Disc Herniations – Low Back

When told by your doctor or chiropractor that you have a herniated or bulging disc it can be quite daunting. Firstly, what is the difference between a bulging disc and a herniated disc. A bulging disc is a bit like a car tyre that has gone down and is s bulging out to the side.  It usually involves greater than 50% of the circumference of the disc. A herniation on the other hand is more like a focal weakness in a car tyre wall and usually involves less than 25% of the disc wall circumference.

Just because you have a herniation it doesn’t necessarily mean that you will have pain. In one study it was revealed that 52% of the population who are walking around without back pain have a bulging disc and 27% had a disc herniation.1

If you do have a herniated disc as seen on MRI or CT scan there are certain factors that are important in deciding on whether you will have a good outcome. Before we go there you should know that MRI is superior to CT scan for visualising disc pathology and therefore it is our preference that you have an MRI.

Firstly, let’s address the size of the herniation.  Some studies show that the larger the herniation, the more likely it is to shrink. Secondly, the composition of the herniation is also important. If it is made up mainly of nuclear material (the inside part of the disc), then it is more likely to reabsorb. If it is made up of fragments of cartilage or bone, then it has less chance of reabsorption. Furthermore, if the disc material migrates vertically it has a better chance of being reabsorbed. Another factor to take into consideration is the amount of compression on a nerve. If the herniation is touching the nerve but not compressing it then you are less likely to be getting weakness in your leg.  When you consult with us we will study your MRI by looking at the images and we will inform you as to what composition and degree of compression you have.

In certain cases we can help but firstly you will need to be examined and if you have already had an MRI, we will need to study those.  Good luck.

1.Jenson MC, Brant ZM, Obuchowski N, Modic MT, Malaksian D, Ross JS: Magnetic resonance imaging of the lumbar spine in people without back pain. New England Journal of Medicine, 1994; 331: 69-73