There are many terms associated with spinal disc problems and the pain that comes with those conditions. Two of the more common spinal disc disorders are bulging discs and herniated discs. These terms are often used interchangeably, however, there are significant differences in the two conditions. These are both common conditions, and many people develop bulging or herniated discs in their spine.
What Are Discs?
Discs are sponge–like cushions that sit between the vertebrae of your spine. Both bulging and herniation affects these oval-shaped intervertebral discs. Discs are composed of two layers of cartilage, a hard outer layer and a softer, pliable gel-like interior called the nucleus pulposus. Terms that are used to describe conditions of the discs that cause pain include:
- Bulging Discs
- Herniated Discs
- Ruptured Discs
- Slipped Discs
- Degenerative Discs
What Is a Bulging Disc?
A bulging disc is the more common of the two conditions. A Bulging disc could be thought of as the precursor to disc herniation. A bulging disc is considered to be “contained”, meaning that there is no indication of a crack or tear in the outer layer of the disc. Characteristics of a bulging disc include:
- Protrudes slightly outside its space into the spinal column
- No part of the nucleus pulposus fluid has leaked out
- The disc remains intact, with just a small protrusion of the outer layer
What Is a Herniated Disc?
Herniated discs are sometimes called ruptured or slipped discs. A herniated disc is considered to be “non-contained”, meaning that there is a break in the discs outer layer that causes the nucleus pulposus to leak out. Herniated discs will most likely cause pain. Characteristics of a herniated disc include:
- The disc has broken open in some way, be it completely or partially
- The fluid within the disc may leak out, spreading into the spinal canal or onto the spinal nerves
- The fluid that is leaked causes pressure to nerves and may cause pain to radiate to the arms or legs
What is The Difference Between the Two Conditions?
Both bulging and herniated discs affect the spinal discs and may or may not cause pain. These conditions may also have similar causes and similar symptoms, but how are they different? The differences between bulging and herniated discs include:
- Bulging discs are contained, herniated discs are non-contained
- Bulging discs are intact, herniated discs are broken or cracked
- Bulging discs may protrude, while herniated discs leak fluid
- Bulging discs are more common, but herniated discs more commonly cause pain
- Bulging discs affect a large portion of the disc, while herniated discs may only affect one particular area of the disc
What Are The Symptoms of These Conditions?
Not all bulging or herniated discs present with symptoms, however, symptoms that do occur can be very painful. The symptoms for both bulging and herniated discs are similar in nature. Symptoms of bulging and herniated discs include:
- Pain that can vary according to location of the affected disc
- Radiated pain that can travel to the extremities
- Tingling and numbness
- Weakness in the muscles
- Very rarely, a loss in bladder or bowel control
What Causes These Disc Problems?
A bulging or herniated disc can seem to get worse overtime or it can come on suddenly. Just as bulging and herniated discs have similar symptoms, they can also have similar causes. Causes of bulging and herniated discs include:
- Inadequate posture
- Injury to the spine
- Repeated back or spinal strain
- Typical usage over time
How Are Disc Problems Diagnosed?
If you are experiencing back pain your doctor will likely begin by doing a complete medical history and physical exam. Your doctor will want to know when your symptoms began, what your symptoms are and whether or not you have had any radiating pain or previous back injury. You may be referred to a specialist for further testing and final diagnosis. Other tests used to diagnose disc problems include:
- A neurological exam to evaluate your muscle strength and reflexes
- X-ray, CT scan or MRI, which can identify a bulging or herniated disc and its location
- Discogram, to pinpoint the affected disc or discs
- Bone scan, to identify any underlying spinal conditions
- Blood tests, to evaluate levels that may indicate metabolic conditions that cause back pain
How Are These Problems Treated?
Treatment of bulging or herniated discs will likely begin with conservative options and will likely advance to surgical procedures if no conservative treatment works to alleviate pain. Treatment options include:
- Physical therapy
- Chiropractic visits
- Pain management
- Microdiscectomy, in which a portion of the herniated disc is removed.
- Spinal fusion, in which the spine is surgically fused to limit movement between discs.
No matter which of the two conditions is present, any problems of the spinal discs can be very painful. Both bulging discs and herniated discs can produce similar symptoms and can be caused in similar ways. Regardless of the cause, both bulging and herniated discs may respond to different levels of treatment. Pain level and treatment options will vary from person to person. If you are experiencing back pain, contact your doctor for a complete evaluation and diagnosis.