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Herniated Disc vs. Bulging Disc: What's the Difference?

January 23, 2024

The terms “herniated discs” and “bulging discs” are often used interchangeably, but they are not the same. Both conditions are indeed common causes of neck and back pain, but they have key differences that may shape how they present and are treated. 

It’s time to dispel the confusion around herniated disc vs. bulging disc symptoms and causes. 

Remember, while we can offer a better picture of what may be going on beneath the surface, only a doctor can give you personalized medical advice. Please reach out to Long Island Brain & Spine and request an appointment for more information.

What Is a Herniated Disc?

Your spine is made up of bones called vertebrae. These stack on top of each other to make a long column. But bones are solid; they need something else to cushion and connect them. That’s where discs come in. 

Dr. McCormick from Long Island Brain and Spine put it like this: “Discs are cushions between the vertebrae in the spine. They are made up of an outer layered ring of tough cartilage, the annulus fibrosus, and an inner layer, the nucleus pulposus which is a softer, gelatinous material made up of water, type II collagen, chondrocyte-like cells, and proteoglycans, which help function as a ‘shock-absorber.’”

A herniated disc occurs when some of that softer inner layer pushes through a tear in the annulus, the outer protective ring. 

Dr. McCormick explains, “Disc herniations are protrusions of the nucleus pulposus through the outer ring of cartilaginous fibers. They are larger [than bulging discs], and thus more likely to cause significant compression of nerve roots, causing more pain and, in some cases, weakness and numbness.”

A disc that herniates is usually a result of a degenerative disc disease, which causes discs to wear down over time. You might also see herniated discs referred to as slipped discs, ruptured discs, or disc extrusions

Herniated Disc Symptoms

Symptoms of a herniated disc vary depending on where the disc is located and whether it’s pressing on any nerves. It’s common for herniated disc symptoms to affect one side of the body.

However, many people with a herniated disc don’t show any symptoms. Indeed, you can have a herniated disc – or several – without even knowing it. Symptoms might develop once the situation is severe, or you might not discover a herniated disc without a spinal image. 

If you do experience symptoms of a herniated disc, they’re likely to include the following:

  • Arm or leg pain. A sharp or burning pain that may shoot into your arm or leg when you move, cough, or sneeze. Herniated discs in your lower back might trigger pain in this area as well as the buttocks, thigh, calf, or feet. A herniated disc in your neck is likely to cause pain in your arm or shoulder.
  • Muscle weakness. Muscles served by nerves affected by a herniated disc tend to weaken. You might stumble or have a hard time lifting and holding items.
  • Tingling or numbness. Pressure on nerves can cause numbness or tingling in parts of the body like the hands, feet, arms, etc.

Causes of a Herniated Disc

Gradual and age-related wear and tear, known as disc degeneration, is typically the culprit behind disc herniation. Our discs naturally become more rigid and prone to injury as we age. 

Beyond this, though, it can be tricky to pinpoint the cause of a herniated disc. Sometimes, isolated incidents – like lifting heavy objects improperly – can be enough to cause a tear or rupture. Twisting and turning while lifting may also cause herniation. 

What Is a Bulging Disc?

A bulging disc, also known as a disc prolapse, occurs when the inner parts of a disc protrude into the spinal canal, but the outer layers (the annulus) remain intact. The inside of the disc is expanding outward, but the outer layer has not burst.

As Dr. McCormick said: “Disc bulges… can contribute to narrowing and irritation of nerves. They occur along the perimeter of the disc and are typically smaller than herniations.”

But that doesn’t mean that a bulging disc isn’t still a problem worth paying attention to. The disc is still taking up space in the spinal canal that it shouldn’t, which can lead to nerve root compression and pain. 

Bulging Disc Symptoms

The symptoms of a bulging disc tend to be similar to those of a herniated disc (nerve irritation and muscle weakness, for example), but they are usually not as severe.

Regardless, it will be important, if you have any symptoms, to speak with a doctor who can identify the source of your symptoms and offer appropriate treatment.

Causes of a Bulging Disc

Degenerative disc disease is the most common cause of bulging discs, as is the case for herniated discs. Repetitive motions and lifting heavy objects can also cause a bulging disc. 

Herniated Discs vs. Bulging Discs: Key Differences

Clearly, herniated discs and bulging discs can be hard to distinguish at a glance. But they deserve to be treated like the separate phenomena they are. 

A vital difference between the two is whether or not the outer layer of tough cartilage is ruptured. A bulging disc doesn’t necessarily affect the entire perimeter of a disc. The inside cushion can make the disc protrude without breaking this barrier. But when a disc herniates, its outer layer forms a hole or tear. 

Another important distinction is the level of pain that results from the disc injury. Herniated discs are generally more likely to cause pain because they tend to protrude further and irritate nerve roots more often. The herniation itself may cause inflammation of the nerve root, further exacerbating negative symptoms.

What Herniated Discs and Bulging Discs Have in Common

Though herniated and bulging discs aren’t the same, they do have a lot in common. 

Herniated and Bulging Disc Risk Factors

Risk factors don’t guarantee you’ll experience a disc problem, but they can increase your chances. Some of the main risk factors for a herniated or bulging disc include the following:

  • Excess body weight, which can put extra stress on the discs in the lower back
  • Demanding physical labor like lifting, pulling, pushing, bending, etc.
  • Genetics lead some people to inherit a predisposition to developing herniated discs.
  • Smoking can cause discs to break down more quickly.
  • Frequent driving or being sedentary for long periods can put extra pressure on the spine.

Treatment for Herniated and Bulging Discs

While there are some differences between treatment for herniated discs and treatment for bulging discs, some of the general steps your healthcare provider might take include:

  • Helping you manage muscle pain, inflammation, and limited mobility with things like muscle relaxants or anti-inflammatory medications
  • Referring you to a physical therapist, who can help you use exercises to relieve pressure on nerves, loosen tight muscles, and promote better circulation
  • Administering a spinal injection, which is a shot of steroid medication that’s placed directly into the spine to reduce swelling and promote healing

In cases where a large disc problem injures vital nerves, like those to the bladder or bowel, or when other treatments fail, surgery may be considered. However, it’s only used as a treatment option in emergencies or as a final attempt to relieve pressure on nerves.

Again, remember that these treatments can only be carried out by a medical professional. This article is designed to be informative and not to replace the opinion or diagnosis of a licensed medical doctor.

Herniated and Bulging Disc Treatment at Long Island Brain and Spine

You deserve a neck and back pain specialist who deeply understands the spine and can offer a robust, effective treatment plan. You deserve the help of a compassionate and knowledgeable team like Long Island Brain and Spine.

No one should accept pain as part of life!

Dr. William E. McCormick is a board-certified, published neurosurgeon with an excellent reputation as a trustworthy and thorough doctor. 

Here is a review of his work from one of his patients:

“Dr. McCormick is an awesome doctor. I went to see him after many failed attempts at relief for herniated discs, sciatica, and back pain. 

He was caring and compassionate. He went over all the options with me and viewed surgery as the last option. Needless to say, I did have surgery with him, and I am happy to say that I can walk again, pain-free. 

Thank you, Dr. McCormick.”

  • Janette C. 

Professionals like Dr. McCormick can treat neck and back pain at Long Island Brain & Spine by using state-of-the-art technology to diagnose any issues and help get you on the road to recovery. Our years of experience allow us to develop a trusting and personalized relationship with our clients so they can get to the point where they no longer feel they need to accept pain as part of life.

Thank you!

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