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What is the difference between a disc protrusion/bulge/herniated and a slipped disc?

A disc protrusion is typically classified as a disc with less than 180 degrees of the disc displaced, while a bulging disc is more than 180 degrees.

A healthy intervertebral disc comprises two parts. The centre of the disc is called the nucleus pulposus, which comprises a strong gelatinous like substance. The outer part is the annulus fibrosis. This is rich in pain carrying nerve fibres called nociceptors, in particular the outer 1/3 of the disc. When the disc loses its elasticity, it may protrude outside its normal boundary and may compress the spinal nerves or spinal cord.

A ‘disc bulge’ is a word used to describe findings seen on an MRI study of the spinal discs. The spinal discs are soft cushions that rest between the bones of the spine, the vertebrae. A normal spinal disc is critical to mobility of the spine. The disc functions to absorb energy in the spine, yet also allow the spine to bend and rotate.

A disc bulge is more common in the lower back (Lumbar Spine), but can occur anywhere in the spine, including your neck (cervical). If the disk bugle is progresses and the outer layer of the disc starts to rupture it is referred to as a herniated disc.

Similar to a disc bulge, a disc herniation or protrusion can also extend into a tunnel and compress a nerve. However, unlike a disc bulge, a disc herniation involves tearing of the disc. The fibrous outer ring of the disc tears creating a fissure from the edge of the disc to the nucleus (the jelly-like inner core). This allows the core to protrude, creating an out pouching. This is a Disc Herniation or sometimes called a Disc Protrusion.

Symptoms of a bulging disc include:

  • Numbness
  • Weakness
  • Tingling
  • Muscle spasms or cramping

These will depend on the region of the spine where nerve compression occurred, but they typically occur along the spine.

A slipped disc is when a soft cushion of tissue between the bones in your spine pushes out. It’s painful if it presses on nerves. It usually gets better slowly with rest, gentle exercise and painkillers.

A slipped disc (also called a prolapsed or herniated disc) can cause:

  • lower back pain
  • numbness or tingling in your shoulders, back, arms, hands, legs or feet
  • neck pain
  • problems bending or straightening your back
  • muscle weakness
  • pain in the buttocks, hips or legs if the disc is pressing on the sciatic nerve (sciatica)

Not all slipped discs cause symptoms. Many people will never know they have slipped a disc.

In reality, the term disc protrusion or slipped disc is a ‘catch-all’ term for a range of disc problems where a portion of the disc wall becomes weakened and bulges or ultimately disrupts with the soft “Nucleus Pulposus” extending backwards into the spinal canal and irritating or compressing the descending or exiting nerves.

A recent MRI of my spine showed that I have a number of broad based disc protrusions in my lumbar and thoracic spine as well as large disc herniation in my cervical spine but at the moment none are needing surgical intervention.

Source: Spinal Foundation, NHS Spinal Stenosis

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Photo by Karolina Grabowska on Pexels.com

I found this great post on Pinterest from author Danni Newcomb on Hub Pages.  She explains that ‘Degenerative Disc Disease (or DDD) is caused by degeneration of the discs in the spinal column. Age can cause this, but most of the time it is cause by some sort of trauma to the spine. People with bulging or herniated disc almost always have this disease, as well as people with Scoliosis.

Symptoms range from person to person as well as the particular location of the spinal injury. People with lower back injuries can experience numbness and tingling in the legs and buttocks. The symptoms can also get as severe as temporary paralysis in the legs or a particular leg. Someone with upper back pain can experience headaches, numbness and tingling of the neck and arms (or arm). Muscle spasms, memory loss, and weakness in the limbs are also possible symptoms.

In some cases, DDD has been seen as a hereditary disease. However, not all doctors will agree on this and there have been no conclusive studies done to prove one way or the other.

Treatment for DDD can be somewhat complicated. Most doctors will start you on physical therapy and pain medications to see if some of the pain is alleviated. Others might try steroid injects at the points on the discs that are messed up to try to directly alleviate the pain.

If these methods do not work, your doctor might recommend surgery. They can perform a spinal fusion, place rods into your spinal column, and a few other alternative surgery methods. Surgery is entirely up to you and you should not feel pressured by your doctor to have surgery unless your ailment has become life-threatening.

Acupuncture, herbs, pool therapy, messages; all of these are other methods to look into and see if they’re right for you. Check with you insurance and see if they cover any of these alternative methods. Some insurances will pay for them if you have a doctor state that he or she believes you could really benefit from such methods.

Review every option available to you with your doctor. Talk to your family about these options and see what best fit your lifestyle. Also, making simple lifestyle changes can make a world of difference in your pain and how you handle it’.

My recent MRI results showed that I have bilateral sacroiliac arthritis and multi level degenerative arthritis to my lumber spine ( in other words DDD). I have also got some fluid retention in my lumber joints so the first thing they are doing is some injections into my sacroiliac joints.

I was seen first by a hip consultant as I was suffering from hip pain and unable to lie on either hip which was diagnosed as bursitis but with back problems you can get referred pain so it can sometimes be difficult to diagnose.

There are new techniques around now for DDD called IDD Therapy which is I have written about before here. I am thinking of trying the IDD therapy if the injections don’t work. Other treatments include pain killers, muscle relaxants, heat and rest, all of which I do on a daily basis.

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It’s not just Fibromyalgia sufferers who complain of change of seasons pain. Studies have shown that people suffering from joint pain, headaches, arthritis, stomach pain, back pain, CFS and fibromyalgia may experience flare ups or increases in pain correlated with changes in barometric pressure and other factors when temperatures go from warm to cool or cold.

Southside Pain Specialist say barometric pressure is the weight of the surrounding atmosphere. This pressure typically drops prior to bad weather, which means there is less air pressure on the body. This causes tissue to expand. Expanded tissue creates pressure within the body that then results in pain or the sensation of pain or discomfort. People who suffer from chronic pain may have heightened sensitivity to such pain.

Web MD explain that you can’t change the weather, but if your rheumatoid arthritis acts up when it’s cold and rainy, there’s a lot you can do ease stiffness and pain. Research suggests autumn may be the sweet spot for RA, while winter and spring are the most challenging. 

The changing of seasons can trigger cluster headaches, which happen one or more times a day for a few weeks or months. Clusters are common in the fall and spring, when we adjust our clocks for daylight saving time.

Hunimed point out that it’s not just joints that can be affected by seasonal changes, your stomach can also suffer. It is important to understand the differences in seasonal patterns and how they can bring about abdominal pain. In both children and adults, both acidity and heartburn along with other digestion issues may exist due to common chronic pain conditions, they can also be triggered by various factors that may vary with age. Nevertheless, particular attention should be paid to nutritional and lifestyle choices.

In current urban lifestyles, many individuals don’t get enough sleep and many also stay up until early hours of the morning either watching TV or surfing the net. This is often accompanied by late night snacking, forcing the digestive system to work at an hour when it should be resting.

Vanness Chiropractors say our bodies adjust to the climate we’re living in, so any dips in weather equal back pain, no matter the starting temperature or the degree of the dip. Decreased pressure causes the body’s tissues to expand and press against joints and structures in the back, and you’ll recognize that the pressure dropped with the return of your consistent back pain.

When the barometric pressure drops, this fluid surrounding the joint expands, thus causing the body’s tissues and membranes to stretch even further. This chain reaction means that your pain nerve fibers are irritated – and you’re all of a sudden acutely aware of your back pain.

The Centre For Spine say up to 8 in 10 people will have back pain in their lifetime, and in many cases, a flair up is caused by a drop in temperature. Aches and pains during these cold months can be some of the hardest to deal with because tendons and joints contract in the cold air, making the pain seem more excruciating. If you are one of the many people who suffers from winter pain, there may be a few solutions that will actually decrease your pain.

According to an extensive review of clinical research by Pain Treatment Topics, authored by Stewart B. Leavitt, MA, PhD., people suffering from pain usually had inadequate levels of vitamin D. “In our review of 22 clinical research studies persons with various pain and fatigue syndromes almost always lacked vitamin D, especially during winter months.

When sufficient vitamin D supplementation was provided, the aches, pains, weakness, and related problems in most sufferers either vanished or were at least helped to a significant degree.

Some tips on how to help ease the pain during the change of seasons are to stay warm, and add extra layers. Stash a blanket in every room of your home. Power up a space heater. If your place is drafty or cool, Cadet says, look for home improvements that seal up drafts.

Lotions or essential oils also do the trick. Warm them up in your hands first. Then use them to massage your joints. Your instinct may be to hunker down at home when it’s rainy or cold outside, but try to resist. If you want to feel better, get active. Try an activity that doesn’t put pressure on your joints, like yoga, tai chi, and swimming. Regular stretching can help you ward off pain and stiffness. Eat well as a healthy diet makes a difference in how you feel when the seasons change.

Source : Centre for Spine, Vanness Chiro, Web MD, South Side Pain, Hunimed.