Herniated disk vs. bulging disk: What's the difference?

The terms "bulging disk" and "herniated disk" are used to describe the appearance of intervertebral disks as seen on imaging scans. Both of these changes can be due to age-related wear and tear on the spine.

However, the appearance of a disk doesn't necessarily indicate a problem. Some bulging and herniated disks cause pain. Some don't. The presence and location of pain — as well as the results of a physical examination — tell your doctor whether a bulging or herniated disk is a problem for you.

A bulging disk does look different from a herniated disk. A bulging disk is one in which the outer layers (annulus fibrosis) of the disk simply bulge into the spinal canal. The bulging typically affects a large portion of the disk. Bulging disks are more common than herniated disks and usually cause no pain.

In contrast, a herniated disk is one in which the inner part of the disk (nucleus pulposus) has leaked out of the disk through a crack in the annulus fibrosis. This is also referred to as a ruptured disk or slipped disk. The typical appearance of a herniated disk on imaging studies is a small area of the disk hanging out into the spinal canal. Herniated disks are less common and may cause pain.

Treatment of a painful disk may include:

• Rest
• Pain medications
• Physical therapy
• Cortisone injections
• Heat or cold therapy
• Surgery