Table of ContentsView AllTable of ContentsBulging DiscHerniated DiscWho Should Have an MRITreatment
Table of ContentsView All
View All
Table of Contents
Bulging Disc
Herniated Disc
Who Should Have an MRI
Treatment
A herniated orbulging discin the back can be identified withmagnetic resonance imaging(MRI), a test typically recommended when you’ve experienced back pain symptoms for at least six weeks.Many people don’t experience early symptoms, though, and the changes often are an incidental finding when the MRI was done for another reason.
Age-related changes in the spine cause discs that cushion the vertebrae bulge and become misaligned with the spine.With aherniated disc, it can press against the spinal cord andspinal nerves. Causes can include repeated heavy lifting, poor posture, or a history of back injury or underlying health condition.
Treatment may not be needed for bulging discs. However, several options for treatment, such as physical therapy and steroid injections, exist.
This article explains bulging and herniated discs and how MRI is used to help diagnose them. It discusses other factors in diagnosis, including treatment options and how your healthcare provider can determine if they are needed.
Nancy Ross / Getty Images
Causes and Signs of a Bulging Disc
A bulging disc on an MRI is difficult to interpret in isolation. For the most part, bulging discs are common even in healthy people, so other symptoms and findings are an important part of diagnosis.
Causes
A bulging disc is typically considered to be age-related. Over time, there are degenerative changes that cause the disc to bulge downward with gravity.
Signs
Many people with a bulging disc won’t have symptoms, at least initially.And while MRI findings are helpful, they need to be evaluated alongside other findings that include:
A significant disc bulge would be expected to cause leg pain as a result of irritation to the nerves going down the legs.As the condition progresses, more than one disc can be affected. It also can lead to other spinal conditions, includingspinal stenosis(narrowing of the spinal canal).
A Disc Bulge on MRIOn MRI, a disc bulge measures greater than 25% of the total disc circumference. Its displacement is usually 3 millimeters or less from the normal shape and position of the disc.
A Disc Bulge on MRI
On MRI, a disc bulge measures greater than 25% of the total disc circumference. Its displacement is usually 3 millimeters or less from the normal shape and position of the disc.
What Is Degenerative Disc Disease?
Causes and Signs of a Herniated Disc
Causes that can lead to a herniated disc include:
A single incident can cause a herniated disc but it’s more likely due to cumulative influences.
Symptoms of a herniated disc include back and leg pain as well as:
In some cases, people can lose lower body function that affects their ability to walk, or control over the bowel and bladder.
A Herniated Disc on MRIHerniated discs appear as less than 25% of the total disc circumference. They also are different based on the type. These types include:Disc protrusion, in which the displacement is limited and ligaments are intactDisc extrusion, in which part of the disc remains connected but has slipped through the annulus (outer covering of the disc)Disc sequestration, in which afree fragmentof the disc has separated entirely
A Herniated Disc on MRI
Herniated discs appear as less than 25% of the total disc circumference. They also are different based on the type. These types include:Disc protrusion, in which the displacement is limited and ligaments are intactDisc extrusion, in which part of the disc remains connected but has slipped through the annulus (outer covering of the disc)Disc sequestration, in which afree fragmentof the disc has separated entirely
Herniated discs appear as less than 25% of the total disc circumference. They also are different based on the type. These types include:
Types of Spinal Disc Herniation
Who Should Have an MRI of the Back
The MRI is generally safe for most people, including those with implanted cardiac devices like newerpacemakers.It’s important to make sure that the healthcare team knows about cochlear implants or other devices so they can take necessary precautions.
For all people, the American College of Radiology recommends that symptoms be present for six weeks before an MRI is done. A specialist, however, may want to see MRI results sooner, especially if symptoms include:
An MRI also may be needed if symptoms are rapidly worsening. Keep in mind, though, that many people with a disc bulge don’t have symptoms at all and the MRI findings follow testing that was for another issue.
In most cases, an MRI is an outpatient procedure that can be completed in an hour or less, but it can take longer if contrast dye is used. You’ll lie still on a table-like platform as your body enters the imaging zone of the machine. Your healthcare provider will give you specific instructions about MRI preparation.
MRIs Can Be Safely Performed in Patients With Pacemakers, Study Finds
Treatment for Herniated or Bulging Discs
Treatment for a herniated or bulging disc will depend on its cause and the severity of your symptoms.
Bulging Disc Treatment
Many disc bulges don’t require treatment. However,treatment for bulging disc paincan include:
Keep in mind that the MRI findings may not identify or rule out all conditions, including muscle strains or ligament injuries that may require different treatment, such as targeted exercise.
Herniated Disc Treatment
Treatment for a herniated disc may be similar to a bulging disc, depending on the cause and severity of any symptoms. Along with physical therapy and medications, including steroid injection, many cases will resolve in six to 12 weeks.
In some cases, treatment with a transcutaneous electrical nerve stimulation (TENS) device may bring relief. Surgery may be recommended if conservative interventions don’t work.
Alternative treatments for herniated or bulging discs can include relaxation techniques and othernatural back pain remedies. Some people may want to tryacupunctureand other complementary or integrated medicine approaches.
Herniated Disc Surgery: Overview
Summary
A herniated or bulging disc often is identified during magnetic resonance imaging (MRI), although in many cases it’s an incidental finding on an MRI that was done for other reasons. A bulging disc is a relatively common finding, even in people who experience no symptoms.
In other cases, though, a herniated or bulging disc is associated with other concerning symptoms including back pain, problems walking or moving, and tingling or burning sensations from nerve damage. Your healthcare provider can discuss treatment options such as pain medication and physical therapy. In rare cases, surgery may be needed.
13 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Academy of Neurological Surgeons.Herniated disc.Brinjikji W, Diehn FE, Jarvik JG, et al.MRI Findings of Disc Degeneration are More Prevalent in Adults with Low Back Pain than in Asymptomatic Controls: A Systematic Review and Meta-Analysis. AJNR Am J Neuroradiol. 2015;36(12):2394-9. doi:10.3174/ajnr.A4498Penn Medicine.Bulging Disc vs. Herniated Disc: What’s The Difference?Wu PH, Kim HS, Jang IT.Intervertebral Disc Diseases PART 2: A Review of the Current Diagnostic and Treatment Strategies for Intervertebral Disc Disease.Int J Mol Sci. 2020 Mar 20;21(6):2135. doi: 10.3390/ijms21062135.Amin RM, Andrade NS, Neuman BJ.Lumbar Disc Herniation. Curr Rev Musculoskelet Med. 2017;10(4):507-516. doi:10.1007/s12178-017-9441-4Radiopaedia.Disc herniation.American Academy of Orthopaedic Surgeons.Herniated disk in the lower back.Wei B, Wu H.Study of the distribution of lumbar modic changes in patients with low back pain and correlation with lumbar degeneration diseases.J Pain Res. 2023 Nov 6;16:3725-3733. doi:10.2147/JPR.S430792Bhuva AN, Moralee R, Moon JC, Manisty CH.Making MRI available for patients with cardiac implantable electronic devices: growing need and barriers to change.Eur Radiol. 2020 Mar;30(3):1378-1384. doi: 10.1007/s00330-019-06449-5.Brinjikji W, Luetmer PH, Comstock B, et al.Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015;36(4):811-6. doi:10.3174/ajnr.A4173Fujii K, Yamazaki M, Kang JD, et al.Discogenic Back Pain: Literature Review of Definition, Diagnosis, and Treatment. JBMR Plus. 2019;3(5):e10180. doi:10.1002/jbm4.10180Wang S, Zhao T, Han D, Zhou X, Wang Y, Zhao F,et al.Classification of cervical disc herniation myelopathy or radiculopathy: a magnetic resonance imaging-based analysis.Quant Imaging Med Surg. 2023 Aug 1;13(8):4984-4994. doi:10.21037/qims-22-1387National Institute of Neurological Disorders and Stroke.Low back pain fact sheet.
13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Academy of Neurological Surgeons.Herniated disc.Brinjikji W, Diehn FE, Jarvik JG, et al.MRI Findings of Disc Degeneration are More Prevalent in Adults with Low Back Pain than in Asymptomatic Controls: A Systematic Review and Meta-Analysis. AJNR Am J Neuroradiol. 2015;36(12):2394-9. doi:10.3174/ajnr.A4498Penn Medicine.Bulging Disc vs. Herniated Disc: What’s The Difference?Wu PH, Kim HS, Jang IT.Intervertebral Disc Diseases PART 2: A Review of the Current Diagnostic and Treatment Strategies for Intervertebral Disc Disease.Int J Mol Sci. 2020 Mar 20;21(6):2135. doi: 10.3390/ijms21062135.Amin RM, Andrade NS, Neuman BJ.Lumbar Disc Herniation. Curr Rev Musculoskelet Med. 2017;10(4):507-516. doi:10.1007/s12178-017-9441-4Radiopaedia.Disc herniation.American Academy of Orthopaedic Surgeons.Herniated disk in the lower back.Wei B, Wu H.Study of the distribution of lumbar modic changes in patients with low back pain and correlation with lumbar degeneration diseases.J Pain Res. 2023 Nov 6;16:3725-3733. doi:10.2147/JPR.S430792Bhuva AN, Moralee R, Moon JC, Manisty CH.Making MRI available for patients with cardiac implantable electronic devices: growing need and barriers to change.Eur Radiol. 2020 Mar;30(3):1378-1384. doi: 10.1007/s00330-019-06449-5.Brinjikji W, Luetmer PH, Comstock B, et al.Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015;36(4):811-6. doi:10.3174/ajnr.A4173Fujii K, Yamazaki M, Kang JD, et al.Discogenic Back Pain: Literature Review of Definition, Diagnosis, and Treatment. JBMR Plus. 2019;3(5):e10180. doi:10.1002/jbm4.10180Wang S, Zhao T, Han D, Zhou X, Wang Y, Zhao F,et al.Classification of cervical disc herniation myelopathy or radiculopathy: a magnetic resonance imaging-based analysis.Quant Imaging Med Surg. 2023 Aug 1;13(8):4984-4994. doi:10.21037/qims-22-1387National Institute of Neurological Disorders and Stroke.Low back pain fact sheet.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Academy of Neurological Surgeons.Herniated disc.Brinjikji W, Diehn FE, Jarvik JG, et al.MRI Findings of Disc Degeneration are More Prevalent in Adults with Low Back Pain than in Asymptomatic Controls: A Systematic Review and Meta-Analysis. AJNR Am J Neuroradiol. 2015;36(12):2394-9. doi:10.3174/ajnr.A4498Penn Medicine.Bulging Disc vs. Herniated Disc: What’s The Difference?Wu PH, Kim HS, Jang IT.Intervertebral Disc Diseases PART 2: A Review of the Current Diagnostic and Treatment Strategies for Intervertebral Disc Disease.Int J Mol Sci. 2020 Mar 20;21(6):2135. doi: 10.3390/ijms21062135.Amin RM, Andrade NS, Neuman BJ.Lumbar Disc Herniation. Curr Rev Musculoskelet Med. 2017;10(4):507-516. doi:10.1007/s12178-017-9441-4Radiopaedia.Disc herniation.American Academy of Orthopaedic Surgeons.Herniated disk in the lower back.Wei B, Wu H.Study of the distribution of lumbar modic changes in patients with low back pain and correlation with lumbar degeneration diseases.J Pain Res. 2023 Nov 6;16:3725-3733. doi:10.2147/JPR.S430792Bhuva AN, Moralee R, Moon JC, Manisty CH.Making MRI available for patients with cardiac implantable electronic devices: growing need and barriers to change.Eur Radiol. 2020 Mar;30(3):1378-1384. doi: 10.1007/s00330-019-06449-5.Brinjikji W, Luetmer PH, Comstock B, et al.Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015;36(4):811-6. doi:10.3174/ajnr.A4173Fujii K, Yamazaki M, Kang JD, et al.Discogenic Back Pain: Literature Review of Definition, Diagnosis, and Treatment. JBMR Plus. 2019;3(5):e10180. doi:10.1002/jbm4.10180Wang S, Zhao T, Han D, Zhou X, Wang Y, Zhao F,et al.Classification of cervical disc herniation myelopathy or radiculopathy: a magnetic resonance imaging-based analysis.Quant Imaging Med Surg. 2023 Aug 1;13(8):4984-4994. doi:10.21037/qims-22-1387National Institute of Neurological Disorders and Stroke.Low back pain fact sheet.
American Academy of Neurological Surgeons.Herniated disc.
Brinjikji W, Diehn FE, Jarvik JG, et al.MRI Findings of Disc Degeneration are More Prevalent in Adults with Low Back Pain than in Asymptomatic Controls: A Systematic Review and Meta-Analysis. AJNR Am J Neuroradiol. 2015;36(12):2394-9. doi:10.3174/ajnr.A4498
Penn Medicine.Bulging Disc vs. Herniated Disc: What’s The Difference?
Wu PH, Kim HS, Jang IT.Intervertebral Disc Diseases PART 2: A Review of the Current Diagnostic and Treatment Strategies for Intervertebral Disc Disease.Int J Mol Sci. 2020 Mar 20;21(6):2135. doi: 10.3390/ijms21062135.
Amin RM, Andrade NS, Neuman BJ.Lumbar Disc Herniation. Curr Rev Musculoskelet Med. 2017;10(4):507-516. doi:10.1007/s12178-017-9441-4
Radiopaedia.Disc herniation.
American Academy of Orthopaedic Surgeons.Herniated disk in the lower back.
Wei B, Wu H.Study of the distribution of lumbar modic changes in patients with low back pain and correlation with lumbar degeneration diseases.J Pain Res. 2023 Nov 6;16:3725-3733. doi:10.2147/JPR.S430792
Bhuva AN, Moralee R, Moon JC, Manisty CH.Making MRI available for patients with cardiac implantable electronic devices: growing need and barriers to change.Eur Radiol. 2020 Mar;30(3):1378-1384. doi: 10.1007/s00330-019-06449-5.
Brinjikji W, Luetmer PH, Comstock B, et al.Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015;36(4):811-6. doi:10.3174/ajnr.A4173
Fujii K, Yamazaki M, Kang JD, et al.Discogenic Back Pain: Literature Review of Definition, Diagnosis, and Treatment. JBMR Plus. 2019;3(5):e10180. doi:10.1002/jbm4.10180
Wang S, Zhao T, Han D, Zhou X, Wang Y, Zhao F,et al.Classification of cervical disc herniation myelopathy or radiculopathy: a magnetic resonance imaging-based analysis.Quant Imaging Med Surg. 2023 Aug 1;13(8):4984-4994. doi:10.21037/qims-22-1387
National Institute of Neurological Disorders and Stroke.Low back pain fact sheet.
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