Slipped Disc vs Bulging Disc vs Herniated Disc: What's the Difference?
Your MRI report says "disc bulge", your friend says "slipped disc", and your GP mentioned a "herniated disc". Are they three different problems? Here's the short answer from our Leederville practice: "slipped disc" is the everyday name for a herniated disc, and a bulging disc is a milder, broader change in the same disc. Nothing actually slips, and the label on your scan matters less than you'd think. Here's how the terms differ, what each one means for recovery, and what to do next.
Disc changes are very common in people with no back pain at all: by age 80, about 84% show a disc bulge and 43% show a protrusion on imaging [1][2]. This shows that just because you don't have back pain doesn't mean you don't have a problem: changes in your discs can be there without symptoms, which is why a proper assessment matters.
Can a Chiropractor Help With a Bulging or Herniated Disc?
Chiropractic care doesn't make a disc "go back in", and nobody should promise that. What the research suggests is that it may help with pain and function while the disc settles. In a randomised trial of 192 adults with back-related leg pain, those who had spinal adjustments plus home exercise and advice were more likely to have a 75% or greater reduction in leg pain at 12 weeks than those on exercise and advice alone (37% versus 19%). The difference had faded by 52 weeks, and no serious treatment-related adverse events were reported [3]. For more on the evidence, read can a chiropractor fix a slipped disc, and if the pain runs down your leg, our sciatica guide explains why.
Dr Miles' tip: A warm pack on the sore area or a short warm shower can ease the muscle tension around a sore disc. Use whichever feels better, and avoid lying on it for hours.
Are a Slipped Disc, a Bulging Disc and a Herniated Disc the Same Thing?
Partly. "Slipped disc" (or "slipped disk") is a popular term, not a medical one. A bulging disc and a herniated disc, on the other hand, are described differently by radiologists, and the difference is about the shape and size of the change. If you'd like the full picture of how we approach all three, see our guide to slipped, bulging and herniated discs.
What Is a Bulging Disc?
Think of a disc as a jam doughnut: a tough outer ring with a softer centre. In a bulging disc, the ring pushes out evenly, over a wide stretch of its edge, without the centre breaking through. Under the 2014 US spine society nomenclature, a bulge extends beyond the vertebral edges over more than about a quarter (90 degrees) of the disc's circumference [4][5]. Bulges usually reflect everyday wear and tear, and they're often painless [6].
What Is a Herniated Disc (or Herniated Disk)?
A herniation is more focal: a smaller area, less than about a quarter of the circumference, where disc material has pushed out through a weak spot [4][5][6]. It can irritate a nearby nerve, and the chemical inflammation around it can cause pain even when the nerve isn't squashed [6]. Radiologists describe herniations in three steps [4][5]:
Protrusion: the push-out has a wide base, wider than it is deep.
Extrusion: disc material has broken through the outer ring and has a narrow neck, but is still connected to the disc.
Sequestration: a fragment has separated and drifted away from the disc.
Does the Label on Your Scan Predict How Much It Will Hurt?
Worth Noting: The Low Back Pain Clinical Care Standard reports that in people without back pain, disc bulges show on imaging in 30% of 20-year-olds and 84% of 80-year-olds, and protrusions in 29% and 43% [2]. A scan finding doesn't automatically explain your pain, and the Standard says imaging isn't needed for most low back pain unless there are warning signs or it would change your management [2].
This is why we treat you, not the picture. Some people have a large herniation and little pain, while others have a modest bulge that hurts. What matters most is your symptoms: where the pain travels, whether you have numbness or weakness, and how you're moving.
Which Type Heals Best?
You might expect a bigger herniation to do worse. Interestingly, the opposite is often true for the disc itself. A 2022 review of the research reported that symptomatic herniations resorbed (shrank back) in an average of 62 to 66% of cases across 38 clinical studies, and that extruded and sequestered herniations had higher regression rates than bulging and protruding ones [7]. The review also found that about 22% of people with extruded or sequestered herniations ended up needing surgery [7], so "shrinks well" doesn't mean "always settles without help".
Dr Miles' tip: Short, gentle walks beat lying still. The Clinical Care Standard says prolonged bed rest should be avoided and that staying active supports recovery [2]. Change position often rather than sitting for long stretches.
When a Disc Problem Needs Urgent Care
Go to Your Nearest Emergency Department If You Experience: loss of bladder or bowel control, numbness around the groin or between the legs, progressive weakness or numbness in one or both legs, severe pain that keeps getting worse, fever or feeling generally unwell, or back pain after a serious accident [2]. Don't wait for an appointment. If your pain isn't improving after about a month, get it reassessed [2].
The Bottom Line: "Slipped disc" is a nickname for a herniated disc, and a bulging disc is a broader, usually milder change. Both are common, both often settle, and your symptoms matter more than the wording on your scan. Chiropractic care may help you manage pain and keep moving, and warning signs always come first.
Frequently Asked Questions
Is a bulging disc the same as a slipped disc? Not quite. "Slipped disc" usually means a herniated disc, where material has pushed out of a focal weak spot. A bulge is a broader, more even outward change that is often painless [5][6].
Which is worse, a bulging or herniated disc? A herniation is more likely to cause pain because it can irritate a nerve [6], but severity depends on your symptoms, not the label.
Is a disc bulge serious? Usually not. Bulges are very common in people without pain and are generally part of ageing [2]. See your GP promptly if you have any of the warning signs above.
Do I need an MRI to know which one I have? Usually not. The Clinical Care Standard says imaging is kept for suspected serious causes or when it would change your care [2].
Ready to Find Out What's Behind Your Disc Pain?
Book a visit with Dr Miles at Up Chiropractic in Leederville and we'll work out what's going on and whether chiropractic care is right for you: Book an appointment. You can also see our services.
References
Brinjikji W, Luetmer PH, Comstock B, et al. "Systematic literature review of imaging features of spinal degeneration in asymptomatic populations." American Journal of Neuroradiology. 2015;36(4):811–816. https://pubmed.ncbi.nlm.nih.gov/25430861/
Australian Commission on Safety and Quality in Health Care. "Low Back Pain Clinical Care Standard." https://www.safetyandquality.gov.au/sites/default/files/2022-08/low_back_pain_clinical_care_standard.pdf
Bronfort G, Hondras MA, Schulz CA, Evans RL, Long CR, Grimm R. "Spinal manipulation and home exercise with advice for subacute and chronic back-related leg pain: a trial with adaptive allocation." Annals of Internal Medicine. 2014;161(6):381–391. https://chiro.org/Low_Back_Pain/Spinal_Manipulation_and_Home_Exercise.shtml
Fardon DF, Williams AL, Dohring EJ, Murtagh FR, Gabriel Rothman SL, Sze GK. "Lumbar disc nomenclature: version 2.0. Recommendations of the combined task forces of the North American Spine Society, the American Society of Spine Radiology and the American Society of Neuroradiology." The Spine Journal. 2014;14(11):2525–2545. https://pubmed.ncbi.nlm.nih.gov/24768732/
Radiopaedia. "Intervertebral disc disease nomenclature." https://radiopaedia.org/articles/intervertebral-disc-disease-nomenclature
North American Spine Society. "Bulge Herniation." Know Your Back. https://www.spine.org/KnowYourBack/Conditions/Degenerative-Conditions/Bulge-Herniation
Yu P, Mao F, Chen J, et al. "Characteristics and mechanisms of resorption in lumbar disc herniation." Arthritis Research & Therapy. 2022;24:205. https://pmc.ncbi.nlm.nih.gov/articles/PMC9396855
