If you’re an athlete or someone who enjoys staying active, then you know that pain is just a part of the game. And while aches and pains are bound to occur every once in a while, if you’re experiencing back pain regularly, then it’s time to take action. In this blog post, we’ll take a closer look at bulging discs and herniated discs – two common causes of back pain – and offer some advice on how to manage them. Let’s get started!
We often get this question a lot: What is the difference between a bulging disc, a herniated disc, to a slipped disc?
There are a lot of words that people use to describe problems with their back, and that can sometimes lead to confusion. The reality is that slipped disc is not necessarily a disc that’s slipping off. It’s the structures around the disc that does. But over time, what that can do is change the integrity of the disc.
This can make it so that the tissues can cause bones to slip over time. People misinterpret it as that they’re bending forward and their disk just kind of slips out the back (“slipped” discs). That is not exactly how your spine works and we’re not that frail, fortunately.
The difference between a bulge versus a herniation
Think of an inflated balloon that is being held between your hands. Imagine it as a somewhat reasonable, healthy disc. The function of a disc is to cushion everything. Our spine is shaped like an S so that it shock absorbs all the weight it has to carry. It acts like one big spring motioning up and down. It’s the discs in between the structures that give it cushioning.
Every disc in our body is made of rings. Rings grow outwards from a core. This is similar to how our nails grow out, with the living part of our nails (the nail bed) putting out connective tissue. Spinal discs work in the same way – there is a core that is alive and constantly putting out layers of connective tissue, which creates these rings. These rings allow for bounciness in the disc.
Now, if a disc is injured or if something happens where you get a rift in that disc, all of a sudden, you get a herniation where one part of the disc is weaker than the rest.
A healthy disc is resilient. A bulging disc is a disc that’s bulging around the edges. It would be very similar to the visual of belly fats. Indeed, it’s not a healthy construction. A bulging disc is one in which its capacity for being a nice shock absorber is limited. In the long run, it starts to sort of compress and bulge in every direction.
Bulges and herniations are both types of injuries. With a bulge, it seems like most of the tissue is still there but it’s not very strong. With a herniation, there is a small spot that seems to have taken the most damage. Essentially, a bulge is just a general weakening of the disc. Whereas a herniation is a focused weakening of that disc.
Both can be asymptomatic, meaning there is minimal to no problem at all. Or either one of them can be painful depending on what else is going on that’s causing that bulging or herniated disc.
How can we tell if we have a bulging or herniated disc?
Usually, we at Wellward tell our patients that a bulging disc is nothing to get worried about. However, it can give us a clue as to what can be an underlying cause of pain. Typically, the bulge itself may not be painful. However, if the bony endplates on both sides of the disc have developed fractures or have been injured, then it can become more and more problematic as you age. In general, the bulges can be normal, age-appropriate changes that we see in almost everyone.
There was a study that looked at MRI findings in normal individuals. These people were not symptomatic of any kind of pain, and almost 90% of patients had some kind of problematic finding: whether it was a bulge or herniation, or degeneration. And yet these are people who are walking and talking as if nothing is going on in their spines.
The same goes with a lot of degenerative changes that we get panicked about. More often than not, they’re normal, age-appropriate changes that may or may not be problematic. For instance, the case of rotator cuff injuries. There was one statistic that said: “Your age is about the same probability as having a rotator cuff tear.”
This means that every 80-year-old that you look at doesn’t go around getting rotator cuff surgery. It’s the ones that are symptomatic from it that can have surgery or some of the surgical alternatives available.
A person with bulging discs may not know it, but there are ways to find out.
A good rule of thumb is if you’re hurting, then, let us check it out. This way we can make sure this is nothing serious. If it is, it’s something that we can get ahead of before it becomes more problematic. Pain is our body’s only way of communicating damage to us.
It’s the way that it communicates injuries that need attention. Chronic injuries, no matter how small they seem, can be a good opportunity to improve how that part of your body works. This will help stop the injury from getting worse in the future.
Early intervention is prevention. An ounce of prevention is worth a pound of cure
What’s next after finding out exactly that there is a bulged disc? Is it surgery?
A lot of people panic when they see their radiologic findings on an MRI showing bulging disc, disc degeneration, or stenosis. And in a lot of people’s minds, this Is an indication it needs surgery. That’s not the case.
A vast majority of spinal problems can be addressed without surgery. It’s only a small minority that requires surgery. What we do for a bulging disc is figure out why is that disc showing signs of degeneration, whereas the other ones are not. Typically, it’s because the ligament capsule around that disc (the annulus) has been injured. Or perhaps, the ligaments that support the bony structure around that disc have been damaged.
Either way, going through the process of pain mapping, we can pinpoint exactly what’s wrong and make some alterations. Through the pain mapping method, we can get you on a path to either repairing it with exercise or using injections. If those don’t work out for some reason then there are more sophisticated regenerative procedures like stem cell differentiation that might provide help in this area of your body’s tissues.
Our successful patients are the ones that are using all of those methods. The reason is that when they start to exercise, they built up some resiliency. When we know exactly where the tissue is injured, that helps to make sure every intervention is focal and confident in the right direction. The orthobiologics do the trick.
Not every patient receives the “Cadillac” of all treatments. A lot of patients can get by with less. Although, when the condition is something that’s been going on for a long time, or if you want to accelerate the repair process, then certainly those orthobiologics help move things along. You wouldn’t get the same outcome though, without the rehab and the exercise.
You’d be surprised at how many people think they’re exercising correctly and yet they’re doing everything to cause harm to their lower back. With their best intentions, they’re doing it every day, but it’s getting worse for some reason.
As you can see, bulging discs, herniated discs, and “slipped” discs are all terms used to describe a wide range of spinal issues. While they may be alarming at first, know that our team is here to help you through your pain management journey. We offer free discovery calls so that we can learn more about your specific condition and develop the best treatment plan for you. Don’t suffer from debilitating pain any longer! Contact us today to schedule your free call and start feeling better tomorrow.
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DISCLAIMER: The information in this email is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. All content is for general informational purposes only and does not replace a consultation with your own doctor/health professional
