What is the Difference Between Disc Bulge and Herniation

Disc bulge and herniation are two different medical conditions that affect the spinal disc. Spinal disc is a gel-filled disc that acts like a shock absorber. It is located between each of the bones in the spine. However, disc bulge and herniation may have similar symptoms.

The key difference between disc bulge and herniation is their cause. In disc bulge, the outer layer of a spinal disc extends beyond its usual boundaries without the jelly-like interior protruding into the spinal cord, while in herniation, the tough outer layer of the spinal disc has completely ruptured, and the jelly-like interior is protruding into the spinal cord.

CONTENTS

1. Overview and Key Difference
2. What is a Disc Bulge 
3. What is Herniation
4. Similarities – Disc Bulge and Herniation
5. Disc Bulge vs Herniation in Tabular Form
6. Summary – Disc Bulge vs Herniation
7. FAQ –  Disc Bulge and Herniation

What is a Disc Bulge?

Disc bulge or bulging disc is a medical condition in which the inner portion of the intervertebral disc begins to protrude from the outer wall of the disc. However, in this condition, the tough outer layer of the spinal disc is not completely ruptured, and the jelly-like interior is not protruding into the spinal cord.  A bulging disc can often be a precursor to a herniated disc. Approximately 90% of bulging disc cases are found in the lower back. The most common locations are between the lumbar vertebrae L4 and L5, and between L5 and the sacrum (S1).

Common causes of a disc bulge include trauma, genetics, poor posture, repetitive motions, poor lifting techniques, and contact sports. Moreover, the symptoms of this condition may include pain radiating down from the neck to the upper extremities, pain in the upper back that radiates to the stomach and chest, and pain in the hips, legs, buttocks, and feet.

Disc bulges can be diagnosed through family medical history, physical examination, neurological examination, and imaging tests. Furthermore, treatment options for disc bulges include resting, taking pain medications, steroid injections, physical therapy, and surgeries.

What is Herniation?

Herniation or herniated disc is a condition characterized by a partial rupture/complete collapse of the outer wall of the intervertebral disc, with the gel-like material inside the disc spilling out to the spinal cord. The spilling of gel-like material causes pressure on the spinal cord or spinal nerves. A herniated disc often affects one side of the body and have symptoms such as arm or leg pain, radiating numbness or tingling in body parts served by the affected nerves, weakened muscles served by the affected nerves, and poor movements.  Most often, this condition is a result of disk degeneration. It may also be caused by lifting heavy objects and twisting and turning while lifting.

Herniation can be diagnosed through physical examination, imaging tests, and nerve tests. Furthermore, treatment options for herniation may include taking non-prescription pain medications, muscle relaxers, opioids, corticosteroid injections, physical therapy, and surgeries.

Similarities Between Disc Bulge and Herniation

1. Disc bulge and herniation both affect spinal discs.
2. Disc bulge can lead to herniation.
3. Both can be caused by physical trauma.
4. Both may have similar symptoms, such as pain, tingling, and weakness in the affected region.
5. They can be treated through taking pain medications, steroid injections, physical therapy, and surgeries.

Difference Between Disc Bulge and Herniation

Definition

1. A disc bulge is a condition where the spinal disc is not broken, meaning the outer wall of the intervertebral disc remains intact but bulged.
2. Herniation is a condition where there is a partial rupture or complete collapse of the outer wall of the intervertebral disc, and the gel-like material inside the disc spills out to the spinal cord.

Severity

1. Disc bulge is a minor condition.
2. Herniation is a severe condition.

Causes

1. A disc bulge can be caused by trauma, genetics, poor posture, repetitive motions, poor lifting techniques, and contact sports.
2. Herniation can be caused by gradual, aging-related wear and tear, lifting heavy objects, and twisting and turning while lifting.

Symptoms

1. The symptoms of disc bulge are neck or back pain, with tingling, numbness, or weakness in the arms, hands, legs, or feet.
2. The symptoms of herniation are pain on one side of the body, sharp pain in one part of the leg, hip, or buttocks, numbness in other parts, pain when moving the neck, or deep pain near the shoulder blade.

Diagnosis

1. Disc bulges can be diagnosed through family medical history, physical examination, neurological examination, X-ray, CT scan, MRI, myelogram, and electromyography.
2. A herniated disc can be diagnosed through physical examination, Electromyography (EMG), nerve conduction velocity test, spine MRI or spine CT, and spine X-ray.

Treatment

1. Treatment options for disc bulges include resting, taking anti-inflammatory medicines, steroid injections, physical therapy, and surgery.
2. Treatment options for herniation include taking non-prescription pain medication, neuropathic drugs, muscle relaxers, opioids, cortisone injections, physical therapy, and surgery.

The following table summarizes the difference between disc bulge and herniation.

Summary – Disc Bulge vs Herniation

The spinal disc is an important part of the spine. The spinal disc is a cushion of fibrocartilage, and it is the principal joint between two vertebrae in the spinal column. Disc bulge and herniation both affect spinal discs. However, in disc bulge, the spinal disc is not broken, meaning the outer wall of the intervertebral disc remains intact, but the outer wall is bulged, whereas, in herniation, there is a partial rupture or complete collapse of the outer wall of the intervertebral disc and the spilling of the gel-like material inside the disc to the spinal cord causing pressure on the spinal cord or spinal nerves. This summarizes the difference between disc bulge and herniation.

FAQ: Disc Bulge and Herniation

1. Is disc bulge serious?

• A disc bulge can often lead to more serious conditions, such as herniation if left untreated. The moment you start experiencing symptoms, it is best to consult a doctor immediately.

2. What causes a disc bulge?

• A disc bulge can be caused by aging, traumatic injuries such as falls, performing repetitive bending or twisting motions, improper lifting of heavy objects, and participating in contact sports.

3. How does one fix a disc bulge?

• Treatment for a disc bulge includes taking nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, physical therapy, undergoing chiropractic, massage, ultrasound therapy, applying heat or cold, taking limited bed rest, using braces and support devices, and surgery.

4. How does a herniation or herniated disk feel?

• The pain in herniation might shoot into the arm or leg when people cough, sneeze, or move into certain positions. This pain is also often described as sharp or burning. People who have herniated disks often experience radiating numbness or tingling in body parts served by the affected nerves, too.

5. What is the most common treatment for herniated discs?

• For non-emergency cases, herniated disk surgery is an option when other treatments don’t work. However, the other treatment options for herniation include taking non-prescription pain medication, neuropathic drugs, muscle relaxers, opioids, cortisone injections, and physical therapy.

Reference:

1. “Bulging Disk in Back.” Medical News Today, MediLexicon International.
2. “Herniated Disk.” Mayo Clinic, Mayo Foundation for Medical Education and Research.

Image Courtesy:

1. “Lumbar Disc Lesions Classification” By Harrygouvas at English Wikipedia (CC BY-SA 3.0) via Commons Wikimedia
2. “Blausen 0484 HerniatedLumbarDisc” By Blausen.com staff (2014). “Medical gallery of Blausen Medical 2014”. WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436. – Own work (CC BY 3.0) via Commons Wikimedia

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