Many patients inquire about the difference between a bulging disc and a herniated disc. This is indeed one of the more common questions I receive regularly in my correspondence with readers. So, to answer the query once and for all, I thought I would dedicate an article specifically to the topic and add in some information relevant to patients diagnosed with either medical term.
I hope this essay helps to clarify this often confusing issue and better prepare each of you to find the care you might require for your intervertebral troubles.
Bulging discs and herniated intervertebral discs are terms used interchangeably by some doctors, while they mean different things to other doctors. This is very common in medicine and particular prevalent in the back pain treatment industry.
A disc bulge is a diagnostic term usually reserved for a minor protrusion in which the disc structure remains sound and intact.
A herniated disc can be a bulge, but it can also be a more serious event in which the outer disc wall becomes compromised, enacting a ruptured disc, also known as an extruded disc and sometimes, a sequestered disc.
To simplify, a bulge is like a balloon which is swollen, but generally shaped the same and solid in structure. A herniation is when a separate contained pocket opens up from the outer wall of the disc or the outer wall develops an annular tear, allowing interior nucleus to leak out.
Neither is inherently worse than the other, since both can cause pain through the usual processes of spinal stenosis and foraminal stenosis. However, treatment options may be slightly different, since some therapies and procedures work better with contained bulges and are not viable options for discs that have ruptured or leaked.
Confused yet? Yeah, I am sure.
The name game for herniations goes even deeper than this. Many doctors use completely different terms to describe herniations, including: prolapsed disc or disc prolapse, disc protrusion or protruded disc, collapsed disc and slipped disc. None of these terms are specifically used for particular criteria, but all are interchangeably pronounced for herniations of various degrees, confounding patients in the process. I always recommend that patients who receive a disc diagnosis speak to their direct care provider for details on the condition.
It never ceases to amaze me just how many patients receive MRI results which are never explained to them, forcing them to turn to other sources, such as this site, for basic information which is within their rights to fully comprehend. Shame on you doctors!
When it all comes down to it, there is really no importance placed on the term used to diagnose a disc condition. A name is just that; nothing more than a word. What is crucial is to receive the facts about herniated discs and understand the extent of the concern and the prognosis for the future.
If these pieces of diagnostic information are not provided, you must demand them! If you are still not happy, find a new doctor, since yours is dropping the ball at every opportunity. Regardless of how many times I get this same question, I will always answer it. I understand that although I hear the question daily, each new person who asks it expects a solid answer which they will hear for the very first time.