You got an MRI for your back or neck pain, and the report came back reading like a foreign language. Herniation. Desiccation. Extrusion. Foraminal narrowing. It is unsettling to hold a document about your own spine and not understand a word of it — and it is even worse when nobody takes the time to translate.
Here is what the most common terms actually mean, and why the scariest-sounding ones are not always the ones that matter.
“Bulging disc” vs. “herniated disc” — they are not the same
A spinal disc is a cushion between two vertebrae. Think of it like a jelly donut: a tough outer ring with a softer center.
A bulging disc means the whole disc has spread out a little past its normal border, like a hamburger slightly too big for its bun. It is extremely common and often causes no symptoms at all.
A herniated disc means the softer center has pushed through a tear in the outer ring. Your report may call it a protrusion (a small, contained push) or an extrusion (the material has broken further out). An extrusion sounds alarming — and our published case series documented measurable reduction in an extrusion without surgery, so it is not automatically a one-way ticket to the operating room.
“Degenerative disc disease” is not really a disease
This phrase frightens people more than almost any other term, and it shouldn’t. It mostly describes normal, age-related changes — drying out (you may see the word desiccation) and losing some height over time. Plenty of people with these findings have zero pain. It is closer to “your spine has some mileage on it” than a progressive illness.
“Stenosis” and “foraminal narrowing”
Stenosis means narrowing. Central canal stenosis is narrowing of the main channel your spinal cord runs through; foraminal narrowing is tightening of the small openings where nerve roots exit. When those spaces get tight, they can pinch a nerve — producing pain, numbness, or tingling that travels down an arm or leg.
The most important thing nobody tells you
Your MRI describes structure, not pain. Studies repeatedly find bulges, herniations, and degeneration in people with no symptoms at all. So a finding on your report does not, by itself, explain your pain.
What matters is whether a specific finding lines up with a specific symptom — and that is something an MRI alone can never tell you. It takes a hands-on exam that pairs what the images show with what your body is actually doing. That is also why non-surgical spinal decompression works for so many people: when the right level is identified, decompression targets that disc directly instead of treating the whole spine generically.
Frequently Asked Questions
Does a herniated or extruded disc always mean surgery?
No. Many herniations and even extrusions improve with non-surgical care. Our published case series documented measurable reduction in a disc extrusion without surgery. A proper exam and imaging review determine the right path.
My MRI says “multilevel degenerative changes” — should I worry?
Some degeneration is a normal part of aging and is often present in people with no pain. What matters is whether one specific level is actually driving your symptoms, which an exam — paired with the imaging — is designed to figure out.
What is the difference between a bulging and a herniated disc?
A bulge is the whole disc spreading slightly past its border. A herniation is the inner material pushing through a tear in the outer ring. Herniations are generally more likely to irritate a nerve, but severity depends on size and location, not the label alone.
Should I bring my MRI to a consultation?
Yes. Reviewing your actual images and report lets us give you a specific, honest answer instead of a generic one.
Get your MRI reviewed by a decompression specialist
Contact Dudum Chiropractic in Walnut Creek for a consultation and imaging review.
If you are holding an MRI report full of terms you never signed up to learn, bring it in. We will tell you in plain language what it means for you — and whether you are a candidate for non-surgical care.
Serving Walnut Creek, Lafayette, Concord, Pleasant Hill, Danville, Orinda, and the entire East Bay.
Dr. JD Dudum, D.C., is the founder of Dudum Chiropractic in Walnut Creek, CA, and a published researcher on non-surgical spinal decompression in the Journal of Contemporary Chiropractic. This article is for educational purposes and is not a substitute for an individual evaluation.