There are many terms to describe spinal disc pathology and associated pain such as herniated disc, bulging disc and pinched nerve. All are used differently and at times used interchangeably.
Unfortunately, healthcare professionals do not agree on a precise definition of any of these terms, and patients may be frustrated when they hear their diagnosis referred to in different terms. The unusually wide range of terms used to describe spinal disc problems (such as ruptured disc, torn disc, slipped disc, collapsed disc, disc protrusion, disc disease, and black disc) can add to the confusion.
Pinched Nerve Vs. Disc Pain
When a patient has a symptomatic herniated disc, the disc itself is not painful, but rather the material that is leaking out of the inside of the disc is pinching or irritating a nearby nerve. This type of pathology produces pain called radicular pain (e.g., nerve root pain) leading to pain that may radiate to other parts of the body, such as from the low back down the leg or from the neck down the arm. Leg pain from a pinched nerve is usually described as sciatica.
- Disc Pain
When a patient has a symptomatic degenerated disc (one that causes low back pain and/or leg pain), it is the disc space itself that is painful and the source of pain. This type of pain is typically called axial pain.
Either of the above two conditions can occur in the cervical (neck), thoracic (upper) or lumbar (lower) spine. They tend to be most common in the lower back because the lower back bears the most torque and force on a day to day basis.
Keep in mind that all the terms—herniated disc, pinched nerve, bulging disc, slipped disc, ruptured disc, etc.—refer to radiographic findings seen on a CT scan or MRI scan. While these test results are important, they are used in tandem combined with patients specific symptoms and results of physical exam.
Tingling, numbness, or weakness that radiates into the shoulder, arms, or fingers
Trouble with gripping or lifting objects
Problems with walking, balance, or coordination
Loss of bladder or bowel control
Treatments for Herniated Disc
Many herniated discs resolve on their own with time
Physical Therapy, Exercise and Stretching
Strengthening supporting structures may help relieve pressure on the nerve
- Non-steroidal anti-inflammatory drugs (NSAIDS)
Ibuprofen, Naproxen or COX-2 inhibitors for pain relief
Narcotic Pain Medication
Help decrease inflammation
Direct treatments to a localized area may help reduce inflammation
Surgical intervention may be considered to relieve pressure on the nerve
The key is to seek treatment from a specialist and obtain a primary diagnosis. Conservative treatments may include simple rest and activity modification. Pain management through medication may help as well. Physical therapy and surgery maybe also be considered.