Your spine is made up of 24 vertebrae with soft discs between them that act as cushions, or shock absorbers. The discs themselves are made up of two parts: a tough outer layer that holds the disc together, and a gel-like interior that helps to soften the impact of walking, lifting, and other everyday activities.
Whether it’s due to an accident, overexertion, or just getting older, we put a lot of wear and tear on these discs and over time they can become damaged. This can cause a number of problems, but two of the most common are bulging or herniated discs, which just so happen to be the leading causes of back pain – especially in the lower back.
What’s the difference between a bulging disc and a herniated disc?
When it comes to these two very similar conditions, it’s a little confusing because people throw around terms around that may or may not mean the same thing. For instance, some people refer to a herniated disc as a “slipped” disc while others coin it a “ruptured” disc, even in medical circles, but they refer to the same condition.
However, the terms bulging disc and herniated disc actually mean two different things. So, let’s explore those differences.
A bulging disc is simply a swelling in the disc without a tear or rupture in the outer wall. It looks somewhat like a bubble sticking out between the vertebrae. Because the inner part of the disc is still contained, a bulging disc doesn’t usually press on the nerves and many people don’t even realize they have a problem.
How can you tell if you have a bulging disc? Common symptoms include:
- Pain and stiffness in the neck, upper back or lower back, depending on which part of the spine is affected
- Numbness, tingling in the extremities
- Muscle spasms, weakness
A bulging disc is usually the result of normal wear on the spine and the discs due to things like repetitive strain, routine heavy lifting, and age-related wear – after all, the discs are meant to act as buffers between the vertebrae.
A herniated disc, on the other hand, means the soft inner layer has “slipped” or “ruptured” through a crack or tear in the outer layer and into the space where the nerves are.
How can you tell if you have a herniated disc? Many people experience symptoms such as:
- Pain in the neck or back
- Pain that radiates down the buttocks and legs (sciatica)
- Tingling or burning sensation
You may experience some or all of these symptoms, and most people report these irritations in the arms, legs and feet.
With a herniated disc, the pain is usually caused by a pinched nerve. When the inner part of the disc gets into the space where the nerves are, it presses on the nerve, causing inflammation and irritation that leads to sharp, shooting pains that radiate to other parts of the body, such as from the low back down the leg or from the neck down the arm. Leg pain from a pinched nerve is commonly called sciatica.
Almost like adding insult to injury, the inner part of the disc also contains a chemical that can further irritate the nerves, and the tearing of the outer layer can cause fragments of tissue to get lodged in the spinal canal – all of which can lead to more inflammation and pain.
Pain can come from the actual disc itself if it dehydrates or wears out to the point that it causes instability in the spine (called degenerative disc disease). Degenerative disc pain is usually chronic, low-level pain around the disc with occasional episodes of more severe pain.
Will a bulging or herniated disc heal on its own?
“Overwhelmingly, disc herniations are able to be treated successfully with conservative modalities. Oftentimes, physical therapy, anti-inflammatory medications, nerve pain medication, a nerve root injection to sort of settle down the nerve inflammation, are all the body needs to help it heal on its own.”– Dr. Richard Hostin
In the majority of cases, both a bulging and herniated disc will heal with only conservative (nonsurgical) treatment, especially if you take things a little easier. That doesn’t mean be a couch potato – that can actually make things worse and prolong recovery time. The best way to help reduce swelling and ease pain is just to do low-intensity activity like walking.
The physicians at Southwest Scoliosis Institute usually start by recommending non-steroidal anti-inflammatory drugs (NSAIDs) to help relieve some of the inflammation and pain. They may also prescribe stronger medications like muscle relaxers to help with muscle spasms or other medication to relieve nerve pain. With more serious disc herniations, an epidural steroid injection might be needed to reduce inflammation in the disc and surrounding nerves.
Additionally, physical therapy and specific core exercises are key elements of most treatment plans, as they help strengthen the muscles that support and protect the spine.
Some other things you can try to help relieve pain from a herniated disc include:
- Heat/cold therapy (though heat should be avoided for the first 2-3 days)
- Soft tissue massage
- Stretching exercises like yoga or Pilates
How long does it take to heal from a bulging/herniated disc?
“For about 10-15% of patients, the body cannot heal on its own and they’re left with ongoing pain symptoms. The most common treatment in this situation is a microdiscectomy. This surgery is very quick – it takes about 45 minutes – and most patients leave the hospital the same day.”– Dr. Richard Hostin
Most (80-90%) cases involving bulging or herniated discs will heal within 2-4 months, depending on the severity of the injury, as well as your age and overall health. An important difference is that a herniated disc is a permanent injury that usually results in chronic, recurring pain, which is why exercises and activities to strengthen the supporting muscles are so essential.
In cases where the pain and other symptoms do not get better with conservative treatment within six weeks, our physicians may discuss surgical options with you. The most common surgeries to address a disc herniation include:
- Microdiscectomy. This is performed using minimally invasive techniques, and the surgeon removes part of all of the herniated section of disc. Recovery time is typically around six weeks.
- Spinal fusion. This surgery involves fusing two or more vertebrae together to reduce the movement between bones. This surgery is more common when the discs are damaged due to age-related wear. Recovery time usually ranges from 3-6 month, as the bones need to be allowed to fuse while they heal.
Evaluation and treatment for bulging or herniated disc at Southwest Scoliosis Institute
If you think you may have a bulging or herniated disc, it’s important that you are seen by a physician who specializes in providing comprehensive orthopedic care to properly diagnose and treat complex spine conditions.
Southwest Scoliosis Institute’s board-certified orthopedic surgeons, Dr. Richard Hostin, Dr. Ioannis Avramis and Dr. Shyam Kishan, have years of experience evaluating and treating patients with these kinds of conditions. They’ve treated more than 27,000 patients and performed more than 5,600 surgeries, and they can help you get back to living pain free.
If you are in pain and think you may have a bulging or herniated disc, we can help. Call us for an evaluation at (214) 308-0227 or visit our contact page today!