Often throughout my career I have been asked what is the difference between a herniated and a bulging disc. The way that I like to explain the difference is to compare the discs, or the cushions between the bones in your back, to jelly doughnuts (had one at the Y this morning after I finished my workout. One of the guys who comes in to the Y brought in some doughnuts to celebrate his return to health and I couldn’t resist replacing the calories I had just spent approximately an hour exercising off!). To get back to business, the annulus, or wall of the disc though much harder and much firmer, is like the dough of the doughnut. Inside the annulus, or wall of the disc, is a gel material, the nucleus of the disc, which, again, is much harder and much firmer than the jelly inside the disc. For numerous reasons, the wall of the disc develops a small tear and that tear grows and grows due to the strains associated with everyday life. Gradually, the nucleaus, the gel inside the disc, fills in the tear and such simple things as coughing or sneezing cause the tear to become bigger and thus more of the gel fills in the enlarged tear. Gradually, over a period of time, the tear works its way from the center to the outer edge of the wall of the disc and causes the outer wall of the disc to bulge, thus what is known as a bulging disc. Or, for comparison to the jelly doughnut, as long as the jelly in the doughnut is contained within the dough of the doughnut, but the outer part of the dough is stretched or distended, it is a bulging doughnut! When the gel breaks all of the way through the wall of the disc, or the jelly begins to leak outside of the doughnut, it is known as a herniated disc. Either way, a foreign material, either the wall of the disc or the nucleus (gel) of the disc, may enter into the opening where the nerve exits from the spinal cord, causing a pressure to be placed on the exiting nerve.
There are many effective treatments for both bulging and/or herniated discs, and the neuritis (neur = nerve and itis = inflammation or inflammation of the nerve) or neuralgia (algia = pain, nerve pain or pain in the nerve) associated with the bulging or herniated disc. Treatments range from conservative care all the way to surgery. That will be the topic of another blog, but as a chiropractor I would encourage anyone to try conservative care before resorting to surgical intervention. I will just mention here that through the more than thirty years that I have been in practice we have had a very high success rate with the conservative care that we provide in our office. We now use the most incredible technology that I have seen for the treatment of lower back (lumbar spine) herniations, that being spinal decompression with the DRX9000. I have available for viewing pre and post MRI’s of one of our patients who was treated with the DRX9000 and the associated reports from Fort Hamilton Hospital which show the largest herniation I have seen in my years of practice on the pre spinal decompression treatment with the DRX9000 and show the herniation being essentially gone on the post MRI. I also have the patient’s permission to show his MRI’s to anyone who would like to see them. But, as I said, that is the topic for another blog.