Spinal disc herniation and bulging discs have nearly identical symptoms and can present almost in the same way. Both cause localized pain, nerve impingement, and are treated similarly with chiropractic. In most cases spinal disc herniation is not painful, it is the material that leaks out of the disc that causes pinching, inflammation, and irritates the nerves around the area, causing radicular pain.
Radicular pain/nerve root pain radiates/spreads to other areas of the body, like the low back to down the leg or from the neck down the arm. Leg pain from a pinched nerve usually leads to sciatica. A spinal disc itself can be the source of pain if it is dehydrating or degenerating causing pain and instability in the spinal segment, which is known as degenerative disc disease. Disc degeneration pain tends to include chronic, low-level pain around the disc and infrequent episodes of severe pain.
Spinal Disc Herniation Differences and Similarities
Spinal disc herniation and bulging discs have similar roots that make them difficult to diagnose. Some core comparisons that can be made include:
- Both include pain and tenderness
- Both are caused by cartilage movement/slippage
- They cause nerve pinching and nerve pain
- They occur more often in the neck and lower spinal regions
How they differ:
- Bulging discs protrude
- Herniated discs rupture
- Bulging discs are more common
- Herniated discs are less common
- Bulges are caused by constant pressure
- A herniation is caused by trauma
- Bulging discs create dull radiating pain
- Herniated discs cause sharp intense pain
It is the severity that separates them. Bulging discs tend to be more passive and can be treated with incremental adjustments, while herniated discs usually require a more aggressive adjustment approach.
How the injury affects the spine and overall wellness is the objective when diagnosing. Bulging discs are often associated with chronic pain that does not go away with time and needs proper treatment. Herniated discs are considered severe because of the disc fluid spilling/leaking out affecting the surrounding nerves. Left untreated, bulging discs lead to intermittent nerve blockages/pinching and posture problems. Herniated disc left untreated leads to chronic nerve pain and permanent nerve damage, which can develop into a series of issues. This includes limited mobility and/or loss of feeling in the affected area.
Chiropractic diagnosis for bulges and spinal disc herniation is recommended because of the specialization in spine care and focusing on all symptoms. For example, although it is not typically this simple, analysis revealing tingling in the fingers and sharp pain in the lower spine indicates herniation. Conversely, dull aches in the low back and down the legs, indicate sciatic pain that can be traced to a disc bulge. Making the correct diagnosis is crucial in developing the right treatment plan. The wrong treatment plan could result in worsening of the injury and creation of new injuries. Injury Medical Chiropractic provides optimal care along with education for patients to understand everything that is going on with their bodies.
Types of pain
Pain can be grouped into three categories:
- Early warning pain is most recognizable with the withdrawal reflex. For example, touching a scalding hot object and quickly pulling away. A protective mechanism that helps the body avoid danger and is important for survival.
- Inflammatory pain occurs following an injury or surgery when the body is healing and in recovery. Inflammation prevents the body from moving too fast or too hard causing re-injury. This type of pain is important while healing, but is a cause for concern if it continues after the injury has healed.
- Pathological pain happens after the body has healed but the nervous system has suffered damage. This often occurs with individuals that get injured in a way that changes the way the body functions. If the nervous system does not heal properly, the body’s protective pain responses can begin to create false alarms and become chronic.
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Santilli, Valter et al. “Chiropractic manipulation in the treatment of acute back pain and sciatica with disc protrusion: a randomized double-blind clinical trial of active and simulated spinal manipulations.” The spine journal: official journal of the North American Spine Society vol. 6,2 (2006): 131-7. doi:10.1016/j.spinee.2005.08.001