If you've had an MRI of your spine, you may have seen terms such as disc bulge, disc protrusion, or disc herniation in the report. These findings are common, but understanding what they actually mean—and whether they're responsible for your symptoms—can be confusing.
A bulging disc and a herniated disc both involve changes to the intervertebral discs of the spine, but they aren't exactly the same thing.
At Northwood Chiropractic & Wellness in Maple Grove, MN, we evaluate patients with back pain, neck pain, sciatica, numbness, tingling, and other symptoms that may be associated with spinal disc conditions.
What Is a Spinal Disc?
Intervertebral discs sit between the vertebrae of your spine. They help absorb forces, provide cushioning, and allow the spine to move.
Each disc consists of a tougher outer portion called the annulus fibrosus surrounding a softer inner portion called the nucleus pulposus.
Over time—or sometimes following an injury—the structure and shape of a disc can change.
Two findings you may encounter on an MRI are a disc bulge and a disc herniation.
What Is a Bulging Disc?
A bulging disc occurs when part of the disc extends beyond its normal boundary.
Rather than disc material pushing through one small, localized area, a disc bulge generally involves a broader portion of the disc.
A bulging disc doesn't necessarily cause pain.
Many people have disc bulges or other degenerative changes visible on imaging without experiencing significant symptoms. Whether a disc is clinically important depends on factors such as its location, the structures it affects, and whether the imaging findings correspond with the patient's symptoms and examination.
What Is a Herniated Disc?
A herniated disc involves a more localized displacement of disc material.
Depending on the location and direction of the herniation, the displaced disc material may irritate or compress a nearby spinal nerve.
When that happens in the lumbar spine, symptoms can include low back pain, pain traveling into the buttock or leg, numbness, tingling, or muscle weakness.
A lumbar disc herniation affecting a nerve root is also one potential cause of sciatica.
Herniated discs can also occur in the cervical spine, where they may cause neck pain or symptoms that travel into the shoulder, arm, or hand.
Bulging Disc vs. Herniated Disc: What's the Difference?
The main difference involves how the disc material extends beyond its normal boundary.
A bulging disc typically involves a broader portion of the disc extending outward.
A herniated disc generally involves a more localized area of displaced disc material.
However, the terminology on an MRI is only part of the picture.
A larger abnormality doesn't automatically mean more pain, and a smaller disc problem isn't automatically insignificant. The location of the disc abnormality and whether it affects a nearby nerve can be more important than simply how dramatic the MRI report sounds.
Can a Bulging Disc Cause Pain?
Yes, but not every bulging disc is painful.
A disc bulge may become clinically important if it contributes to narrowing around a spinal nerve or affects other pain-sensitive structures.
Depending on the location, symptoms may include:
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Low back or neck pain
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Pain traveling into an arm or leg
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Numbness or tingling
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Burning or electrical sensations
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Muscle weakness
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Symptoms that change with certain movements or positions
Because these symptoms can have several possible causes, an examination is important before assuming that a disc bulge seen on an MRI is responsible for the pain.
Can a Herniated Disc Cause Sciatica?
Yes.
If a lumbar disc herniation irritates or compresses one of the nerve roots that contributes to the sciatic nerve, pain may travel from the lower back or buttock into the leg.
Some people also experience numbness, tingling, burning, or weakness.
Where the symptoms occur can provide useful information about which nerve may be involved.
Does a Bulging or Herniated Disc Heal?
Symptoms associated with disc problems can improve considerably with time and appropriate conservative care.
The goal isn't necessarily to make an MRI look normal. Instead, treatment focuses on improving symptoms, movement, strength, function, and the patient's ability to return to normal activities.
The appropriate treatment depends on the patient's symptoms, examination findings, neurological status, overall health, and imaging findings when imaging is necessary.
How Are Disc Problems Diagnosed?
Diagnosing a disc-related condition involves more than simply reading an MRI report.
An evaluation may include assessment of:
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Pain location
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Range of motion
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Muscle strength
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Reflexes
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Sensation
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Orthopedic testing
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Neurological findings
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Positions or movements that reproduce symptoms
Imaging such as MRI may be appropriate when symptoms or examination findings indicate that additional information is needed.
The goal is to determine whether the imaging findings actually correspond with what the patient is experiencing.
Can Chiropractic Care Help With a Bulging or Herniated Disc?
Some patients with disc-related conditions may be candidates for conservative chiropractic care.
Treatment should be individualized rather than based solely on the terminology used in an MRI report.
At Northwood Chiropractic & Wellness, we evaluate the patient's symptoms, examination findings, neurological status, and available imaging before determining whether conservative treatment is appropriate.
Depending on the condition, care may incorporate chiropractic treatment, therapeutic exercise, mobility work, manual therapy, and other conservative approaches.
Some appropriately selected patients may also be candidates for non-surgical spinal decompression.
What Is Non-Surgical Spinal Decompression?
Non-surgical spinal decompression uses a specialized table to apply controlled traction to the spine.
It may be incorporated into a conservative treatment plan for appropriately selected patients with certain disc-related conditions.
Spinal decompression isn't appropriate for every patient with a bulging or herniated disc. A proper examination is important to determine whether it is an appropriate treatment option.
When Should You Seek Immediate Medical Attention?
Most disc problems aren't medical emergencies.
However, seek immediate medical attention if back pain is accompanied by significant or rapidly worsening muscle weakness, loss of bowel or bladder control, or numbness involving the groin or saddle region.
These symptoms can indicate serious neurological compression and require urgent medical evaluation.
Bulging Disc and Herniated Disc Treatment in Maple Grove, MN
If you've been told that you have a bulging or herniated disc—or you're experiencing back pain, sciatica, numbness, tingling, or pain traveling into your leg—the MRI finding is only one part of determining what's causing your symptoms.
At Northwood Chiropractic & Wellness in Maple Grove, Minnesota, we evaluate spinal and musculoskeletal conditions to determine whether conservative treatment is appropriate.
Depending on your condition, treatment may include chiropractic care, therapeutic exercise, manual therapy, and non-surgical spinal decompression.
If you're experiencing symptoms that may be related to a spinal disc problem, schedule an evaluation to determine what's causing your symptoms and what treatment options may be appropriate.
Dr. Greg Beenken
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