After a car accident you may be diagnosed with a bulging disc or a herniated disc. To make things even more complicated, your medical provider might even tell you that you are suffering from degenerative disc disease. What is the difference and what does all of this mean?
The Annular Tear
Before we make some differentiations, it is important to understand the definition of the annular tear.
An annular tear refers to a tear or damage to the outer layer of a spinal disc (known as the Annulus Fibrosis). As I explained in a previous post, you can think of the disc as a jelly donut. The fibrous outer portion of the disc protects the inside which is jelly-like.
Bulging discs can be traumatically related injuries, where the discs are usually still contained with the annulus fibrosis. Bulging discs can still be very painful because the bulging portion of the disc can push against your spinal cord.
A herniated disc often tends to be considered more serious by the medical community because a portion of the nucleus, or inside material pushes out into the nerve.
The most common soft tissue injury that occurs in car accidents, is the herniated disc.
Understanding the Anatomy
The spinal column is made of up of bones known as vertebrae (plural)-Vertebra (singular). Each vertebra is separated by a disc which you can think of as a jelly donut. The fibrous outer portion of the disc protects the inside which is jelly-like.
The discs, together with ligaments and joints connect each vertebrae and help maintain the spine’s normal alignment and curvature while also allowing for movement.
At the center of the spinal column there is an open channel called the spinal canal. The spinal cord and the spinal nerves are located in the spinal canal where they are surrounded by spinal fluid and protected by the strong spinal column.
What is a Herniated Disc?
A herniated disc occurs when the fibrous outer portion of the disc ruptures or tears and the jelly-like core squeezes out. When the herniated disc compresses on a nearby nerve the result can be a pinched nerve. Herniations can occur from the strong impact of a car crash.
Herniations can cause numbness, tingling, or weakness in the arms or legs. The substance that makes up the disc’s jelly-like core can also inflame and irritate the nerve, causing additional pain.
How is it Diagnosed?
Herniations are typically diagnosed by using one or a combination of the two most common tools:
-Magnetic Resonance Imaging (MRI) -This is the most common tool used by medical professional to diagnose herniations. MRIS are either done by placing the injured personal into a tunnel like structure. Open/Stand Up MRIS are also commonly used.
-Electromyography (EMG)-This tests electrical activity of a nerve root to help determine the cause of the pain.
How is a Herniated Disc Treated?
Herniations are typically treated conservatively with physical therapy. If the conditions does not improve medical professionals will usually administer epidural injections. In some cases, surgery may be required.
Degenerated Disc Disease
Degeneration of discs is usually observed as the gradual thinning of the disc due to loss of fluid in the disc. This reduces the ability of the disc to act as shock absorbers and makes it less flexible. The loss of fluid makes the disc thinner and narrows the distance between the vertebrae. The body reacts to this thinning by creating bone spurs (osteophytes). Bone spurs can put pressure on the spinal cord resulting in pain and affective nerve function. Degenerative disc disease can occur and be accelerated by a traumatically related herniation or bulge.
Understanding The Difference Between A Herniated vs. Bulging Disc
The real difference is the degree of the protrusion. A bulging disc is a smaller protrusion of the central nuclear material still contained by some of the outer annular fibers. A herniated disc is one that has ruptured through the annulus.
The best way to understand disc injuries it to go back to the jelly donut analogy. A bulging disc would be when you squash down on a jelly donut and the jelly never comes out, that is a bulging disc. A herniated disc is when the jelly actually comes out.
If you were hurt in a an automotive accident, be sure to contact our Westchester car accident lawyers for a free consultation.