An anterior herniated disc is a frontal facing disc defect and is one of the least commonly seen spinal abnormalities on MRI studies, since the overwhelming majority of disc bulges and ruptures affect the posterior side of the intervertebral disc structure.
Anterior bulges are occasionally part of diffuse disc bulge syndromes, but rarely exist by themselves as focal disc protrusions. Anterior disc bulges are almost always thought to be innocent of causing pain, but some care providers may implicate them as a symptomatic origin in order to convince a patient that they require profitable treatment.
The scope of this article will provide facts about frontal disc herniations which do not influence the spinal nerve structures, thereby making them almost universally non-symptom-generating intervertebral irregularities.
Anterior refers to the frontal side of the disc structure. This is the side which does not face into the spinal canal, but instead faces towards the ventral plane of the body.
Being that anterior herniations have virtually no chance of compressing a neurological structure, they are most often dismissed as the source of pain, unless there is another structural issue present, such as a discogenic condition in which nerves have grown into the damaged disc or a sizeable annular tear. Even in these scenarios, the disc is rarely seen as the direct cause of pain and is virtually never treated surgically.
In all my years working as a patient advocate and back pain educator, I have never seen a definitive example of a symptomatic anterior herniation. That is not to say that they can not exist, just that they are extremely unlikely to cause any pain.
No one is actually sure why discs rarely herniate anteriorly. Of course, this diagnosis is usually great news compared to a significant herniation which does stand the chance of impinging on a nerve root or compressing the actual spinal cord. It seems like the tendency for discs to bulge posteriorly is the result of a poor evolutionary design.
I have heard of some chiropractors speculating that anterior herniations are mostly problematic, but this should be no surprise among certain opportunistic care providers who will blame any structural irregularity for enacting pain in order to secure a long-term customer.
In maybe a tiny number of cases, the disc may have something to do with some degree of pain, through some very atypical process, but in all others, anterior bulges are just another scapegoat condition blamed for sourcing pain, when all along the disc abnormality is innocent and coincidental to any symptoms which may exist.
If you have an anterior disc herniation which is the definitive source of pain, I would love to hear your story. You can share your experience on our forum to help others who may also have these rare problematic disc abnormalities.