Herniated discs vs. Bulging discs

Herniated discs vs. bulging discs

What’s the difference, and does it matter?

Technically, there is a difference. The American Society of Neuroradiologists has published strict definitions of a variety of terms in order to provide uniformity among medical specialists in their use of nomenclature, including the definitions of herniated discs and bulging discs. And, now, many doctors do abide by these strict definitions, if they have read them. But from a clinical standpoint, it doesn’t matter much which term you use. Each can still be a source of pain. It is probably true that herniations are more likely to be a source of pain, and of persisting pain, and probably are more likely to necessitate eventual surgery.

Herniated discs vs. bulging discs

And you can have discs that have both of these lesions present at the same time. Sometimes you’ll have a broad disc bulge, and part of that bulge will stick out further with a herniation. That doesn’t necessarily make it a worse problem. In fact, sometimes the bigger the disc herniation, the more likely it is that your body will absorb the disc and you’ll get better. But none of this appearance of your disc is a reliable predictor of your outcome. So we just have to do the safest treatments and see how you respond to treatment and let that be our guide.

In my experience, the most effective and safest way to treat disc herniations is to use spinal decompression mackines for treatment. This involves placing someone on the table, securing their anatomy to the table, and gently tractioning them apart to get pressure off of the disc, joint and nerve, if it’s pinched. This works very effectively for both neck and back problems. Usually effective treatment will require some number of sessions, but in comparison to other non-surgical treatments, it works pretty fast, and it is much more effective for more people than all the other treatments I’ve used in my 35 years of practice, including orthopedics, physical medicine, physical therapy and neurosurgery. Now, I send fewer than 5% of patients for pain managment injections or surgery.