THE DIFFERENCE EXPLAINED
The difference between a herniated and bulging disc are simple. To use a common metaphor among physicians, think of a disc like a jelly donut. The donut has a liquid center surrounded by a thicker shell. If you press down on the donut, the sides bulge out as the jelly inside presses against them – this is a bulging disc or disc protrusion. If you press down on the donut hard enough that the jelly comes out, it becomes a herniated disc, ruptured disc, or torn disc.
BUT WHAT DOES IT MEAN FOR ME?
If you’re in pain, the nuances in the definitions are likely of little interest to you. The question you’re asking is why am I in pain and how do I get better? Here’s a brief primer on how each condition causes pain:
Pinched Nerve Pain
When a disc herniates, the material leaking out from the disc rather than the disc itself causes the pain. The material inside the disc can pinch or irritate a nearby nerve causing what is called radicular pain (or nerve root pain) that may radiate to other parts of the body. Leg pain from a pinched nerve is referred to as sciatica.
A degenerated disc can cause pain within the disc space itself. This type of pain is referred to as axial pain, or degenerative disc disease.
DIAGNOSING AND TREATING PAIN
All of these terms refer to radiographic findings (such as a CT or MRI scan), and while these findings are important they’re only one piece of the puzzle in diagnosing disc problems. The truth is just because a scan shows a herniated or ruptured disc doesn’t necessarily mean the disc is the cause of your back pain. The pain may be caused by a muscle strain or other soft tissue injury, in which case treating your bulging disc won’t provide any relief.
Your doctor will use the results of a CR or MRI scan combined with your medical history and symptoms to determine the cause of your pain and the best treatment course. The correct treatment plan will depend on this diagnosis.