Herniated or bulging discs
Defining Herniated or Bulging discs
A herniated disc and a bulging disc are the same on some levels and completely different on other levels.
A bulging disc is an inflamed disc and has a broader based outward expansion from its normal state. As the swollen fibers push outward, contact with nerves, the spinal cord, or bony structures occurs. As the inflammation spreads, the pain begins to encompass more tissues and nerves, transmitting more pain signals to the brain.
A herniation is more of a rupture that goes through the outer disc material and allows the nucleus of the disc to extrude outside of the disc margins. We see similarities between the two types of pain, though the compressed tissue makes a difference. The degree of inflammation plays a role in pain also. Herniation is a worse scenario to treat due to the openness of the disc nucleus to the outside. 35% of men and 45% of women having this pain at some point in their lifetime.
Causes of Herniation
These disc events happen most often with repetitive flexion stresses to the lower back or lower neck. One study (Adams & Hutton et al, Spine 1982) suggests that 28,000 repetitions of flexion are required to herniate a disc. If there is compression on the disc with flexion, fewer cycles are required to herniate a disc. Bending forward at the waist over a life time can cause this bulging or herniation. Most recently, we have been seeing an increasing problem with neck discs bulging due to working on screens for a long time.
There are different types of herniations. The worst being the sequestered disc herniation. In this case the nucleus material pushes out, breaks away from the disc, and becomes a free floating mass. This mass is near the spinal canal and the only solution is surgical removal of the disc fragment.
The most frequent type of herniation has the nucleus material remaining attached to the disc. If we can take the pressure off the disc, the nucleus will draw back into its normal position. During this process we have to keep the inflammation down so healing can take place.
Disc pain is characterized as a pain that radiates from the lower back into the leg. Disc pain from the neck radiates into the arm, or can go down the spine. A disc can be painful in and of itself. It will feel like a deep localized sharp pain which is more intense in flexion and relieved by extension.
This is a simplified look at disc herniation. The only true way to determine disc herniation is via advanced imaging techniques like MRI. Your chiropractic doctor works with these conditions and will be able to help you determine the next course of action.