Bulging Disc or Herniated Disc – Were You Misdiagnosed?

One of the most common causes of back pain is a problem with your discs, but a common confusion is between a bulging disc and herniated disc. Often, mistakenly, people think of them as the same condition, but they are, in fact, not.

What Is a Bulging Disc?

A bulging disc is when your disc, as a result of age, bulges out on its edge. It does not always affect the entire perimeter, but at least a quarter of the disk will emerge from between the vertebrae.

Disc bulges are a sign of normal wear and tear; they are not so much a condition as a thing which happens to your spine as it ages.

What Is a Herniated Disc?

A herniated disc is more serious. A crack in the outer cartilage allows the inner layer of the disc to protrude. This is also called a ruptured disc or a slipped disc. In general, it protrudes further and is more likely to cause pain.

Both bulging and herniated discs can exist without causing any pain and, in fact, it’s possible not to know you have one.

When pain does occur, it generally worsens when doing certain motions, such as bending over, standing up out of a chair, rotating your spine, and sometimes walking.

How Is a Bulging Disc Treated?

In most cases, bulging discs cause no pain and need no treatment. Occasionally, they may press on a nerve, causing some pain. You might benefit from physiotherapy or exercises to strengthen your back, or from a visit to an osteopath.

How to Treat a Herniated Disc

Herniated discs are often treated in a similar way, with conservative treatment. This might include pain medication, cortisone injections, and physical therapy. In a few cases, surgery might be recommended, usually if conservative treatments fail to improve symptoms after six weeks. Normally, this involves the surgeon removing the protruding portion of the disc, but for severe herniation the entire disc will have to be removed and the vertebrae fused. This is a last resort operation because it will permanently affect the range of motion in your spine.

Can a Doctor Confuse the Two?

It can happen that a herniated disc may be misdiagnosed as a bulging disc. Depending on the shape of the herniation, the two may look very similar in an MRI. Specifically, multi-focal disc protrusions (more than one protrusion on the same side) can look very much like a bulge. In most cases, if there is pain, that will clue the doctor in. Bulging discs only very rarely cause significant pain. In some cases this may not matter; certain treatments, like osteopathy, can be equally good for each problem. However, a misdiagnosis may cause you to go longer than needed before necessary surgery.

What Other Misdiagnosis Problems Can Occur?

Another problem which can occur is that you come in with pain, the doctor does an MRI and finds a bulging or herniated disc, and assumes that’s the cause of the pain without looking further. Herniated discs don’t always cause pain. Indeed, something else possibly caused your back pain, which your doctor missed while focusing on the disc. This kind of misdiagnosis results in surgery that does not work, called failed back surgery syndrome. It’s also possible that a doctor may assume that pain is from a herniated or bulging disc, due to how common these conditions are, and not properly investigate. Some conditions which can be mistaken for a herniated disc are:

Superior Cluneal Nerve Entrapment Neuropathy

This means you have a pinched nerve near your buttock, resulting in lower back pain that is not actually connected to your spine. The symptoms, which include pain when bending, rotating, or walking, are very similar to those of a disc problem.

Gluteus Medius Muscle Pain

The gluteus medius muscle is a buttock muscle you use when standing on one leg, walking, and running. Often, excessive sitting and standing still for too long causes symptoms. This pain is generally diagnoses by the location of the trigger point; as it’s a muscle problem it is usually treated with medication and physiotherapy, but there is an occasional need for relatively non-invasive decompression surgery.

Piriformis Syndrome

This is a muscle that connects the sacrum (tailbone) and causes buttock pain and sciatica (nerve pain down one leg). Caused by your structure, prolonged sitting and climbing stairs aggravates symptoms. Treat it with special stretches and medication.

Sacroiliac Joint Pain

This is the joint between the spine and pelvis. Repetitive strain is a common cause of this, and it often includes joint pain as well as pain in the back and buttocks. Various treatments are used, including medication, physical therapy, and wearing a special pelvic belt to support the joint.

Peripheral Nerve Problems

Surgeons mistake problems with nerves in the leg for herniated discs. These occur in a variety of places, ranging from the head of the fibula to the ankle.

Conclusion

If a doctor misdiagnoses a disk problem, this can result in unnecessary surgery that does not solve the problem. Back surgery is expensive and not without risks. Indeed, fusion has permanent effects on how you move and go through life. Because of this, seek a second opinion before agreeing to back surgery. Spinal surgeons have varying opinions on when surgery is needed. A second doctor may have something else you can try first.

If you or a family member experience failed back surgery syndrome because your doctor misdiagnosed you, then you may be eligible for compensation. Contact Weltchek Mallahan & Weltchek for a free initial consultation to find out if we can help you get the compensation you deserve.