Should you get a cortisone shot for low back pain? Many patients come to our alternative medicine clinic in... Read More ››
Is A Herniated Disc The Same Thing As A Bulging Disc?
Herniated, bulging, ruptured and deteriorated discs are being diagnosed more frequently today than ever before. Not because more cases are occurring but rather improved MRI imaging allows doctors to visualize these conditions in greater detail and sooner than ever before. This has been a tremendous benefit for patients who no longer have to undergo exploratory surgery to find out what is causing their pain. Many people ask,
“Is a Herniated Disc The Same Thing As A Bulging Disc? Here’s a nutshell explanation…
After being diagnosed with disc problems, many patients are confused as to what exactly is wrong with them and what their disc treatment options are. Many doctors either don’t have the time or just don’t want to explain the differences between these conditions. One of the many things I am most proud of at our clinic is not only do we explain these conditions, we are equipped to conservatively treat and resolve many of these cases because we have a wide variety of protocols and procedures.
Discs are tissue between vertebrae in the spine. They have several functions; one is to act as a spring or cushion between the bones so that when we jump up and down the bones don’t smash into each other. Second they create a space between the bones so a joint is formed to allow for movement. And three, that space also allows nerves to pass between the two vertebrae. Discs are made up of two parts, an outer portion made up of cartilage and an inner portion called the nucleus. These two parts like the rest of the human body is predominantly composed of water. For the sake of a layman’s analogy and to help you understand disc pain, let’s a disc can be visualized as a jelly doughnut, where the jelly is the nucleus (the part of the disk that can bulge or herniate or escape the confines of the center of the doughnut) and the surrounding cake is the cartilage.
Bulging discs occur when the nucleus moves from its central position pushing (bulging) the cartilage outward. Imagine pushing on a jelly doughnut downward and a little crooked, the jelly shifts to the open wedge side of the doughnut and ‘bulges’ the cake slightly. When the disc bulges it tends to move in a rearward direction which is where the nerves are. When the disc touches or hits the nerve, pain, burning, numbness/tingling, spasm even paralysis can occur.
“Is a Herniated Disc The Same Thing As A Ruptured Disc?”
Is when the nucleus is forced out of the confines of the cartilage. With the jelly doughnut, if we pushed real hard downward and a little crooked the jelly will shift as stated previously to the open wedge and blow out of the cake portion of the doughnut. As with bulging, the direction of the nucleus rupturing usually occurs rearward and onto the adjacent nerve. Ruptured discs need to be seen by a surgeon.
Herniation means tearing…annular tearing of the cartilage that surrounds the nucleus of the disc. A herniated disc is a condition half way between bulging disc and ruptured disc (to complicate things further, a ruptured disc is sometimes referred to as a sequestered disc). Going back to the jelly doughnut analogy, if we start pressing down like the ‘bulging disc’ example and add a little more pressure the jelly begins to tear the cake from the inside working outwards but DOES NOT break through the cake. In a sense, a herniated disc can be viewed as a very severe bulge.
“Is a Herniated Disc The Same Thing As A Degenerating Disc?
As the name implies, the disc is degenerating. This degeneration may be caused by chronic or long term misalignment of two or more vertebrae. The misalignment causes uneven stress on the disc and slowly begins to press the water in the discs out into the surrounding tissue spaces, very much like a sponge was being squeezed. And just as a sponge gets smaller/thinner after having the water squeezed out of it, a disc that loses its water becomes thinner. As the disc thins the two vertebrae begin to ‘pinch’ the nerve between them with resulting neck or back pain, arm or leg pain, or sciatica or numbing and tingling.
Discs in the cervical and lumbar regions are more likely to have problems and produce pain than disc’s in the thoracic or dorsal spine (middle back). Conservative and proactive treatment can many times be very effective to relieve pain. Surgery (like a laminectomy procedure or discectomy or microdiscectomy) can be warranted in some cases that do not respond to physical therapy, spinal decompression or chiropractic care.
*Please keep in mind that the above examples are generalized for the lay person (with pain searching for understanding) to help visualize what is wrong with them. (Most patients appreciate simplicity rather than a thesis). If you are the 1% and want more than simplicity, I applaud you. If you are a student or doctor and want an authoritative guide and explanation on disc injuries and disc anatomy…go here.
Posted from Lakewood, Colorado, United States.