People often throw out the terms “bulging disc” and “herniated disc” interchangeably, but it’s important to realize that these are actually two different types of conditions with varying types of treatments. Today, we explain what distinguishes a bulging disc from a herniated disc, and how the pair of ailments are treated.
Spinal discs act as natural cushions between our spinal vertebrae, and the outer layer of these discs is known as the annulus fibrosus. In the simplest medical terms, a bulging disc occurs when a disc extends out further than normal, but the disc is still contained in the annulus fibrosus. In a herniated disc, part of the nucleus of the disc extends outside of the annulus fibrosus.
Picturing this process is a little easier if we put it in terms everyone is familiar with – food. More specifically, donuts. Imagine your spinal vertebrae are actually separated in individual jelly donuts. These jelly donuts help facilitate movement by distributing pressure evenly throughout your spine. Over time, these donuts may slowly start to break down after years of wear an tear. Imagine slightly pressing on that jelly donut. The donut will get a little wider and extend beyond its normal space, but the jelly remains inside the donut. That’s a bulging disc. Now, if you press down harder or punch the donut, the jelly is going to spill out of the center of the donut. This is similar to what happens to your spinal discs when a herniation occurs.
Bulging discs are more common, but oftentimes symptoms are minimal and discomfort is minor. Herniated discs are more rare, and while some are asymptomatic, these types of injuries are more likely to cause moderate to severe pain and discomfort.
Treatment for bulging and herniated discs is similar but not exactly the same.
Bulging Disc – Treatment for a bulging disc typically involves rest, pain relievers, doctor manipulation/chiropractic care, physical therapy and pain injections. In rare cases, surgery may be necessary to preserve disc stability or to prevent further damage.
Herniated Disc – As a general rule, a patient with a herniated disc will begin with 6 to 12 weeks of conservative treatment like physical therapy, epidural injections and pain relievers. The majority of herniated discs will resolve without surgery, but plenty of patients need an operation to receive full relief. The goal of any herniated disc surgery is to remove a portion of the disc that is impinging on the nerve root, which is typically 5-10% of the disc.