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A Herniated Disc or a Bulging Disc: Is There a Difference, and How Can I Tell?
A Herniated Disc or a Bulging Disc: Is There a Difference, and How Can I Tell?

Back pain is a common affliction among Americans and people in general. Beacon Orthopedics and Sports Medicine states that one of the primary causes of disability throughout the world is back pain. Those who suffer from debilitating back pain hear terms like “bulging discs” and “herniated discs,” but might not necessarily understand what the difference is between them.

What’s the difference?

The spine is comprised of bone segments that are separated by “jelly-filled” discs. These discs act as shock absorbers for the spine, cushioning the bone as your body moves throughout the day bending, walking, running, and even falling. The outer layer of these jelly-filled discs is a tough, elastic skin that allows the discs to flex and compress, giving the spine flexibility.

  • Bulging DiscNeurosurgeons of New Jersey shares that as the body ages, the discs become dehydrated and stiffen. As a result, the discs may begin to compress, causing the outer layers to bulge into the spinal canal, contributing to nerve compression. Often, bulging discs are asymptomatic and need no treatment at all. Beacon Orthopedic and Sports Medicine explains that bulging discs may also progress through four phases: degeneration, prolapse, extrusion, and sequestration.
    • Degeneration is the initial bulge of the disc and generally has no pain unless the bulge is pressing on a nerve root.
    • Prolapse moves a bulging disc to a herniated disc, and at this point the problem may be referred to as both a bulging disc and a herniated disc. No jelly has moved out of the disc at this point, but the bulge has become more pronounced.
    • At the extrusion phase, some of the jelly from inside the disc has begun to slip outside the elastic skin. At this point, the disc is no longer a bulging disc, but a herniated disc.
    • During sequestration, the jelly that has escaped the disc becomes unattached from the disc.
  • Herniated DiscNeurosurgeons of New Jersey goes on to explain that a herniated disc happens when a hole forms in the outer layer (elastic skin) of the disc and some of the inner jelly escapes through the hole. This type of herniation is referred to as “free fragment,” “non-contained,” or “extruded” herniation. Another type of herniation may occur when compression of the disc stretches the elastic layer so thin that a “large piece of inner portion is able to migrate significantly into the spinal canal.” This is referred to as “contained fragment herniation.” Age and dehydration of the disc are contributing factors. A traumatic injury may weaken the outer wall of the disc also contributing to herniation. Although not every herniated disc causes pain, this problem is far more likely to be the cause of discomfort as the jelly pushes against nerve roots in the spine, according to Beacon Orthopedic and Sports Medicine.

How can I tell the difference between the two?

The American Association of Neurological Surgeons states that the only way to get a proper diagnosis of either a bulging disc or a herniated disc is through your symptoms, your medical history, a physical exam, and some type of imagery test.

  • X-rays won’t actually show the bulging or herniated disc, but they will eliminate other injuries, infections, or tumors that might be the cause of your pain.
  • Computed tomography scans (CTs) give greater detail about the spine and the distance between the vertebrae. They are used to show enlargements and degenerations of discs and the size and shape of the spinal canal.
  • MRIs give the all-around image. They reveal the spinal cord, nerve roots, degeneration, and tumors all in one test.
  • Myelograms have a contrast dye injected into the cerebrospinal fluid. This allows doctors to see any pressure being exerted upon the spinal cord or nerves.
  • Electromyogram and Nerve Conduction Studies measure electrical impulses along nerves. Doctors can then determine if the damage is ongoing or in the process of healing, and catch any other possible nerve compression sites.

With a herniated disc, individuals often notice acute pain, tingling, numbness, or a loss of range-of-motion.

What causes bulging discs and herniated discs?

According to Beacon Orthopedic and Sports Medicine, age is one of the leading causes of bulging and herniated discs. Unfortunately, the effects of age can’t be undone. Poor posture, improper lifting of heavy weight, repetitive stress, obesity, genetics, and traumatic injury can also be causes. If bulging or herniated discs run in your family, the best treatment for the problem is prevention. Practice good posture; don’t slouch. Be sure to lift weight properly, using your knees, not your back. Keep your weight within the “ideal” range so as to eliminate unnecessary wear and tear on your spinal discs.

How are bulging or herniated discs treated?

If you are diagnosed with bulging or herniated discs, only a doctor can prescribe the appropriate treatment regimen for your problem. According to the American Association of Neurological Surgeons, the most common treatment options are

  • Pain management. Non-steroidal anti-inflammatories in pill form or even a topical cream is often the first treatment option. If that doesn’t work, a steroid injection is the next step.
  • Physical therapy. Your doctor may combine the pain medication with physical therapy. The therapist will develop an individualized treatment plan that can involve heat, ice, ultrasound, traction, massage, and electrical stimulation.
  • Surgery. If none of the above solutions provide relief, surgery is the final step. A number of different options are available, and your doctor will discuss your options with you and direct you to the best choice.

If you are suffering from back pain, tingling in your extremities, or lack of mobility related to due to a back injury, contact the specialists at Atlanta Brain and Spine Care. Their doctors will sit down with you, diagnose the problem, and develop the appropriate treatment for you.

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