In the previous post I attempted to explain the basic differences between a disc bulge and a disc herniation. In doing so we learned that a disc herniation can be contained or uncontained and it can be focal or broad based. Disc herniations can also be further categorized as a protrusion or an extrusion. A protrusion is when the base of the herniation is wider than at any other point. An extrusion, usually a type of a focal herniation, is just the opposite in that the base is more narrow than other parts of the disc material. See the picture below.






If the extruded disc material becomes displaced and has no continuity with the disc of origin it can further be classified as a sequestered disc (Not to be confused with a sequestered government). This is sometimes referred to as a free floating fragment. Sometimes even with a MRI it is hard to see a break in the continuity and because of this sometimes you will see the term disc migration.

So overall you can either have a disc bulge or a disc herniation. And the herniation can be categorized as contained or uncontained, focal or broad based and protruded or extruded. The extruded disc can be sequestered or non sequestered. I know this sounds like semantics but it's important to know what you have been diagnosed with, because the prognosis and best treatment options are different for each.  As far as a slipped disc...more often than not when someone talks about a slipped disc they are talking about a herniation, but not always. A disc cannot slip in and out of place, although there are some forms of decompression therapy that can sometimes reduce the overall size of the herniation and therefore minimize the symptoms. Usually when someone in my office tells me that their disc slips in and out at times causing pain, I usually attribute that to inflammation. That's not to say they don't also have a herniation present. So if you ever have a MRI and are told you have a herniation, don't be afraid to ask questions and find out for sure what is going on with your back. In part three I will talk about the symptoms associated with disc injuries and what treatment is available. As always, if are looking for a chiropractor in Campbell County or you have any questions regarding this topic call Alexandria Chiropractic Center at 859-635-6666 and ask to speak with Dr. Kevin Crowley. Or go to the "ask the doctor" page on our website.

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