Schmorl's nodes are a spinal abnormality that typically develops from trauma or the normal wear and tear associated with age. Running is a high-impact sport that causes repeated pressure on the spine and its cushioning cartilage. Over time, Schmorl's nodes can develop. Pain and stiffness can accompany this condition, though most cases are asymptomatic and do not require surgery. Talk to your doctor if you have consistent back pain or stiffness.
The Spine
Your spine is composed of 24 bones called vertebrae, stacked from your pelvis to the base of your skull. The main portion of each vertebra is known as the vertebral body. In between each vertebra is a cartilage disc that absorbs shock and allows the spine to move and flex. The discs are filled with a gel-like substance called the nucleus pulposus; tears or herniations to these discs cause the nucleus pulposus to leak, resulting in vertebral compression. Schmorl's nodes develop when the fluid from a disc enters into the body of a vertebra.
Schmorl's Nodes
Schmorl's nodes begin with trauma to the spine or after years of repetitive use and shock and are diagnosed through X-rays. A disc is forced upward or downward, into the adjacent vertebral body. If the disc ruptures, the gel-like center leaks out into the surrounding bone, deforming the bone. Most common in the middle and lower spine, Schmorl's nodes are not usually painful; they can, however, cause pain and stiffness in the spine, depending on the degree of damage. They can impede activity, such as running, making specific movements difficult.
Running's Impact on the Spine
Running's high-impact movement places repeated stress on bones in the legs and spine. Runners are at risk for back-related injuries, particularly those involving the cartilage discs between vertebrae. Running imparts greater pressure on the spine than walking. Downhill running adds to impact, increasing pressure on the spine and cartilage discs, according to a study published in January 2007 in the "Journal of Athletic Training." Over time, herniation or degeneration of the discs can occur, increasing the potential for developing Schmorl's nodes.
Treatment
Your doctor may recommend rest as part of your treatment plan. He also may suggest you reduce your weekly mileage or intensity as well as introduce other activities into your exercise regimen, such as walking or swimming. In most cases, Schmorl's nodes do not require surgery, particularly if no symptoms are present. Asymptomatic cases are treated conservatively, while symptomatic cases, such as those with pain and stiffness, may require chiropractic work or surgery to correct the problem.
References
- Cedars-Sinai: Vertebrae of the Spine
- Cedars-Sinai: Discs
- "Journal of Anatomy"; Schmorl's nodes (intravertebral herniations of intervertebral disc tissue) in two historic British populations; G.Saluja, et al.; April 1986
- Spine-Health; Running and Lower Back Pain; S. McCance, M.D.
- "Journal of Athletic Training"; Sagittal Lumbar Spine Position During Standing, Walking, and Running at Various Gradients; D. Levine, Ph.D., P.T., O.C.S., et al.; January 2007
- "Korean Journal of Pain"; Rami Communicans Nerve Block for the Treatment of Symptomatic Schmorl's Nodes -- A Case Report; J.S Jang, et al.; December 2010
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