What Is The Difference Between A Bulging Disc And A Herniated Disc?
When it comes to diagnosing the cause of chronic back or neck pain, patients can be met with a variety of terms that are difficult to decipher. Two of the most commonly confused diagnoses are a bulging disc and a herniated disc. While both of these conditions can cause symptoms that include both localized and radiating pain, the difference in severity of each condition is what is most important for patients to know.
What are intervertebral discs made of?
To truly understand the difference between a bulging disc and a herniated disc, it is important to know makes up the discs of the spine and what their function is. The intervertebral discs serve as the shock absorbers of the spine, as well as prevent the vertebrae of the spine from rubbing against one another. The discs are made of a flexible fibrous outer layer (known as the annulus fibrosis), which keeps the protein-based fluid (known as the nucleus pulpous) inside of the disc.
Both the vertebrae and intervertebral discs are part of the spine and, for that reason, reside in close proximity to the nerves that run through the spine and control many motor and neurological functions.
What is a bulging disc?
A bulging disc is very similar to what the name implies and is often the result of compression on the spinal disc due to the aging process or trauma. As the vertebrae above or below begin to compress the disc, it can begin to bulge outward. This is similar to squeezing a water balloon- the fluid will remain in the balloon but the balloon will bulge at certain ends depending upon the direction of the force.
Generally, a bulging disc will only cause symptoms if the disc extends into the spaces in the spine where it begins irritating or compressing spinal nerves.
What is a herniated disc?
Also sometimes referred to as a “ruptured disc” or “slipped disc”, a herniated disc occurs when the fibrous outer layer becomes cracked or torn and the protein-based fluid inside the disc begins to leak into the area around the spinal nerves. This fluid causes pressure on the nerves of the spine, causing chronic pain as well as pain that radiates into the extremities (Cervical Radiculopathy or Sciatic Pain).
Some of those with herniated discs may never experience any symptoms while others will experience severe and chronic pain. The severity of symptoms usually depends on the location of the disc herniation as well as the size of the herniation.
When should I consult a spine specialist?
If you are experiencing persistent pain in the cervical or lumbar spine, or pain/numbness that radiates into the extremities, it is important to consult a spine specialist as this is a sign of spinal nerve irritation. The spine specialist will create a treatment protocol based on the severity of symptoms as well as each patient’s lifestyle and goals.
It is important to note that once a disc has become bulged or herniated, it is not possible for the disc to assume its original shape. However, conservative modalities (physical therapy) can strengthen the muscle structures near the affected disc and reduce or alleviate the symptoms altogether.
For those who have not seen results from conservative modalities, a spinal procedure may be an option to relieve the pain. One procedure specifically, a Minimally Invasive Discectomy, has been proven to be an effective option for disc herniations. This procedure uses a small incision (usually about 1 inch) as well as small surgical tools to remove only the herniated portions of the spinal disc. The removal of the herniated portion of the disc allows for the decompression of the affected spinal nerve, which in turn relieves symptoms.
Dr. Anthony Virella is a Board-Certified, Fellowship trained Neurological Spine Surgeon with advanced training in the management of complex spinal disorders. He attended medical school at Columbia University College of Physicians and Surgeons and is a graduate of the UCLA Neurosurgery Residency Program. Dr. Virella completed his complex spine in-folding resident fellowship at the world renowned Cleveland Clinic Foundation with Dr. Edward C. Benzel, M.D. Additional work included a second fellowship in Minimally Invasive Spine Surgery at the UCLA Comprehensive Spine Center.
Dr. Virella is a nationally recognized specialist in the field of complex and Minimally Invasive Spine Surgery and has offices located in Westlake Village and Valencia. If you, or someone you love, is suffering from persistent neck or back pain, call us at 805.449.0088 to schedule an appointment.