Disc Herniation

What is a Disc Herniation, What About a Bulge?

disc injury

Not all disc herniations are the same. There are many different types, sizes, location etc., so let me try to boil this down for you. In my blogs I attempt to simplify chiropractic and medical terminology and conditions to a simple illustration. You must understand by boiling things down, just like with water, there will be some reduction. The point is to give you a general concept of the topic and hand so you understand what is going on in your body, not to prepare for a career as a health practicioner so please keep that in mind.

Today we are going after disc herniations. The name alone can lead to some confusion as many health care providers interchange several different names and try to pass them off as the same. Some of these examples include, but not limited to, a disc bulge, disc herniation, disc degeneration, disc sequestration, pinched nerve is even used by some when there is not certain diagnosis that has been determined. Lets take this one at a time but to understand the difference in terms you need to understand a disc. So for simple terms we are going to picture a disc as a jelly doughnut. In the case of disc bulge the jelly would be pushing out on the side of the doughnut causing a change in the overall shape of the doughnut. In the case of a disc herniation, the jelly has actually pieced the wall of the doughnut and is spilling out and no longer fully contained. We all know how hard it is to get jelly back into a doughnut!! This condition is often more difficult to treat conservatively depending on the severity. It is important to note, however, as I said before some practicioners will actually use these term interchangeably which is a no no in my opinion. IF you ask your doctor which you have and he can not explain the difference between the two you may want to consider other options. A sequestered disc is a scenario where some of the jelly doughnut has separated itself from the rest of the doughnut completely and is moving away from the doughnut. This is often time the most difficult to treat conservatively because the sequestered piece is not anchored to any other structure making it difficult to move away from pain sensitive tissue like nerves without surgical intervention. Short of this scenario, conservative treatment has shown to be very successful in reducing patient pain and limitations caused by disc injury.

After you get which type of herniation you have, the next step in determining your best course of action in your care plan is determing whether or not your disc is causing any compression directly to you nerves or in some cases your spinal cord. MRI is the golden standard in making these determination so if your doctor orders one of these, this is one of the indicators he/she should be considering in your care plan. Although you show pain that travels away from the site of pain that does not always mean there is actually compression of that nerve. At times chemicals left behind from a recent injury can mimic this compression even thought the disc material is not actually in contanct with the nerve. This commonly leads to the misconception of a “pinched nerve” I hope this gives you a little look deeper into what different scenarios you can have with disc injury. In the next post I will get into degeneration of a disc and what that means to the people with them!!

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