Disc Bulge vs. Disc Herniation
Low Back Disc Pain
I sometimes hear people compare back pains, and it seems like everyone who has felt pain before is an expert on everybody’s pain. I am here to tell you that not all back pains are created equal. Mechanical back pain is simply not as severe as disc pain. Mechanical back pain is for another day, because I want to focus on the discs.
Discs, also known as intervertebral discs, are shock-absorbing cusions made up of thick cartilage and a gel-like nucleus. They are sandwiched between the bones in your spine. It helps to think about them like jelly donuts. First of all, jelly donuts are awesome! Secondly, it helps you visual learners that are already bored with words like “mechanical” and “intervertebral.”
In your spine are 6 cervical discs (neck, C2-C7), 12 thoracic discs (mid-back, T1-12), and 5 lumbar discs (low back, L1-L5). They are named by either the bone above the disc or by both bones that the disc sits between. For example, the L4 disc can also be called the L4/L5 disc.
Disc Bulge
Each disc has a normal round shape and height, and the circumference of the disc should be the same as the bone above and below. By definition, a disc bulge is when half or more of the disc is “bulging” out beyond the margins of the bones. This occurs from normal wear and tear, is very common in the lower neck and lower back, and in many cases, does not even cause symptoms.
Disc Herniation
A disc herniation occurs when some of the nucleus (jelly) moves towards the outer edge of the cartilage (donut) and causes a protrusion of less than half the disc. These are a much bigger problem, despite many of these also being asymptomatic. In some cases, when a person comes to my office with this condition, they have extreme muscle spasms, difficulty bending over, dressing, getting up and down, etc. In more serious cases, pain, numbness, and/or tingling may be felt in the legs and feet (or arms and hands if the problem is in the neck).
A disc herniation can be further classified as a protrusion-type (jelly still in the donut), extrusion (jelly is sticking out of the donut), or sequestration (jelly has left the donut entirely).
For a little more clarification, please see my quick video HERE.
What to do if you have Disc Injuries in the Spine
As a chiropractor, I know that I can guide a patient through these conditions very effectively. Disc bulging responds well to treatment, and chiropractic and laser therapy are part of a very good management strategy as you try to avoid the dreaded herniation. A large majority of protrusion-type disc herniations resolve without surgery, but certainly require more treatment and time. Extrusions and sequestrations almost always require a referral out for epidural injections, and/or neurosurgical consultation.
If you suspect a disc problem, or if you already have your MRI report, hopefully this info is easy to follow and helpful. Once you know what is happening, the next step is to take some action.
Pain is garbage, so get checked, get a plan, and get on with a better life.
Here for you always,