A human intervertebral disc is surrounded by dense fibrous tissue called the annulus. When the annulus is still intact but the nuclear material in the disc is pushing out toward the nerves, we consider that a bulging disc. When the fibrous tissue around the disc or annulus is actually torn, nuclear disc material can break through the covering or annulus and directly contact the nerves. This is what we consider a herniated disc.
Please note that frequently these terms are used interchangeably and you must discuss the details of your health issue with your doctor after they review your imaging studies.
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A herniated disc is a traumatic focused injury to the disc, which results in a portion of the nucleus, or inside material, pushing out into a nerve.
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Many times the terms a herniated and a bulging disc are used to describe an abnormal disc in the spine. Typically, a disc can protrude against a nerve root, which can cause symptoms, and these discs are typically called herniated discs. A bulging disc is usually used to describe a disc that bulges back slightly but does not appear to be causing significant compression or significant symptoms; however, often the two terms are used to describe a similar situation where there is an abnormal disc.
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A disk bulge may occur from normal disk settling that occurs with age, or it can be related to thinning of the containing outer fibers of the disk, allowing the nucleus of the disk to “bulge.” A herniation occurs when the nucleus protrudes through the containing fibers and into the spinal canal.
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As the disc undergoes the natural process of degeneration, it loses the ability to retain the hydration necessary to support the spine. The result is a diffuse bulging similar to a tire that loses air pressure. In the case of the disc it is loss of hydraulic pressure. Another consequence of the degenerative process is the development of fissures or cracks that result from the desiccation of the disc. Fragments of the inner portion or "nucleus" of the disc can herniate or rupture by way of these fissures through the outer layer (the annular ligament). While a bulging disc is a diffuse process, a herniation is a focal protrusion that often results in painful symptoms called radiculopathy.
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Any time the disc ruptures and extends back into the spinal canal, the terms bulging disc or disc herniation is used. These terms are used synonymously; however, disc bulging usually refers to a wide but small disc protrusion. A herniated disc refers to one small area and a larger disc protrusion.
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A bulging disc is an intact one that protrudes slightly as a result of degeneration. A herniated disc is one that has developed a hole in it and squirted out some of its soft inner material. If this material is compressing or causing inflammation of a nerve, it can cause back and/or leg pain. Bulging discs, on the other hand, can commonly be found in people who have no back or leg pain, and are considered a normal part of spine aging.
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A herniated disc is one in which the lining of the disc (annulus) tears and a portion of the central soft part of the disc (nucleus) pushes through that tear to impinge upon a nerve root. In a bulging disc the annulus remains intact and simply has a bulge in it. Most bulging discs are normal.
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Bulging discs are still contained within the annulus fibrosis. Herniated disc extend outside the annulus.
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There are several answers. Radiographically, both are disc protrusions but of varying degrees. Physiologically, a bulging disc does not cause nerve compression and a herniated disc does cause nerve compression. However, a "bulging" disc may cause a physiologic response of nerve compression either by dynamic compression of the nerve or by inflammatory excitation of the nerve.
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A bulging disc is an early step in the degenerative process of all lumbar discs. As the disc begins to lose its normal water content, it will begin to gradually narrow. This causes the disc to lose much of its "shock-absorbing" effect. This loss of height also allows the outer lining of the disc, called the annulus, to gradually bulge outward as the disc narrows. This process is often compared to an air mattress or a pillow, which would gradually broaden out as it flattens down while losing air. It is rare for a bulging disc to cause significant pressure on the adjacent nerves. A herniated disc, by comparison, occurs when the outer lining of the disc becomes torn, allowing the inner softer disc material to be expressed out of the normal confines of the disc itself and, thus, out pressure on the adjacent nerves. Herniated discs tend to cause "sciatica" or leg pain, due to this pressure on the nerves. A bulging disc usually tends to cause only mechanical back pain, due to irritation of the disc lining itself.
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The disc consists of a relatively firm exterior called the annulus and a softer interior called the nucleus. Any stretch or tear of the annulus can result in a bulge or rupture (herniation) of the disc. A disc bulge typically refers to a smooth, rounded extension of the beyond its usual location. A herniation typically refers to a more localized injury to the disc, where some of the softer nucleus material "squeezes out of its normal position." Both of the problems can be significant sources of pain.
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Loss of the normal structural integrity of the intervertebral disc can lead to either a bulging or herniated disc. Bulging discs are very common and develop in most individuals as we age. A disc bulge is a diffuse symmetrical swelling of the disc caused by early disc degeneration and collapse. Bulging discs rarely cause symptoms unless associated with spinal stenosis. In contrast, a herniated disc is one in which the outer layer of the disc, called the annulus, is weakened, allowing the inner disc material to squeeze out of the disc. If the herniated disc material presses against a nerve root, it may cause leg pain or numbness.
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A bulging disc is a slight protrusion of the center of the disc (nucleus pulposus) into the spinal canal. In a bulging disc, the outer ring (annulus fibrosus) has not ruptured. A disc herniation is a large protrusion of the nucleus pulposus, which has burst through the annulus fibrosus into the spinal canal, invading the surrounding nerves and causing pain in the back, buttocks, hips or legs.
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As a disc is damaged, the surrounding fibers start to tear. When partially torn, the fibers become weaker, and the center of the disc can start to bulge out. As the damage worsens, the fibers can tear altogether, allowing a portion of the central disc to herniated, or move out completely.
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The first thing to understand is that the disc is made up of two components, the central soft compressible portion called the nucleus and an outer ring called the annulus. The outer ring keeps the disc together. With a bulging disc, that outer ring or annulus weakens and the inner nucleus tends to push out against the annulus causing the disc to bulge out of the confines of the disc space and project to some extent into the spinal canal which is behind the disc. With a herniated disc, there is actually a tear in the annulus and a piece of the nucleus projects out of that disc space through the annular tear and into the spinal canal.
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This is really a difference of degree. The disk material lives in a capsule. A bulging disc is a smaller protrusion of the central nuclear material still contained by some of the outer annular or capsular fibers. A herniated disc, also known as a "slipped" or "ruptured" disk is a protrusion that has ruptured through the annulus.
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Many times these terms are used interchangeably
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Anatomically, there is no difference between a herniated disc and a bulging disc. There is not an actual definition for a bulging disc. A disc herniation is an extrusion of disc material beyond the posterior margin of the vertebral bodies above and below the disc space. A bulging disc is considered a small (less than 3 mm in size) herniation that is contained within these margins.
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All discs degenerate as we age. Discs are basically shock absorbers which hold a lot of water. Each disc begins to lose its water and its shock absorber effect starting in the late teens. Degeneration of discs is not necessarily a problem and is frequently a normal process of aging. It is only when a degenerated or bulging disc causes pain does it become a problem. When a disc degenerates to such an extent or a small tear develops in the outer third of the disc, pieces of the disc can move out near the area of the spinal nerves, and that frequently is known as a disc herniation. This can put pressure on a nerve root as it exists from the spine and causes the condition known as sciatica, which is pain radiating all the way down the leg usually to the foot.
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Herniated disc is completely out of the patient. Space-bulging disc - small part protruding out.
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Herniated disc and bulging disc usually imply the same thing.
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I always tell my patients that if you think of your disc as a jelly donut, you can squash down the jelly donut and the jelly never comes out. That is a bulging disc. A herniated disc is when the jelly actually comes out.
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There is no specific definition for the term herniated disc, bulging or protruded disc. Scientific studies indicate that individual spine specialists utilize these terms interchangeably. More helpful definitions are the terms contained or non-contained disc herniation. A non-contained disc herniation indicates a disc has herniated material that is no longer connected to the main portion of the disc. A contained disc is a disc herniation that still has connections to the main disc. These definitions are very helpful in terms of the surgical treatment and prognosis of someone who has a disc herniation.
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This is really a difference of degree. A bulging disc is a smaller protrusion of the central nuclear material still contained by some of the outer annular fibers. A herniated disc is one that has ruptured through the annulus. It is best to give the actual measurements of the protrusions instead of just using the descriptive terms herniated or bulging or even ruptured.
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The difference is merely one of degree. In a herniation, more of the annulus is injured allowing for a further or larger deformity of the shape of the disc, i.e. it protrudes out further.
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