FAQ’s Herniated or Bulging Disc
There are a large number of both physicians and patients who will use these terms interchangeably when discussing a damaged spinal disc, when they are in fact separate conditions. A bulging disc usually precludes a herniated disc.
The discs of the spine are small fluid sacs located between each of the spinal vertebrae, and these discs serve as a cushion for the spine during movement. It is thanks to these discs that the spine is able to flex and bend to the degree it does. Over time, spinal discs are subject to degeneration and potential chronic pain.
A bulging disc is a condition in which the disc starts to lose water during degeneration. This causes the disc to flatten somewhat and protrude beyond the intervertebral space that houses it (Almost like a tire that is flattening and bulging). Bulging discs may span beyond this intervertebral space, putting excess pressure on the spine and potentially compressing a local spinal nerve root.
Herniated discs are where the discs outer layer has ruptured or torn, resulting in the leaking of the gel-like fluid that is contained within the disc. Disc herniation can result in the deflation of the disc, weakening the spinal support offered by the disc and potentially pinching on an adjacent nerve root.
What causes a Herniated or Bulging Disc?
Even though these are separate conditions of the spinal discs, there are similar causes between the two. These causes include arthritic damage from repetitive strain, excess wear and tear on the discs linked to poor posture, spinal injury to the discs, and degenerative disc disease.
Each of these can lead to a weakening of the disc, resulting in either an internal disc injury (bulging) or an external one (herniation). It is possible for a patient to sustain a disc injury at any age, but these injuries are much more likely to occur later in life as general degradation of the disc has had more time to take effect.
The symptoms of a Herniated or Bulging Disc
The symptoms a patient will experienced from this condition will vary based on the location of the damaged disc and the severity of the damage. Pain that is felt at the location of the damaged disc and radiates outwards is common among all disc injuries.
Damaged lumbar discs (the lower back) can result in pain felt in the buttocks and legs (sciatica), and may result in a feeling of leg weakness or numbness if one or more nerves are compressed. Damaged cervical discs (the neck) can lead to chronic episodes of headaches for the patient, and may result in a feeling of weakness felt within the arms if one or more nerves are compressed. Damaged discs in the thoracic region (the abdomen) can lead to pain within the rib and flank area.
How is a Herniated or Bulging Disc diagnosed?
The diagnosis method that will be used will be based on what symptoms are being shown by the patient. Generally, imaging tests will be performed in order to evaluate the spine and to search for damaged discs in the area of symptoms. During this, the physician will also search for the presence of compressed nerves in those cases where symptoms warrant it.
For patients who have had it confirmed that one or more discs are damaged, a discogram may be performed to evaluate exactly which disc is the source of symptoms. This is not a therapeutic test, but a preoperative test for degenerative disc disease.
Treatment options for a Herniated or Bulging Disc:
For both conditions:
- Trigger point injections
- Epidural Steroid Injections
- Physical Therapy
- Spinal Decompression Therapy
- TENS Units
- Medications – NSAIDs, Lyrica, Neurontin
For a bulging disc:
- Intradiscal Injections
- Stem Cell Injections
- Facet Injections
Both bulging disc and disc herniation are typically able to be treated nonoperatively. Over 90% of the time, surgery can be avoided at Dallas pain management centers!