You have likely heard the terms herniated disc and bulging disc before. You probably know they’re both associated with your spine. You may even know they both can be painful, but you may be wondering “is a bulging disc the same as a herniated disc?”
In a nutshell, no, they’re not the same condition, despite the fact they both impact the discs in your spine.
What Is a Bulging Disc?
A bulging disc results when your intervertebral disc compresses a spinal nerve. An intervertebral disc is a disc that provides a soft cushion between the vertebrae. As you get older, you might strain your discs either by injury or progressively due to lack of exercise, poor posture or repetitive aggravating movements like:
- Lifting
- Bending
- Continual sitting
- Continual standing
These factors might not cause harm individually, but over your lifetime, they could cause your intervertebral discs to lose their original shape and integrity. When your discs become compressed, they might flatten out and herniate or bulge into your spinal canal. This situation puts pressure on your spinal nerves and spinal cord and leads to an array of painful symptoms, or possibly none at all.
A bulging disc, unlike a herniated disc, remains intact. Sometimes, a spinal bone spur and a bulging disc can occur simultaneously, which doctors refer to as disc osteophyte complex.
What Is a Herniated Disc?
People may use several different terms when referring to a herniated disc, including:
- Slipped disc
- Collapsed disc
- Ruptured disc
- Prolapsed disc
Some even call it a bulging disc, although as you’ve just learned, it isn’t the same thing. Each name is similar in that it refers to an abnormal spinal disc that has become weak and is pressing outward on your spinal cord, causing you pain. Herniated discs can be an extremely debilitating and painful injury. It can cause severe pain in your neck, legs, arms, shoulders, back and hands. Herniated discs fall into three main categories:
- Contained disc herniation: A spinal disc where the nucleus is stretching or bulging the outer annulus and hasn’t pushed through (herniated) the annulus wall into your spinal canal.
- Sequestered disc herniation: A ruptured spine disc that has broken away from your spinal disc and drifted into your spinal canal.
- Extruded disc herniation: A ruptured spine disc where the nucleus has broken through your annulus wall while entering your spinal canal but is still connected to your spinal disc.
Differences Between a Bulging and a Herniated Disc
When talking about a bulging or herniated disc, it can become confusing because of their similarities. This is because the word “herniated disc” really refers to a disc in a certain stage of herniation:
- Degeneration: When it initially bulges
- Prolapse: When the bulging worsens
- Extrusion: When the gel slips out of the disc
- Sequestration: When the gel isn’t attached to the disc any longer
When a disc is in the prolapse or degeneration stage (when it’s referred to as a bulging disc), it’s essentially still a herniated disc, despite the fact it hasn’t actually herniated yet. This accounts for just about all the confusion over bulging and herniated discs.
So, when someone is talking about a bulging disc, they’re talking about a disc either in the prolapse or degeneration stage. When they’re talking about a herniated disc, the disc could be in any of the stages. You can’t know for sure which one they’re referring to unless you know they have an understanding of the differences between the both.
Differences between bulging and herniated discs include the following.
1. Contained Vs. Non-Contained
Intervertebral disc conditions are either “contained” or “non-contained.”
Bulging Disc
Bulging discs haven’t broken open, and the nucleus pulposus is still contained in the annulus fibrosus. You can compare bulging discs to volcanoes before an eruption. They might be a precursor to herniation. The discs might protrude into your spinal canal without breaking open. The nucleus pulposus (the gel-like interior) doesn’t leak out. The disc stays intact, but you have a small bubble popped out and connected to the disc.
Herniated Disc
Non-contained discs are those having either completely or partially broken open. You can imagine it like your annulus fibrosus is a tube, filled with nucleus pulposus (toothpaste) placed under pressure (squeezing the tube). This pressure (you squeezing the tube) causes the toothpaste inside the tube to go wherever it can. Toothpaste could leak out if there are any weak spots in the tube (a hole).
So, when your disc herniates, its contents might spread out to your spinal nerves and cord. There’s little space for the disc material to move into, so it may head into the space occupied by the nerve roots and spinal canal.
2. Causes
The causes of these two types of conditions can contribute to their differences.
Causes of Bulging Discs
Spinal discs absorb a lot of wear and tear and start weakening and degenerating over time. A common disorder leading to bulging discs is a degenerative disease, often resulting in spinal osteoarthritis. This disease isn’t just a disease, but rather a word used for describing pain from discs degenerating over time. Other bulging disc contributors include:
- Obesity
- Smoking
- Poor posture
- Strain or injury
- Inactivity
Causes of Herniated Discs
Herniated discs, also called slipped discs occur when the discs’ outer ring becomes weak or tears allowing the inner part to slip out. Herniated discs’ contributing factors include:
- Being overweight
- Age
- Having a sedentary lifestyle
- Having weak muscles
- Lifting heavy objects
As you become older, you’re also more susceptible to a herniated disc because aging causes your discs to begin losing their protective water content, making it simpler for them to slip out of place.
Certain movements can also cause herniated discs. For instance, lifting an object could cause you to slip a disc. Lifting a large, heavy object could strain your lower back, leading to a herniated disc. If you have a physically demanding job where you have to perform a lot of lifting, you could increase your chances of suffering a herniated disc.
Being overweight also raises your risk because your spinal discs must support this extra weight. Weak muscles and a sedentary lifestyle could also cause you to slip a disc as well.
Men suffer herniated discs more commonly than women.
3. Symptoms
What is worse — a bulging or herniated disc, in terms of symptoms?
Bulging Disc Symptoms
A bulging disc, or disc protrusion, is a relatively common occurrence and in the early stages, many individuals don’t suffer any symptoms. One problem is bulging discs can remain asymptomatic for a while, making individuals oblivious to the fact they have this problem. This unawareness could lead to further damage, particularly if their job requires repetitive motions and heavy lifting. A bulging disc could sometimes press up against your spinal cord and cause symptoms that include the following.
Lumbar bulging disc could cause:
- Pain in the thighs, lower spine, buttocks and in the feet.
- Difficulty in walking
- Numbness, tingling, and weakness in the buttocks, legs, and feet
Thoracic bulging discs could cause:
- Increased reflexes in your legs, causing spasticity
- Pain and muscle weakness, tingling or numbness in your upper back
- Pain can radiate through the stomach and chest and can be mistaken by patients as cardiovascular problems
- Paralysis from your waist down
- Changes in your bowel or bladder function
Cervical bulging discs could cause:
- Deep pain over or near your shoulder blade
- Pain moving your neck
- Radiating pain in your forearm, upper arm and potentially your fingers
Herniated Disc Symptoms
A herniated disc is where the outer layer of the disc, called the annulus cracks, allowing the inner layer called the nucleus to migrate outward toward the spinal nerves. Herniated discs are more vulnerable to spinal cord pinching and “slipping” into the spinal canal. If this happens, you could experience symptoms in your spine and extremities like:
- Pain
- Weakness
- Burning
- Tingling
- Numbness
Often, these symptoms can become severe enough that you will have to visit a spine specialist.
Both conditions could lead to leg and back pain, numbness, tingling and loss of range of motion. However, these types of symptoms are often more common with a herniated disc. Since the disc material is contained better in a bulging disc than a herniated disc, there’s less of a chance of nerve compression and irritation.
4. Complications
There are also differences in the potential complications related to these untreated disc conditions.
Untreated Herniated Disc
An untreated, severe herniated disc might cause permanent nerve damage. In very rare cases, you could suffer a loss of bowel or bladder control due to a herniated disc pressing on the bundle of nerves called cauda equina which controls nerve impulses in your low back and legs. Another long-term complication is saddle anesthesia. This is where you have a herniated disc compressing your nerves causing you to lose sensation in your inner thighs, back of your legs and around your rectum.
While herniated disc symptoms can improve, they can also worsen. If you find you can no longer engage in activities you could before, see your doctor.
Untreated Bulging Disc
Typically, if you have an uncomplicated bulging disc, you can live an active and normal life without needing to make many accommodations. You’ll usually have a good outcome with or without treatment. However, if it turns into a herniated disc, you will want to seek treatment.
You may need treatment for an uncomplicated bulging disc in certain situations, such as if you have an unusually small spinal canal or exceptionally large disc bulge. In susceptible individuals, even a bulging disc could take up too much spinal canal space where it generates stenosis, meaning the body channel is narrowing abnormally. When this occurs, the doctor might need to relieve the spinal nerve pressure. If you have stenosis, you could experience certain bulging disc symptoms, including:
- Numbness or weakness in one or both of your legs
- Pain radiating into your legs.
These symptoms are signs you need further examination and treatment. Other severe complications like loss of normal bowel or bladder function suggest severe nerve compression and the need for immediate surgical evaluation.
5. Treatment
Doctors treat both of these disc disorders as well as their symptoms in a variety of ways. Your doctor will attempt to diagnose the underlying cause of your back pain and any other symptoms you’re experiencing so that they can decide on the best treatment option for you. Usually, for both conditions, conservative treatments are used first.
Non-Surgical Treatments
Inflammation is the primary symptom for both herniated and bulging discs. After reducing inflammation and improving spinal alignment, many cases don’t require surgery. Some non-surgical treatments that are often used for disc problems are:
- Injections
- Chiropractic treatment
- Oral medication
- Heat and ice treatments
- Physical therapy
You can also make some positive lifestyle changes for the long-term to help decrease your risk of future disc problems. These lifestyle changes include things like getting regular exercise, quitting smoking and losing weight.
Surgery
When conservative treatments aren’t working, your doctor might suggest surgery for a herniated disc. You might be able to opt for least invasive spine surgery. If a herniated disc or degenerative disc is what’s causing your pain, spine surgery might alleviate it. Your doctor might recommend one of two types of surgeries:
- Spinal fusion:In this procedure, the surgeon fuses together two or more vertebrae to keep them from moving. The goal of this procedure is to get rid of the movement between your bones to ease the pain. It’s a particularly common surgery with degenerative disc disease.
- Microdiscectomy: In this operation, the surgeon, through a one-inch incision and tubular retractor, decompresses the bulging or herniated disc.
- Endoscopic Discectomy: This is a least invasive surgery in which the surgeon operates through a 1/2 inch incision and utilizes an endoscope and HD camera to selectively decompress the herniated disc.
- Stem Cell Procedure: Another least invasive option, this procedure involves using stem cells from the patient’s bone marrow. The cells are injected into the bulging or herniated disc to help heal and restore it.
Your doctor probably won’t suggest surgery if a herniated disc or degenerative disc isn’t causing you pain or if you’re having chronic pain, but they can’t find the exact cause.
Can a Bulging Disc Become a Herniated Disc?
Bulging discs are less likely than herniated discs to cause pain because they often don’t protrude far enough to press on a nerve. But can a bulging disc get worse?
Bulging disc pain might start gradually and become worse over time or when you perform certain activities. Typically, though, bulging disc symptoms do get better over time. However, a bulging disc may also progress over time into a herniated disc, leading to worsened symptoms.
Contact International Spine Institute for Bulging and Herniated Disc Treatment
International Spine Institute specializes in providing the least invasive spine surgery and concierge spine care. Our practice evolved due to the need for more individualized concierge spine care. We cater to our patients’ needs and expectations. We don’t rush our patients through their consultation like most orthopedic spine practices. We’re attentive to our patients’ needs and always seek to provide them with answers to their questions and solutions to their concerns.
If you’re struggling with pain, you’ll want to find out what the underlying cause of your pain is so you can experience relief. If surgery is the answer to your pain, you’ll want to choose an operation that will provide you with the best relief with as little recovery time as possible so you can get back to living your life.
We don’t make you wait weeks to set up an appointment and then leave you waiting for hours like many places. We understand you want compassionate, convenient care where you’ll experience relief when it’s all said and done. Dr. Rodriguez strives to listen attentively and educate his patients and to provide them with the least invasive procedures possible so they can get back to their daily lives as quickly as possible. Contact International Spine Institute to set up your appointment today.