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What is the difference between a bulging disc and a herniated disc?

Updated: Sep 2

Written by Eduardo Velasco Valido, AP, LAc, EAMP


This post will teach you about the most common spinal column injuries and the best treatments for returning to everyday life.


Disc Herniation vs. Bulge; first, let’s understand what a disc is:

Anatomy Of A Spinal Disc


herniated disc

Your spine is made up of 24 bones, called vertebrae, that are stacked with one vertebra on top of the other. These bones connect to create a canal (spinal canal) that protects the spinal cord.

Inside the spinal canal, there is the spinal cord that connects the brain with the muscles and organs.

Between each of your vertebrae are flexible intervertebral discs. These work by absorbing shock when you walk or run.





Causes of Herniated Disk or Bulging Disk


Over time, the discs dehydrate, and their cartilage hardens.

These changes can cause the disc's outer layer to bulge, and depending on where the bulge is; you would have pain or not. It would be painful if it were pressing on a nerve.

A herniated disc occurs when a crack in the tough outer layer of cartilage allows some softer inner cartilage to protrude from the disk.

It is one of the most common causes of low back pain and leg pain (sciatica).

Between 60% and 80% of people suffer from low back pain at some point. A high percentage of people have lower back pain and leg pain caused by a herniated disc.

Compared to a bulging disc, a herniated disc is more likely to cause pain because it usually protrudes more and is more likely to irritate nerve roots.

But not all patients will experience pain as a disc degenerates. It remains a considerable challenge for the clinician to determine if a worn-out disc is the source of a patient's pain.


In Chinese Medicine, there are a lot more reasons that may produce a disk herniation or bulge. To simplify, we may say that every time a joint degenerates, it’s because there is a lack of blood flow in the area, the tissue is not receiving the proper nutrition and is not eliminating toxins, that is why it degenerates and depending on each individual, it would do it in a way or other.

Herniated disc symptoms

  • Back pain

  • Neck pain

  • Leg and/or foot pain (sciatica)

  • Numbness or tingling sensation in the leg and/or foot

  • Weakness in the leg and/or foot

  • Nerve compression, sciatica.

  • Loss of bladder or bowel control (infrequent). This could indicate a more severe problem called Cauda Equina syndrome. This condition is caused by spinal nerve root compression, producing a spinal injury. It requires immediate medical attention.


Back pain

Symptoms of bulging discs:

It can be the same as a herniated disk but is usually less severe.

Diagnosis of bulging or herniated disc


Your doctor will ask you different questions to gather information about your medical history and perform a physical examination.

This examination will check if you have muscle weakness or a neurological problem.

An MRI may confirm the diagnosis of a herniated disc.



In our clinic, we can see structural damage in your back by checking your pulse; our training and skills allow us, with a high rate of success, to see if your back pain comes from muscle tension or damage in your disk or vertebra.


Herniated and Bulging disc risk factors

  • Gender; Men between 30 and 50 have more probability of having disc problems. Probably because they often perform more physically demanding jobs.

  • Improper lifting of a heavyweight in the wrong way. If you use your muscles in your back instead of your legs, it may help create disk problems using your muscles in your back instead of your legumes.

lifting weight

  • Twisting your body while you lift a heavy object makes your back more vulnerable.

  • Repetitive activities that overload the spine.

  • Age-related degeneration

  • Sitting, staying seated for long periods, and damage to the back.

sedentary life style

  • Sedentary lifestyle; regular exercise helps prevent many medical conditions, bulge or herniated disk included.

  • Smoking; reduces the amount of oxygen that nourishes the disks and accelerates the degeneration of the tissues.




With the help of the knowledge of TCM, we know that nutrition and lifestyle play a massive role in the formation of disk herniations or disk pathologies.

We are more complicated than a machine, and everything is connected within us; eating the wrong food, poor rest, wrong repetitive emotions, and unbalance in our internal organs may easily produce these back pathologies.

Preventions for bulging or herniated discs:


Living a healthy life, eating a balanced diet, and having an active lifestyle are excellent ways to prevent these problems and can excellenttherexcellent their health issues. But it is not always possible to prevent it; life is complicated and seems to be getting increasingly complicated as we evolve as a society. We are developing, eating worse food, and having unhealthier lifestyles.



Chinese Medicine offers a great way to cure and prevent many different diseases; taking the right herbal formula for you would avoid imbalances in your body which otherwise could create any herniated or bulging disc.

When should I look for help?




Before 5-6 months of suffering severe pain and limitations, especially if you have been trying massage and or under-the-counter pain medication is time to visit an excellent professional because you may have a disc injury, and the problem will more likely keep increasing.

We suggest you visit a good herbalist or acupuncturist when you have pain.

Back pain




Which is the Best Treatment for bulging or herniated disc:


Chinese Medicine



It should be the first option because, when appropriately applied, it offers the best results and almost no side effects. And also, it probably has the best cost-effect ratio.

The best and fastest results are achieved with Acupuncture, Chinese Herbs, and Nutrition. If Acupuncture is unavailable, Chinese Herbs and the proper Nutrition can produce the same beautiful results; it just would take a lite more time to have the desired effects.

We offer an individualized treatment plan for every patient, which is why we have great results.

Within a few weeks, the patient should feel a considerable release of their pain.

The advantage of Traditional Chinese Medicine is that we treat the root of the problem, so not only can we address the origin of the condition, also it is very effective in preventing new pathologies.

Non-surgical treatment

Unless there are neurological deficits - muscle weakness, difficulty walking - or a Cauda Equina syndrome, the first course of treatment is conservative care.

As it is not clear that surgical treatment is a good option, it is better to try any other option before going under the knife.

Learning pain management may make a big difference in your daily life; one of the best ways is Acupuncture, which usually reduces pain considerably and makes life way easier.



Standard non-surgical measures include:

- Rest:

Generally, 1-2 days of rest can reduce acute pain. During this time, avoid lifting heavy objects. But it’s not good to bed rest for long periods. Avoid being seating for a long time. Make slow movements and be conscious every moment avoiding activities that aggravate the pain.

- Anti-inflammatory medication:

Ibuprofeno or Naproxen may reduce the pain. Hundreds of herbal formulas also work very efficiently with fewer gastrointestinal side effects.

- Physical Therapy:

Some exercises may strengthen your lumbar and tonify your abdomen, stabilizing your back and reducing inflammation and pain.

- Epidural steroid injection:

This uses steroids to reduce inflammation. In some acute situations might be very beneficial.

steroid injection

But not always solve the problem and may produce side effects:

- Localized increase in pain

- Anxiety

- Insomnia

- High blood sugar

- A decrease in immunity due to the suppressive effect of steroids


Surgery


surgery

Only a small percentage of patients with lumbar disc herniation require surgery. Spine surgery is typically recommended only after a period of nonsurgical treatment has failed to relieve painful symptoms.

Microdiscectomy; is the most common surgery for herniated discs in the lumbar area. It consists of the surgical removal of the herniated disc or any fragment that produces pressure on the nerves.


Risk of Surgery

When you need it can save your life, but it should be the last solution to try due to the risks and possible side effects of the surgery:

  • Bad reaction to anesthesia.

  • Infections.

  • Blood clots.

  • Heart attack.

  • Stroke.

  • Nerve damage; may produce weakness, paralysis, pain, sexual dysfunction, or loss of bowel or bladder control.

Patients choose surgery to get rid of their pain, but it does not always allow them to get back to normal physical activities, nor does it always work to resolve the pain.


Can disc injuries get worst after surgery?


There are cases where the pain may become worse. Any surgery is always a significant trauma. The procedure removes a “herniated or bulging disc,” but in the process, the surgeons had to cut through layers of tissue to get to that disc that your body now also has to heal and quickly could end up giving you new issues.

In a spinal fusion, the surgeon screws plates alongside your spine to limit movement in that area. But the spine is designed to move together. Restricting the action in one place increases the stress in the neighboring areas and often becomes painful, and you will likely need to get another fusion in the future.


Western medicine often offers necessary solutions, but they may have significant side effects. We recommend trying the first effective non-invasive natural treatments like Traditional Chinese Medicine.