Is there a difference between a herniated disc and a ruptured disc?

Question

I understand that there's the anulus and so on and what happens when it is penetrated by the nucleus pulposus and hits the nerve, but is something different with a rupture? Just a different name? I've had the herniation before, but the pain and immobility this time is so much more intense. Help!

Answer 1

Various terms are used and they are not well-defined, so they often can be confusing. Disc protrusion. Disc herniation. Disc bulge. Disc prolapse. Often doctors individually use these to mean specific things, but there is no general consensus on their meanings.

Anatomically speaking, we can think about disc 'herniation' in three basic categories.

1) a 'bulge' where the nucleus has penetrated into but not through the annulus.

2) a 'herniation' or 'protrusion' where the nucleus has penetrated through the annulus.

3) a 'prolapse' where some of the herniated nucleus has fragmented and/or broken off into the spinal canal.

Generally, 3 is potentially worse than 2, which is potentially worse than 1.

Hope you find this helpful.

P.S. With spinal disc problems it is CRITICALLY IMPORTANT to coordinate the physical exam findings with any diagnostic tests because 50% of the population has a 'herniated disc' on diagnostic tests WITHOUT SIGNS OR SYMPTOMS. So, just seeing a disc problem on a CT or MRI does NOT mean that is the source of pain. Test findings must correlate with the exam findings. In fact, a good doctor, doing a proper exam, should PREDICT the findings on the CT/MRI (these tests should not be a 'fishing expedition'). If your doctor cannot say to you after taking your history and performing an exam something like this: "I think you may have a disc herniation at L5 on the right", but rather chooses not to say anything and just wants to order "a few tests", you have a doc that is not qualified to diagnose or treat this type of problem!!!

Answer 2

yes