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Hi, Mhoyos0407,

Welcome to EmpowHer, and thank you for your question!

Did your doctor not give you enough information about your condition after your MRI? Don't you hate that?

I'll be glad to see if I can help. First, let's talk about "diffuse bulge."

Your spine is made of 26 little interlocking bones. Between those bones are small discs, which are like gel-filled sacs. They protect the bones from rubbing and scraping against one another, and they make room for the nerves that run from the spinal cord to different parts of your body.

Think of a disc as looking like a Frisbee, only made of gel.

When one of those discs is damaged, either from a trauma (like an accident) or from aging, it can get a little weaker on the outside of the disc. Wherever that weakness is, the gel "bulges" out a little. If it is a little bulge, it looks like a little bubble on the Frisbee. If it is a larger bulge, it basically just makes the whole Frisbee look bigger.

That last one -- the larger bulge -- is called diffuse. So that means that one of your discs in your spine is flattening out in a wide area because it's gotten weaker. And that is part of what causes your intense pain -- there's not as much protected space anymore between the bones of your spine and the nerves where that disc is.

Here's a page that shows you a diagram of a diffuse bulge. It's the second diagram:


Now let's talk about an annular disc tear.

Inside that disc, that gel-like Frisbee, there's a nucleus. As long as the gel material is strong, the nucleus is protected, which is good because it contains those nerve fibers that can be so painful. But when that gel-like material "rips" or weakens enough, some of the nucleus escapes and moves toward the outer areas of the disc. When this happens, you get pain from those nerves.

Here's a page with a diagram of a normal nucleus and one with a tear:


And now let's talk about that disc protrusion.

When that nucleus slips out into the "gel" (which is prpoerly called the annulus), it causes the disc to bulge out from between the vertebrae. Depending on how large the protrusion is, the pain can even travel down the legs.

And right-costolateral is the doctor's description of the location of the bulge, if I am interpreting this right.

So what I take this to mean is that one of your discs is so compressed that the "gel" has weakened, there is a large bulge, in that bulge the nucleus has broken out of its space a little bit, and because of all this, you are experiencing pain from the nerves not being protected.

Does that sound right?

Did you have a trauma or an accident or did this just happen slowly over time?

What treatment is your doctor recommending?

March 5, 2010 - 9:56am


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