Difference Between Herniated and Bulging Disc

Spinal disorders are more common in current medical practice. The two terms herniated disc and bulging disc may sound same, as the end results are of bit similar, but the disease process is different. This article points out the differences between these two terms which would be helpful for better understanding.

Herniated Disc

When the disc gets degenerated, the aging nucleus pulposus, which is the softer central portion of the disc, can rupture through the surrounding outer ring called annulus fibrosis. This abnormal rupture of the nucleus pulposus is called disc herniation.

The disc herniation can happen anywhere along the vertebral column, but the most common location is the lower lumbar region at the level between fourth and the fifth lumbar vertebrae.

Clinically the patient may presents with back pain accompanied with electrical shock like pain, tingling and numbness, muscle weakness, bladder and bowel problems depending on the location of the herniation.

Usually the diagnosis is made clinically, and MRI will be helpful in confirming the diagnosis.

Management of the patient depends on the severity of the symptoms experienced by the patient, physical examination findings and the investigation results.

Bulging Disc

In this condition, the nucleus pulposus remains contained within the annulus fibrosus, and it is not opened up. The disc may protrude into the spinal canal without opening and may be a precursor for herniation. The disc remains intact except for a small protrusion.

The causes are varying including trauma, genetic weakness in the wall of the disc and toxins.

Clinically the patient may presents with intense pain in case the spinal nerves located directly behind the spinal discs are compressed. Other symptoms can vary depending on the location of the lesion. Bulging discs in the cervical spine can cause neck pain, headache, hand pain, weakness and numbness. In the thoracic area, patient may presents with upper back pain radiating across the chest wall, difficulty in breathing and palpitations. In the lumbar region, patient may complain of lower back pain, bowel and bladder problems as well as sexual dysfunction. If the bladder and anal sphincter tone is affected, it becomes a neurological emergency.

Management includes analgesics, muscle relaxants, massage therapy, physiotherapy and in severe cases surgical options can be considered.


What is the difference between Herniated Disc and Bulging Disc?

• In herniated disc, nucleus pulposus ruptures through the annulus fibrosis, but in bulging disc, nucleus pulposus remains contained within the annulus fibrosus.

• Causes of herniation include constant sitting, lifting and trauma while causes of bulging disc are trauma, toxins and genetic weakness of the wall of the disc.

• Bulging disc may be a may be a precursor for herniation.