gel-like material called nucleus pulposus. Schmorl's nodes are essentially masses of nucleus pulposus that bulge through weakened or damaged vertebrae. The material quickly calcifies once it bulges from a disk, resulting in a hard lump that puts pressure on the spine. In most cases, a node is forced either downward or upward from its disk into an adjoining vertebra.
These protrusions are most commonly seen in adults over the age of 50, since spinal disk tissue tends to erode and weaken with age. Osteoporosis, osteoarthritis, and some types of rheumatoid arthritis all increase the risk of disk degeneration. Weakened disks are highly prone to injury, and even a minor fall or a sudden twist can cause herniation. Younger people can also develop nodes if they suffer major spine trauma during a sporting event, car accident, or severe fall.
A person who has Schmorl's nodes may or may not experience pain. Older people who are used to living with minor back pains and stiffness may not even know that herniation has occurred. The signs are much easier to identify if a major injury occurs. A medical professional can check for signs of nodes and other types of spine damage by asking about symptoms, performing a physical exam, and taking diagnostic imaging scans. When a node exists, X-rays and magnetic resonance imaging tests clearly show calcified nucleus pulposus protruding from a disk.
Treatment decisions depend on the amount of tissue damage and the severity of symptoms. People who do not experience overwhelming pain are usually able to get better by resting for several days and slowly returning to activity. If major damage has occurred to the vertebra and spinal cord, surgery may be necessary to excise a node, repair disk tissue, and realign bones. With months of rest and guided physical therapy, most people are eventually able to return to normal activity levels.
