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Emmanuel asked...

What’s the difference between a bulging, slipped and herniated disc?

Tags: backache , bones

What is the difference between a bulging disc, a slipped disc and a herniated disc? What does it mean and can I be cured? It has been a month since I sustained this injury – I don't feel pain any longer and have stopped taking painkillers. I can run, bend forward and exercise. I dare not lift heavy things or do sit ups, though. My physiotherapist said I can recover fully, but my specialist was unsure. Can you help?

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The answer

Bulging, herniated and slipped are all terms that describe the loss of the normal structure and shape of your spinal discs.

Spinal discs separate the vertebrae in your spine and cushion your back. They have a tough outer layer and are a bit like a gel inside.

A slipped disc – also known as a herniated or prolapsed disc – is where the outer case of the disc splits and the gel inside bulges out.

This puts pressure on the spinal cord (the group of nerves that runs down the middle of the spine). It can affect multiple nerves or just one, and often results in back pain and possibly even pain in the area that the nerve controls.

Most people recover from a slipped disc. The spinal disc usually shrinks back and stops pushing on the nerve. In some cases, however, the disc can keep pressuring the nerve but your brain learns to switch off the pain signal.

That said, recovery can take a while – usually between one and three months. It sounds like you are doing all the right things, though; the usual treatments include physiotherapy and pain relief.

The causes of slipped discs

The main causes of slipped discs include:

  • Age. Our spinal discs degenerate over the years through wear and tear
  • Damage, strains and pressure. If you lift or bend awkwardly, or injure your back in an accident
  • Smoking causes your spinal discs to lose their agility
  • Obesity. Extra body weight puts more strain on your back
  • A sedentary lifestyle
  • Sports that involve a lot of weights.

Symptoms of slipped discs

The most common symptoms of slipped discs include:

  • Pain. This usually occurs in your lower back, but you can also experience pain in your neck. If your disc presses on your sciatic nerve, you might also feel pain in your hips and legs
  • Numbness or tingling in your limbs and shoulders
  • Weak muscles
  • Struggling to bend or straighten your back.

It is important that doctors pay attention to the patients’ symptoms when diagnosing a slipped disc because scans do not always correlate with the symptoms you have. For example, there may be minor bulges of several discs seen on a scan but these do not cause any symptoms. Some people may not even show any symptoms and can live with a slipped disc unknowingly. Diagnosis of slipped disc can be done by a physical examination by your GP. Further scans, such as an MRI scan that uses strong magnetic fields and radio waves to produce detailed images of the body, are also helpful.

Treatment of slipped discs

The most common treatments of slipped discs include:

  • Rest
  • Exercise – it may be painful at first but it is important to keep moving. Gentle exercise that doesn’t put too much strain on your back helps to maintain strength and stops you getting too stiff
  • Physiotherapy
  • Applying heat packs or a tens machine may also help relieve some of the discomfort and stiffness
  • Pain relief – often mixing paracetamol and ibuprofen (as prescribed on the packet and if it is safe for you to do so) is a good way to manage back pain.

In more rare cases, pain relieving injections and surgery can also be used.

We would urge to go see your GP as soon as possible to get appropriate treatment.

Prevention of slipped discs

If you want to protect yourself from a slipped disc, it is important to:

  • Maintain good back strength and posture
  • Always use a proper lifting technique
  • Exercise regularly
  • Maintain a healthy weight
  • Stop smoking.

Answered by the Health at Hand nurses  

Further Reading

Slipped disc - AXA PPP healthcare

Top 10 exercises for a healthy back - AXA PPP healthcare

How driving affects your back - AXA PPP healthcare

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