These are not the same thing, and reports use the words precisely even when patients and websites do not.
In more detail
- A bulge is the disc extending beyond its normal margin around more than a quarter of its circumference. It is broad, symmetrical and usually age-related. It is common in people without pain.
- A herniation is focal — under a quarter of the circumference. It comes in degrees: a protrusion where the base is wider than the material pushing out, an extrusion where the material pushing out is wider than its base, and a sequestration where a fragment has separated entirely.
- Counterintuitively, larger extrusions and sequestrations often resorb more completely over months than small protrusions do.
What it means for you
A bulge with no matching symptoms is usually of no consequence. A focal herniation pressing on the nerve root that corresponds to your symptoms is the one worth treating. Most herniations improve without surgery.
Remember the general rule. Findings like this one are common in people with no pain at all, and become steadily more common with age. A finding on a report is not a diagnosis until someone has matched it to your symptoms and your examination. See understanding your MRI report.
Bring your scan and report in and we will go through it with you. Call (314) 310-5577 or request an appointment.
Common questions
Which is worse, a bulge or a herniation?
Neither is automatically worse. A large asymptomatic bulge matters less than a small herniation sitting on the exact nerve causing your leg pain.
Can a herniated disc go back in?
The material often shrinks and is reabsorbed over months. It does not ‘pop back’, but the outcome is frequently the same.
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