Back Injuries:  Disc Bulge verses Disc Herniation

In many personal injury cases we represent victims with back injuries.  If there is no evidence of the injury on an X-ray, CT scan or MRI, the injury is often called “soft tissue” and treated very cautiously by the insurance industry.  If there are broken bones, such as vertebra, such injuries are taken seriously.   These injuries often heal but also may require surgery and result in significant permanent dysfunction.

Many times, however, we represent victims whose injuries are described as a disc bulge or a disc herniation.  When a trauma results in either a bulge or herniation, we need to be doubly sure the doctors have correctly characterized the injury and the prognosis.

Disc Bulge from Trauma

When the physician has diagnosed your back injury as a disc bulge, this means that there is disc material beyond the normal margins of the disc for at least 50% of the circumference of the disc.  This displaced disc material can be the nucleus, the annulus, or parts of both.  Depending on the location of the bulge and the extent of the bulge, it can compress the nerve roots and or the spinal cord, causing pain.  This pain can be more severe than a herniation depending on where it is located and what nerves it is pushing against.

Symmetrical bulges are when the right and left sides of the bulge are, more or less, equally bulging from their normal position.  Asymmetrical bulges are when there is more than 50% of the disc material outside of its normal position but on one side.  This is frequently what causes pain, when it impinges on the nerve or spinal cord.

Disc Herniation from Trauma

According to the Nomenclature and Classification of Lumbar Disc Pathology, adopted by the American Society of Spine Radiology and the American Society of Neuroradiology in 1995, when a disc is herniated, there is a displacement of disc material beyond the limits of the vertebral disc space that extends less than 50% of the disc’s circumference.

A broad based disc herniation involves 25% to 50% of the disc circumference.  A focal herniation involves less than 25% of the disc circumference.

Disc Injuries and Pain and Suffering

Notwithstanding the medical classification of the disc injury, if you have a bulging disc or a herniated disc as a result of trauma, it is important for the treating physicians to focus on how the pathology is impacting you, including the damage to the nerves that the disc is affecting.

An experienced personal injury attorney will request a medical report from your medical expert asking to explain how your disability symptoms are caused by your disc injury or injuries.  A full explanation is required because insurance company adjusters and insurance defense trial lawyers are often trained to put a “bulge” in the insignificant box.

Experienced Personal Injury Lawyer and Back Disease

Wherefore, if you suffer a back injury from a traumatic event causing long-term disability, even if it’s only partial disability and pain, you need to have your personal injury lawyer carefully match up your clinical findings with the objective tests (MRI, CT scans, etc.) before he or she questions the doctors.    A proper understanding of disc disease will enable your lawyer to get a full explanation, which will translate to the insurance company understanding the extent of your injuries.