Doctors and health professionals use many different terms to describe a problem in your disc. What’s the difference between a herniated and a slipped disc? Whats the difference between a prolapse or an extruded disc?
Well, I used to be a huge lover of donuts- my uncle owned “Holey Donuts” for a few years and my favorite donut of all time was the Jelly Filled donut- filled with cream, apple jelly and my favorite lemon jelly.
So today I want to help you understand a disc lesion and compare this with a jelly donut- and really you won’t believe how easy it is to understand.
Here is a normal disc. Each bone in your body is separated by a disc. Each disc has a strong outer layer called a annulus fibrosis and a softer inner part called the nucleus pulposus. A disc is made of an outer layer called the annulus fibrosus- within that annular fibrosis is the nucleus pulposus.
Lets discuss the 3 kinds of disc lesions: A bulging, contained or a non –contained disc. Here are the three types-
Bulging Disc- Pretend you are just starting to eat a jelly donut and you press the donut down with the palm of your hand just lightly. Not enough so that the jelly comes out, but enough that the donuts actual circumference expands.
A bulging disc can also be known as a bulging annulus, disc bulge or a ballooning disc. This is a circumferential, symmetric bulge of the annular fibers.
Disc bulges can occur as part of the natural aging process. When a disc degenerates it can flatten and bulge.
Contained Disc- Lets say you start to eat this jelly donut and this time you press down more firmly enough on the donut causing the jelly to almost come out but not quite. You may notice that one side of the jelly donut is bulged now, but your jelly doesn’t come outside- it remains contained within the donut. So here you have a “contained” disc. Also known as a protrusion, herniated disc, herniated nucleus pulposis, and a "slipped" disc.
In a contained disc the inside nuclear material migrates but is still contained by the outer fibers of the annulus fibrosus. Note that the disc material can migrate to the left or to the right, or sometimes into the center.
- Non-Contained Disc- Lets say you are very anxious to eat your jelly donut- You press really hard on the donut and your jelly comes flying outside. It may stick to the outside of the donut (and you can see this jelly) or even land on your plate.
Also known as a ruptured disc, prolapse, free fragment, sequestered disc, extruded disc, floating disc, free fragment, amputated disc or migrated disc. In this situation, the inside nuclear disc material has broken though the annulus fibrosus. It is called non contained because it is not contained within the annulus fibrosus.
So there you have it- Next time you hear that someone has a "slipped" disc, you'll understand it could be a herniated disc where the nuclear material is contained within the outer ring of the disc.
Bottom line, no matter if you have been diagnosed with a herniated or a bulging disc or even a ruptured disc, pressure can be put on the nerve causing significant pain or numbness and tingling.
I think I will treat myself to a lemon filled donut after all this talk about donuts.
Picture Source: Yokum and Rowe, Essentials of Skeletal Radiology, Edition II,Volume I page 414
Additional Resources:
- Severe Neck Pain from a Herniated Disc, What are Your Treatment Options?
- Neck Pain resulting from a C5, C6, C7, or C8 Radiculopathy
- The causes of a cervical radiculopathy
- Dr.Bellingers Neck Pain Relief Kit shows you the proper neck posture for day to day activities and exercising
- Cervical Radiculopathy?? How will Your Doctor Determine the natur of your neck and arm pain
