The Difference Between a Disc Bulge and a Disc Herniation

Do you know the difference between a bulging and herniated disc? We explain these two common back problems and identify possible causes.

Back and neck pain can be a result of a vertebral disc injury. Chiropractor Dr Greg Sher compares these two common injuries:

Disc Bulge:
In the case of a bulging disc (also called a disc protrusion), the tough outer fibrous layers of the disc, called the annulus fibrosus, have a weak spot. The inner contents of the disc (a gelatinous protein substance called the nucleus pulposus), puts pressure against this weak spot, eventually causing an outwards bulge in the disc. The bulge itself may be asymptomatic or painful. If the bulge presses against an adjacent nerve, the nerve will become irritated and inflamed. This may result in pain or dysfunction in other areas of the body, depending upon which nerve is affected and what structures it innervates (supplies).

Disc Herniation:
In the case of a herniated disc, the tough outer fibrous layers of the vertebral disc may have a tear. This tear permits the inner gelatinous contents to push through the outer fibres, beyond the disc wall. As with a bulge, there are a number of possible symptoms if the protrusion presses against adjacent nerves. This may include severe pain, numbness, tingling, burning, radiculitis (pain down a limb) and even weakness. This is likely to be more painful than a bulge because the inner gelatinous content, not normally located outside of the disc, is detected as a foreign substance by the nervous system, which causes a cascade of inflammatory responses.

Cause of Disc Bulge or Herniation

Vertebral discs have three main purposes:

  1. To keep each pair of vertebrae separate
  2. Allow for movement in all planes including flexion, extension and rotation
  3. Shock absorption of pressure from compression and torsion

A disc bulge or herniation can be caused by a traumatic injury or accident that causes extreme pressure on the fibrous disc layers, from sports or heavy lifting while rotating, or from natural degeneration that comes with age.

Disc injuries such as these should be managed by a qualified healthcare professional. To book in with our osteopathy, Dr Phil Austin, contact our Elevate Sydney CBD Clinic on 02 9252 2225 or book online here.

Adapted from Sydney Spine website and written by Dr Greg Sher.

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