For years, when describing my back issues, I mixed up the terms bulging disc with herniated disc and vice versa. It wasn’t until a neurosurgeon corrected me that I learned that though both conditions deal with disc impingements, each was a separate problem with separate solutions.
A human spine is made up of bones called vertebrae and rubbery discs that rest in between each vertebrae forming the spinal canal. The spinal cord (bundle of nerves) runs down the entire length of the spinal canal.
These spongey discs in your spine act like shock absorbers between the vertebrae, cushioning and protecting the vertebrae from colliding into each other. Each disc is made of the nucleus pulposus (softer center) surrounded by a sturdy elastic-like band (called annulus fibrosus).
With Bulging Discs (also referred to as slipped or protruding disc), often over time, the nucleus pulpous dehydrates causing it to balloon outward, in between spaces in the vertebrae and if it comes in contact with nerve bundles, can cause considerable pain. Common symptoms include tingling or pain in the fingers, hands, arms, neck or shoulders.
A Herniated Discs (also referred to as ruptured disc) results when there is a crack in the tough outer layer of cartilage which causes some of the softer inner cartilage to protrude out of the disk. As stated in Spine Journal research paper, “Herniated discs progress in stages, from prolapsed to protruding, then extruding, and finally sequestration, where the disc material is completely severed from the main disc structure”.
To diagnose whether a person is suffering from a disc bulge or disc herniation, along with a physical examination, a doctor will ask you about the history of your symptoms and how they progressed. In my case, my balance, gait, range of motion and dexterity was tested by pointing toes upward while the doctor pushed in the opposite direction, and other such tests,
Imaging such as X-rays will most likely be requested to check for signs of degenerative disc disease, and other changes in the disc spaces or facet joints. An MRI will be able to show if there are any structural issues impinging on spinal nerves. I also had an EMG done to check for nerve conductivity which again will provide the doctor with a fuller picture of the issue.
Dr. John Shim does a good job of explaining the differences between bulge discs and herniated discs in this video:
