Often times patients use the terms disc bulge, disc herniation, slipped disc interchangeably. Although they do involve the same structures of the spine, these conditions are different. In order to properly explain the differences, its important to understand the structures in the body we are talking about. A “disc” is literally a large piece of cartilage that serves as the padding, and aids movements between the vertebrae or vertebral body in your neck or back. Hence, the large bones that protect your spinal cord. Every vertebrae in the neck, mid-back or low back has a disc in between them save one, the first two vertebrae in your neck. The disc has two main components, the fibrous outer rings that are very durable, and an inner part called the nucleus pulposus which is not as durable. Think about the disc structure like this, if you had a jelly doughnut, and cut the top off the doughnut (transversely) in half you could observe the jelly in the middle of the doughnut and the surrounding doughnut would be containing the jelly itself so it doesn’t leak out. If the jelly were to “leak” into the surrounding doughnut but not outside the doughnut, this would be considered a “disc bulge”.
In the case for a disc “herniation” the jelly would be leaking completely outside the doughnut and onto the table. Obviously, there are variations and different levels of severity of these disc conditions. Generally, a disc bulge is not caused by trauma. A bulge is typically considered a degenerative process that happens over time. Conversely, a disc herniation is caused almost always by trauma. Hence, a car accident, a slip and fall accident, sports event accident, lifting something heavy, etc. Many times, person’s will not know that the have either of these conditions unless the have a spine MRI. You cannot find out for certain that you have a disc bulge or a disc herniation with an X-ray.
There are certain symptoms that are indicative of a disc herniation. Usually, a patient will have shooting pains down an extremity like their arms, fingers, legs, buttock area, feet, etc., or numbness into a certain extremity, or some type of uncomfortable sensation into an extremity. The reason this happens is because the inner part of the disc, the nucleus pulpous, or “jelly” has leaked, because of some type of trauma, into the surrounding areas of the spine and is abutting or touching a nerve root that leads to the particular extremity that nerve controls. Although this sounds much more severe than a disc bulge, a disc bulge can prove to be painful as well. As mentioned above, a disc bulge is a degenerative process that happens over time. Having a disc bulge is considered a comorbid condition to neck or back pain.
In this context, this means that patients with back pain and have a disc bulge are typically harder to treat and often require more treatment to resolve the back or neck pain, regardless of the cause of the pain.The reason is because anatomically speaking, the tissues surrounding your spine, and including the disc itself are not in an optimal state to deal with injury to the area that has a disc bulge. To clarify, a person with a disc bulge may present with neck pain or back pain from an activity that normally would not have caused an injury.
Moreover, patients with a disc bulge are susceptible to having the bulge develop into a disc herniation because the inner part of the disc (the jelly) is not completely contained within the tough fibrous rings of the outer disc structure. We hope this clears up some common confusion between these two conditions. Here at Optimum Health Center and Chiropractic, we deal with these conditions on a daily basis and have specific effective treatment protocols for both of these common ailments.