There are many different terms used to describe spinal disc pathology and associated pain, such as "herniated disc", "pinched nerve", and "bulging disc", and all are used differently by doctors.
Unfortunately, healthcare professionals do not agree on a precise definition of any of these terms, and patients may be frustrated when they hear their diagnosis referred to in different terms. A variety of interchangeable terms (ruptured disc, torn disc, slipped disc, collapsed disc, disc protrusion, disc disease, black disc) can add to the confusion.
Rather than caring about which term is used, it is more useful for patients to gain a clear understanding of the precise medical diagnosis.
- The medical diagnosis identifies the actual cause of the patient’s back pain, leg pain and other symptoms.
The medical professional determines the cause of the patient’s pain through a combination of a review of the patient’s medical history through a combination of:
- Review of the patient's medical history
- A complete physical exam
- One or more diagnostic tests (if needed)
Two Causes of Pain: Pinched Nerve vs. Disc Pain
In identifying the cause of the patient’s pain, there are two general types of spinal disc problems used by physicians:
- On Spine-health.com, this nerve root pain is called a herniated disc. (Other common causes of a pinched nerve may include spinal stenosis and bone spurs from spinal arthritis.
- On Spine-health.com, disc space pain is called degenerative disc disease.
When a patient has a symptomatic herniated disc, the disc itself is not painful, but rather the leaking disc is pinching a nerve. This produces pain called radicular pain (e.g., nerve root pain) leading to pain that may be referred to other parts of the body, such as from the low back down the leg or from the neck down the arm. Leg pain from a pinched nerve is usually described as sciatica.
When a patient has a symptomatic degenerated disc (one that causes low back pain and/or leg pain), it is the disc space itself that is painful and the source of pain. This type of pain is typically called axial pain.
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Either of the above two conditions can occur in the cervical, thoracic or lumbar spine. They tend to be most common in the lower back because the lower back bears the most torque and force on a day to day basis.
It should be kept in mind that all the terms – herniated disc, pinched nerve, bulging disc, slipped disc, ruptured disc, etc. – refer to radiographic findings seen on a CT scan or MRI scan. While these test results are important, they are not as meaningful in determining the cause of the pain as the patient's specific symptoms and the doctor's physical exam results.