Schmorl’s nodes are a common type of lesion that can occur in the spine. They develop when the tissue inside the intervertebral discs slips out and pushes up or down into the adjacent vertebrae.

Schmorl’s nodes usually cause no symptoms. Doctors may find them when performing imaging tests for other reasons. If an individual does not have any symptoms, they usually do not require treatment.

However, if someone experiences pain or mobility issues due to a Schmorl’s node, doctors may recommend conservative treatment with pain-relieving medications and rest.

This article looks at Schmorl’s nodes, their causes, diagnosis, and treatment.

Schmorl’s nodes, or intervertebral disc herniations, are small, round lesions that form on the vertebrae, which are the bones that make up the spine.

They occur when an intervertebral disc, a fibrous piece of cartilage that sits between each bone, herniates and material from the inside presses into the adjacent vertebrae, changing its shape.

Discs often herniate sideways, but in a Schmorl’s node, the herniated disc extends upward or downward into the neighboring vertebra due to issues with the vertebral endplate. This structure sits between the discs and the bones, preventing the disc from bulging.

Intervertebral discs act as shock absorbers and consist of a jellylike center and a firm but flexible outer. If the flexible part of a disc becomes turned, the soft inner part can bulge out. If the bulge makes contact with the bone marrow inside the vertebrae, it can lead to inflammation.

Schmorl’s nodes can occur anywhere within the spinal column, but they most frequently affect the upper lumbar spine.

Schmorl’s nodes are quite common. They are frequently observable in lumbar spine MRIs, particularly in males.

According to a 2019 paper, Schmorl’s nodes may be present in up to 76% of the general population. However, their prevalence is highly variable, with some research suggesting that far fewer people develop Schmorl’s nodes than this.

Schmorl’s nodes are mostly asymptomatic, meaning that people typically experience no symptoms. They are often an incidental finding in MRI scans that doctors perform to diagnose or monitor other conditions.

However, an individual may experience an acute onset of lower back pain or worsening chronic back pain after minor trauma. Rarely, Schmorl’s nodes can develop inflammation and infections.

Researchers believe that the weakening of the vertebral endplates causes Schmorl’s nodes. However, these nodes may also have links to other conditions, such as:

  • Scheuermann’s disease, which causes the vertebra to grow unevenly during childhood
  • metabolic diseases
  • degenerative spine diseases
  • cancer of the spine
  • spinal trauma or fractures
  • spine infections

However, scientists are still learning more about this.

Schmorl’s nodes are not a type of cancerous growth. Doctors typically associate them with benign or noncancerous diseases.

However, people can have Schmorl’s nodes and cancer simultaneously. And in some cases, doctors may mistake one for the other.

For example, a 2015 case report describes a person with thyroid carcinoma metastasis in the spine, which is when thyroid cancer spreads to the spine. Initially, doctors thought the spinal growth was a Schmorl’s node, according to the medical imaging tests they performed.

However, after conducting a biopsy of the lesion, they found the growth was actually a result of thyroid cancer spreading to other areas of the body.

The case study authors recommended that doctors follow up closely with patients when they have a history of metastatic cancer, or current cancer, even if imaging studies suggest a noncancerous diagnosis.

Doctors can diagnose Schmorl’s nodes using diagnostic imaging techniques, such as MRIs.

On an MRI scan, Schmorl’s nodes appear as small, bony abnormalities of the vertebral endplates. If imaging techniques reveal characteristics resembling Schmorl’s nodes, doctors may also run tests to help determine their underlying cause. Healthcare professionals will particularly recommend these tests if there are other symptoms or signs of a spine condition.

Because most Schmorl’s nodes do not cause symptoms, people often do not require treatment.

However, if an individual has painful Schmorl’s nodes, their doctor may suggest rest and pain relief medications. These include nonsteroidal anti-inflammatory drugs and acetaminophen.

The symptoms should resolve within 2–6 months, although it can take up to 12 months for any swelling that shows up on an MRI to gradually subside.

If this conservative treatment approach brings no relief from symptoms, doctors may consider surgery to remove the damaged disc. One surgical technique is lumbar interbody fusion, which involves replacing the damaged disc with a bone graft. Surgeons will attempt to restore the height between the vertebrae and promote fusion of the two bones.

Schmorl’s nodes form when the soft discs between the vertebrae of the spine herniate or bulge through gaps in the vertebra, the bones that make up the spine. Rather than bulging sideways, the herniated areas of the disc protrude upward or downward, affecting the neighboring vertebrae.

The lesions are common, potentially affecting up to 76% of the population. Usually, they cause no symptoms and are not a cause for concern.

However, if an individual experiences problems with pain and mobility or has other conditions or symptoms that suggest a problem with the spine, they should speak with a doctor.