Herniated Disks VS. Bulged Disks: What's the Difference?

By Steve Kravitz, PT, DPT, CST

Your spinal column in your back is made up of a series of bones, or vertebrae, stacked on top of each other. From top to bottom, this column of bones are separated and cushioned by discs. Your discs protect your bones by absorbing the shocks your back receives daily with activities including walking, running, lifting, or twisting.

What’s Causing My Back Pain?

Over time, your discs in your back show signs of general wear and tear as you age. Discs can become dehydrated causing the cartilage to become stiff. Because of these changes, the outer layer of the disc can bulge out fairly even all the way around its circumference. Think of it as a hamburger that is too big for its bun.

When you’re experiencing back pain along with leg pain, many patients associate pain improving when you notice your back pain is now better, but you notice pain further down your leg. This is called peripheralization, which means the affected nerve is worsening. Our goal with treatment is to centralize your pain, meaning your pain is no longer in your leg and may just only be present in your spine. Once the pain has centralized to the spine, it’s important to continue treating this area of the spine for total resolution.

 
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Herniated Discs: What is it?

Herniated discs are one of the leading causes of back pain, most commonly occurring in a patient’s low back or neck. In many cases, a herniated disc is when the soft material inside the disc space pushes out through a tear and will often put pressure on and/or cause inflammation on a nearby nerve. When a nerve becomes compressed or inflamed in your low back, it may radiate pain down to your hip, leg, and/or foot, most commonly referred to as sciatica. Alternatively, if you the nerve becomes pinched or inflamed in your neck, it can often refer pain down to your shoulder, arm, and/or hand. Sometimes this pain can be accompanied by: numbness, weakness, tingling, burning, and/or a prickly feeling. Most people who have a herniated disc don’t need surgery to correct the problem, according to the Mayo Clinic. The first referral most doctors will make with the diagnosis of a herniated disc is to see a physical therapist.

Sufferers describe symptoms including:

  • Dispersed low back pain

  • Numbness

  • ‘Pins and Needles’ extending into the hip, thigh, or lower leg (for lumbar spine herniations)

  • Muscle weakness, muscle spasms, or overactive reflexes

  • Foot numbness, hand numbness, or stiff neck

Causes leading to herniated discs are due to:

  • Injury trauma

  • Chronic poor sitting posture

  • Improper lifting and bending

  • Poor mechanics of other areas of the spine or hips

Bulged Discs: What is it?

Bulged discs can occur in any part of your spine, from your neck to your lower back. The difference between a bulged disc and a herniated disc is that the bulged disc does not fully tear through the tough exterior of the disc and only pouches the disc material out and may put pressure on a nerve. A herniated disc actually has a tear in the exterior of the disc and the soft inner cartilage can protrude out. Think of the disc like a small jelly donut. If you squeeze a jelly donut the jelly may start to push it’s way out of the inside of the donut towards the edges and cause it to deform. This is what a bulge in the disc would represent. If you squeeze the jelly donut and the jelly comes oozing out, that is what a herniation in the disc would be.

Symptoms of a bulged disk include:

  • Pain and numbness, most commonly on one side of the body

  • Pain that extends to your arms or legs

  • Pain that worsens at night or with certain movements

  • Pain that worsens after standing or sitting

  • Pain when walking short distances

  • Unexplained muscle weakness

  • Tingling, aching, or burning sensations in the affected area


Nerve Mobilization is just one part of a unique, personalized approach to Physical Therapy which has been developed over twenty years by Dr. Steve Kravitz of Steve Kravitz Physical Therapy.  To learn more about how Nerve Mobilization can help you,  contact us or read more on our blog.

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Read More of Our Blog Posts:

What You Need to Know About Sciatica

Getting to the Root of Neck Pain