Should I See a Chiropractor for a Bulging or Herniated Disc?

Many people use the terms slipped disc, bulging disc, and herniated disc interchangeably. They are related, but they are not all the same thing. Understanding the difference helps you make smarter treatment choices and avoid unnecessary stress or fear when pain strikes.

Is a Slipped Disc the Same as a Bulging Disc?

In Chiropractic practices, slipped disc is a non-medical term patients often use to describe a disc that has been injured and moved past its usual boundary and is causing symptoms.  This is not a diagnosis.

A disc bulge means the inner part of the disc is pushing outward but still contained within the outer ring (annulus fibrosus). The shape changes, and pressure can increase, but nothing has ruptured.  This is also often known as a disc tear because some of the fibres have lost their integrity.

A true herniation means the inner material (nucleus pulposus) has broken through a tear in the annulus, creating a higher chance of nerve irritation, and is very serious.

Take-home message:
A slipped disc may refer to a bulge or a herniation, but a bulging disc is still contained, and a herniation is not.

Pain of Disc Origin

Disc injuries can hurt for many reasons beyond the bulge itself. Research shows that:

• The disc can activate nociceptors (pain sensitive nerve fibres) in the outer annulus, ligaments, joint capsules, and nearby muscle structures.

• Many large disc bulges or herniations are asymptomatic and may not even be the direct source of pain.

• Disc size does NOT reliably predict symptom severity a small bulge can hurt a lot, and a large bulge can hurt very little.

• Pain is often worse when the disc is loaded, and relief can occur when it is unloaded or de-loaded.

• Inflammation is strongly linked to both pain and disc-degeneration progression, making conservative anti-inflammatory strategies essential.

• Most disc herniations improve within 4 to12 weeks using conservative care, regardless of herniation size.

Vertebral Endplate-Mediated Pain

Not all disc pain comes from the disc itself.

• Inflammation at the vertebral endplates can appear on MRI as Modic Type 1 changes, which are strongly linked to low back pain.

• These changes are inflammation-based, not mechanical, and often respond better to conservative care than fatty Modic Type 2 changes.

• Newer imaging tools (e.g., UTE MRI and MRS) are showing promise for detecting biochemical pain generators, but for now, we still rely on history plus physical exam, plus MRI referral when needed.

Spinal Manipulation and the Intervertebral Disc

Here’s the clinical reality based on 25 years in practice:

• Chiropractors do adjust in disc cases, but within clinical tolerance and when red flags are absent.

• Often spinal adjustments can be paired with mechanical decompression, orthopaedic assessment, posture shifts, and rehab protocols to remove the cause of pressure.

• In my practice, spinal adjustments are applied gradually and selectively. We don’t “force discs back in,” we reduce load bearing pressure caused by spinal dysfunction around the disc.

• Flexion distraction and traction-based approaches do provide measurable symptom reduction by reducing mechanical load on the affected disc.

My clinical rule:
If a patient tolerates movement, position-based unloading, and neuro-orthopaedic testing, and red flags are absent, then chiropractic assessment is safe and appropriate.

If neurological function progressively worsens then escalation is advised.

How Can a Chiropractor Help a Herniated Disc?

At Up Chiropractic in Leederville Perth, disc cases are assessed every week. Most involve middle-aged people getting back into activity and injuring a disc already weakened by degeneration or loading pressure from spinal dysfunction.

We don’t just treat the disc pain, we identify the cause of load and remove it using evidence-consistent care the body can tolerate.

What Is the Difference Between a Bulging Disc and a Herniated Disc?

• Bulge: Contained deformation of the annulus.

• Herniation: A tear in the annulus allows nucleus material to break through into the canal.

Bulge = contained, herniation = through a tear, pain = treat the pressure not only the picture.

What Causes a Herniated Disc?

Common causes include:

1. Age-related disc degeneration creating pre-existing weakness in the annulus.

2. Repetitive micro-trauma from poor posture and bad ergonomics.

3. Sudden trauma falls, accidents, or heavy lifting with rotation.

4. Lifestyle factors: smoking, obesity, sedentary work, lack of exercise.

5. Poor lifting mechanics.

Clinical Example:
A patient bends, lifts, and twists awkwardly carrying exercise equipment. The disc was already dehydrated and load-intolerant, and the sudden pressure caused a rupture of the annulus. The object being lifted, doesn’t need to be heavy. The worse case that I have seen, a patient was simply picking up an empty milk crate, meaning the problem pre dated the injury.

What Are the Symptoms of a Herniated Disc?

Symptoms depend on both severity and location.

Cervical (Neck) Disc Herniation

May include:

• Sharp, shooting pain into upper back, shoulder blades, arms, hands, or fingers

• Numbness or tingling

• Muscle weakness

• Consistent neck pain and discomfort

• Red flag: altered gait, Hoffman sign, or symptoms of myelopathy = urgent referral consideration

Lumbar (Lower Back) Disc Herniation

May include:

• Sharp or radiating pain into low back, glutes, legs, or feet

• Tingling or numbness

• Muscle weakness

• Persistent low back pain

• Red flag: saddle numbness or bladder/bowel dysfunction (possible cauda equina) = seek urgent medical care

How Is a Herniated Disc Diagnosed?

Diagnosis is based on:

• Thorough medical history

• Orthopaedic testing

• Neurological examination

• Functional movement assessment

• Referral for MRI only if symptoms fail to improve with conservative care

In my practice we assess load bearing changes using erect, weight-bearing spinal X-rays to map pressure points in posture and movement.

What Activities Should You Avoid With a Herniated Disc?

Avoid movements that dramatically increase intradiscal pressure:

• Heavy lifting beyond tolerance

• Repetitive bending, twisting, or rotations

• High-impact running or jumping if symptomatic

• Lifting with rotation

Clinical insight: I don’t tell people to stop moving, I tell them to stop loading it wrong.

Safe & Effective Exercise for Herniated Discs

Great rehab options include:

• Spinal decompression / traction positions

• Extension-based unloading if tolerated

• Modified Child’s Pose

• Core motor control rehab

• De-loading movements to reduce nerve pressure

Always stop if the movement increases symptoms.

Resolution of the Herniated Disc

Most patients improve in 6 to12 weeks if inflammation calms and load is reduced.

In practice, I have seen many patients:

• Avoid surgery

• Report major radicular pain reduction

• Return to walking, sleep, and sitting tolerance

• And in multiple cases, MRI scans show measurable reduction in disc bulge size after conservative chiropractic-led care.

Key clinical reality:
A disc may get smaller, dehydrated, resorbed, or unchanged, but pain and disability often still improve. Size alone is not the recovery story.

What I Want Every Patient to Know

• Disc pain is serious, but not always surgical

• Most improve if load is removed and neurology calms

• Chiropractic care treats the cause of pressure, not only the label

• The body needs safety, movement, support, and time, not fear

Get Back to Living Pain-Free

A bulging or herniated disc is not a life sentence. What matters most is that you restore:

✔ Movement
✔ Function
✔ Stability
✔ Load tolerance
✔ Neurological calm
✔ Smarter posture and lifting habits

When we treat in that order, patients recover well.

Conclusion: Should You See a Chiropractor?

Yes! At Up Chiropractic, Leederville Perth, our Chiropractor’s assess you properly, use ortho-neuro exams, and performs spinal adjustments within patient tolerance and without red flags.

Chiropractic care works best when it:

• Removes disc-loading forces from spinal dysfunction

• Improves neurology and pain response

• Restores movement capacity

• Supports a favourable natural inflammatory recovery timeline

It is not about cracking a joint, it is about reducing load at the cause so the disc and nerve can breathe, move, and recover.

How can we help?

If you’re experiencing disc-related back or nerve pain in Perth or Leederville, a Chiropractic assessment can give you clarity, direction, and a tailored non-surgical path forward.

At Up Chiropractic, Leederville Perth, we assess discs clinically, treat gently within tolerance, remove the cause of pressure, restore function, and set a rehab plan that helps you avoid recurrence and recover faster.

Book your consultation if you’re:

• Hurting in the desk chair but relieved by off-load positions

• Experiencing nerve pain, tingling, or weakness

• Or unsure if the disc is the true source

Smarter assessment. Safer spine. Better recovery.

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