Almost every patient who comes in after getting an MRI for back pain has the same question. “It says I have a herniated disc, or a bulging disc, or a disc protrusion, or a disc extrusion. What does that mean? And is it bad?”
The answer is more reassuring than most patients expect. Here’s what the imaging report is actually telling you, what each pattern feels like, and what to do about it.
What a Disc Actually Is
Between every pair of bones in your spine sits a disc. It looks like a flat jelly donut. The outside is tough and fibrous. The inside is soft and gel-like, and it acts as a cushion.
Discs take pressure when you move. They also let your spine bend and twist. A healthy disc has lots of water in it and bounces back from pressure easily.
Discs change as you age. They lose water, get a little thinner, and the outside develops small cracks. Most adults over 30 have some disc changes on imaging, even if they feel totally fine.
This is the first thing patients need to know: disc findings on an MRI are super common in people who feel fine. Studies show 30 to 60 percent of adults with no pain have disc bulges or other “findings” on their scans. The imaging finding by itself doesn’t mean something is wrong. What matters is whether the finding matches what you actually feel.
Bulging Disc
A bulging disc is just what it sounds like. The disc has spread out past where it should be, but the outer wall is still in one piece. The gel inside is still inside.
Think of an over-inflated bike tire. The tube hasn’t popped. It’s just pushed out all the way around.
Bulging discs are very common and often cause no pain at all. When they do hurt, it’s usually because the bulge is pressing on a nearby nerve. The pain pattern depends on where the bulge is and which nerve it’s pushing on.
Herniated Disc
A herniated disc is a bigger deal. The outer wall has cracked, and some of the gel inside has pushed out. There are different sizes of herniation:
Small herniation. The gel pushed out a little but the outer wall is still mostly holding it in. Less serious.
Bigger herniation. The gel pushed out a lot, or it’s broken through the outer wall completely. The gel is still attached to the disc.
Fragment. A piece of the gel has broken off and is floating loose. The most serious type, but the body often absorbs the loose piece over time.
Herniated discs are more likely to cause pain than bulging discs because the pushed-out material is more focused in one spot, so it’s more likely to press on a specific nerve.
What Each One Feels Like
Honest answer: there’s a lot of overlap, and you can’t always tell them apart from symptoms alone. Both can cause back pain, pain that travels into a leg or arm, and numbness or weakness. An MRI is the only way to know for sure.
That said, here are some general patterns:
Bulging disc. Usually a more general back pain. Sometimes pain that travels, but not as bad as a herniation. Worse with long sitting, bending forward, or coughing. Better with walking and moving.
Herniated disc. More likely to cause sharp pain that travels into one leg or arm (sciatica). Numbness, tingling, or weakness in a specific spot. Worse with bending forward or sitting. Sometimes starts suddenly after a specific event, sometimes builds up slowly.
Both usually get a lot better over weeks to months with the right care. The body actually absorbs herniated disc material in a lot of cases. Studies of patients with confirmed disc herniations show 60 to 70 percent get a lot better on their own within 6 months, even without specific treatment.
What to Do About Each
Good news: the care for both is mostly the same. Here’s what helps:
Don’t sit for hours. Sitting puts more pressure on your discs than any other common position. Get up and move every half hour or so. If you have a desk job, this is the most important habit to change.
Walk every day. Walking pumps water and nutrients in and out of your discs. Discs don’t have a direct blood supply, so movement is how they get fed. A daily walk makes a real difference.
Don’t lift heavy things while bent forward. Lifting with a rounded back is the riskiest move for discs. Keep what you’re carrying close to your body. Bend at the knees, not the back.
Sleep position matters. Side sleeping with a pillow between your knees, or back sleeping with a pillow under your knees, takes pressure off the discs overnight.
Certain stretches. Specific stretches that bend the back gently backward often help shift disc material away from the nerves. Not right for every case, so check with a provider first.
Chiropractic care. Targeted adjustments take pressure off the bothered disc, calm the nerve, and free up nearby stuck joints that may be making things worse.
Dry needling and acupuncture. Help with the chronic muscle tightness that usually goes with disc issues.
Some cases do need more help. If you have major weakness, lose control of your bladder or bowels, or the pain is still bad after months of care that is not working, it makes sense to talk to a surgeon. But most disc issues get better without surgery.
When Imaging Is Misleading
An MRI report can scare you into thinking you’re more broken than you are. Phrases like “multi-level disc desiccation” or “broad-based posterior disc bulge” sound serious. They usually describe normal wear that comes with age. Millions of people with zero pain have those same lines in their reports.
One question matters: does the finding match what you feel? A careful exam answers that. A report read by itself often can’t.
When to See a Chiropractor
If your back pain, or pain running down a leg or arm, hasn’t settled in a few weeks, chiropractic care is a good first step. We do a careful exam, compare it with any scans you have, and tell you straight: whether we think care will help, whether a different provider fits better, or whether you should see a doctor first.
If you have any of these, see a doctor before seeing us:
- Sudden severe weakness in a leg or arm
- Loss of bowel or bladder control
- Numbness in the saddle region (between the legs)
- Progressive worsening over days despite rest
- Severe night pain not improved by position changes
- Fever, unexplained weight loss, or history of cancer with new pain
These are red flags that need imaging and medical evaluation first.
Frequently Asked Questions
Can chiropractic care fix a herniated disc?
It depends what you mean by “fix.” An adjustment can’t push the disc back into place. What care does is take stress off the sore area, free up the stiff joints around it, and calm the tight muscles. That gives your body room to heal itself. Many patients with herniated discs get back to full speed with this kind of care alone.
Should I get an MRI?
Not always. An MRI helps most in three cases: your nerve symptoms are bad or getting worse, you have done a real stretch of care and surgery is on the table, or a red flag points to something more serious. For everyday back pain early on, a scan rarely changes the plan.
My MRI says I have multiple disc bulges. Am I going to need surgery?
Probably not. Most bulges are normal wear and cause no pain at all. Even when they do hurt, care without surgery works for most people. Surgery is saved for big nerve problems, pain that won’t budge after months of care, or specific structural problems.
Will my disc heal back to normal?
It often shrinks back over months. Your body absorbs the pushed-out material in many cases. The disc won’t look brand new again on a scan, but it doesn’t have to for you to feel good and move well.
Can I exercise with a herniated disc?
Usually yes, with the right moves. Walking is almost always safe and good for you. Gentle backward-bending exercises often help. Hold off on heavy lifting and high-impact sports until the sharp pain settles. Most people get back to their normal workouts once the sharp pain settles.
Get Started
If you’ve been told you have a disc issue and you’re not sure what to do about it, a chiropractic evaluation can correlate the imaging with your symptoms and give you a clear plan. We see plenty of patients who came in afraid of their MRI report and left with a much clearer picture of what to do next.
We see patients from West Omaha, Millard, Elkhorn, and the broader Omaha area.
Book your visit online or call (402) 330-8600.
About the Author
Dr. Dane Becker found chiropractic the way a lot of his patients do: through pain. A weightlifting injury in college left him with such intense back and chest pain he thought he was having a heart attack. His trainer sent him to a local chiropractor, the pain backed off almost immediately, and he was hooked.
Since 2008 he’s been practicing in West Omaha, serving patients from Millard, Elkhorn, and the broader Omaha area. He trained in sports injuries through postgraduate CCSP education and has worked with numerous NFL, NBA, and MLB players, along with college and professional female athletes. He is also a Certified Whiplash Expert who focuses on auto injury cases. Becker Chiropractic & Acupuncture is a multi-year Best of Omaha winner. When he’s not at the clinic, he’s with his three kids (Colson and twins Lyla and Liam), and the family is happiest on a beach.
