Defintion: Bulging vs Herniated Spinal Disc

Defintion: Bulging vs Herniated Spinal Disc

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dilauro
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Defintion: Bulging vs Herniated Spinal Disc

Disc Definitions

What is an Annular Tear
An annular tear refers to a tear or damage to the outer layer of a spinal disc (known as the Annulus Fibrosus). An annular tear is sometimes a precursor to a herniated disc,

What is the difference between a herniated disc and a bulging disc?

There are some differences of opinions between doctors.

This is one common statement Herniated disc and bulging disc usually imply the same thing. There is no specific definition for the term herniated disc, bulging or protruded disc.

Here are details from Peter F. Ullrich, Jr., MD
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, there is no agreement in the healthcare field as to the precise definition of any of these terms, and patients are often frustrated when they hear their diagnosis referred to in various terms by different practitioners. Additional terms such as ruptured disc, torn disc (or disc tear), slipped disc, collapsed disc, disc protrusion, disc disease, and black disc often add to a patient's confusion.
Rather than try to reconcile the terminology used to refer to disc problems, it's generally more useful for patients to gain a clear understanding of the precise medical diagnosis, which identifies the actual cause of the patient’s low back pain, leg pain, or other symptoms.

Bulging
Bulging discs are still contained within the annulus fibrosis. Herniated disc extend outside the annulus.

Herniated
A herniated disc is a traumatic focused injury to the disc, which results in a portion of the nucleus, or inside material, pushing out into a nerve.

Another View
More helpful definitions are the terms contained or non-contained disc herniation. A non-contained disc herniation indicates a disc has herniated material that is no longer connected to the main portion of the disc. A contained disc is a disc herniation that still has connections to the main disc.

This is really a difference of degree. A bulging disc is a smaller protrusion of the central nuclear material still contained by some of the outer annular fibers. A herniated disc is one that has ruptured through the annulus. It is best to give the actual measurements of the protrusions instead of just using the descriptive terms herniated or bulging or even ruptured.

This one is my favorite
Think of your disc as a jelly donut, you can squash down the jelly donut and the jelly never comes out. That is a bulging disc.
A herniated disc is when the jelly actually comes out.


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cla_gua
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Can a bulge cause as much

Can a bulge cause as much pain as a herniation? Is surgery ever done for a large bulge? For example Fusion, microdisectomy
Thanks,
Clarissa

dilauro
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Bulge causing Pain

Clarissa,

That would be a question that a doctor should probably tell you. Mine is only an opinion. If the bulge is not that big and not pressing on a nerve root, then I would think it should not cause as much pain as a full blown herniation.

But again this is only my opinion

Ron DiLauro Spine-Health System Moderator
Dont laugh at me

jade2 (not verified)
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disc

dilauro- I just read this and notice that I do not have measurements of some discs - just described as mild, moderate etc. I guess I will need to research this issue more. I'll check out the website mentioned. jade

Preety (not verified)
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Severe Back and cervical neck pain Please help

Please help by suggesting what can be done -----

Hi ,

Hope u people reading this message r fine. One of my friend suffering from severe back and neck pain from past 1 year. 6 years before CERVICAL PAIN started and MRI REPORT SHOWED DISC BULGE. She did no treatment , only little bit free hand exercise.. Now her condition is very bad......
In that cervical pain , she completed her studies and job also as a IT professional. Today, because of her pain , she had to resign her job.... She can't sit for more than 1/2 hr. She can't bend, can't pick weight, can't travel , etc....She is having severe lower back pain , and also cervical pain is still there. Her financial condition is very bad, lot of doctors shown, nobody could find the exact cure.

Her latest MRI REPORT showing the following finding -
BULGE OF C3/4 TO C5/6 INTERVERTEBRAL DISC WITH POSTERIOR OSTEOPHYTES CAUSING COMPRESSION OF NERVE ROOTS AT NEURAL FORMANIA.

Now home traction gives 1-2 hrs. relief, but is this the treatment we should depend on, or something else should be done......

I feel very bad for her, can anybody show me some light of hope , so that she gets relief from this lower back and neck pain.

Regards,
Preety.

cla_gua
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Preety- Has your friend seen

Preety- Has your friend seen and neurosurgeon or ortho. surgeon? She has to see a qualified Dr. for the right help. I would suggest she make an appt. with one of them and go from there. As for the lower back pain- Did she get an MRI for that region? And the same advice she needs professional help.

I hope your friend gets better.

krazigirl79
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I have to disagree...

dilauro wrote:
Clarissa,

That would be a question that a doctor should probably tell you. Mine is only an opinion. If the bulge is not that big and not pressing on a nerve root, then I would think it should not cause as much pain as a full blown herniation.

But again this is only my opinion


I actually asked my PM doc this question during my ESI a couple of weeks ago. I keep getting told that I "only" have a 4mm bulge, and when I asked him about it- he said there is no "only" about it.

The disc space and facet joint space on every person varies. 4mm in a 6mm space is huge, whereas 4mm in a 10mm space isn't quite as bad. So it all depends on the space available in your body. Not all person is equal when it comes to bulging / herniated discs.

SO although the 4mm may not be directly pressing on a nerve root, the pressure caused by the displacement of 4mm of a 6mm gap can cause the nerve pain.

My PM doc then told me that I have a very small space, so I have a lot more pain from the 4mm herniation than many people would if they have larger spaces. He said he can tell by the amount of fluid he is able to inject into the site at a time without causing extreme pain. Some people he can just empty the syringe into in one shot, but with me it took almost 30 minutes to empty the syringe because of the lack of space in which to put it in.

lv2mykidz
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Cervical herniated disc repair

I was wondering once you are diagnosed with a cervical disc herniation that is impinging into the spinal canal but only kissing the cord itself, it it even POSSIBLE for the disc to navigate back into the natural disc space between the vertabrae or am I always going to be at the risk of this silly disc doing permanent damage being that it is so close to the spinal cord?????

lv2mykidz
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Cervical herniated disc repair

I was wondering once you are diagnosed with a cervical disc herniation that is impinging into the spinal canal but only kissing the cord itself, it it even POSSIBLE for the disc to navigate back into the natural disc space between the vertabrae or am I always going to be at the risk of this silly disc doing permanent damage being that it is so close to the spinal cord?????

charry
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Hi and Welcome Iv2mykids

I had a herniated disc in my lumbar spine and it did heal on it's own. Not sure how long it took because my second MRI was 15 months later and it wasn't seen. However in it's place I have Degenerative Disc Disease and still have nerve pain the same as when I had the disc herniation.

Have you been to Physiotherapy or seen an Orthopedic or Neurosurgeon yet? I hope it does heal for you but there are many people who have herniated discs and have no pain so it really depends on your symptoms also. When you see the Surgeon he can help you with more answers but hopefully yours will heal but it depends on if there's nerves involved also. That's a good question for your surgeon though if you should wait on surgery or if you're a candidate? There's some great articles here on Spine Health about Disc hernaitions and what to ask your Dr.

I hope you start a new post so people can see your post here. Take care. Charry

DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN