Disc prolapse or disc bulge: understanding your MRI

For anyone who has had an MRI for back pain, seeing words like disc prolapse or disc bulge in a report can feel worrying. It is easy to assume these findings explain your pain, or even represent a life sentence. But is that truly the case?

 

What do disc degeneration, bulge and prolapse actually mean?

Disc degeneration

Over time, discs naturally change. They can lose some of their hydration and elasticity — rather like an older cushion that no longer has quite the same bounce as when it was new.

These changes are a normal part of ageing and do not necessarily mean something is wrong.

Disc bulge

A disc bulge occurs when the disc extends slightly beyond its usual boundary, while the outer layer remains intact.

Think of gently squeezing a jam doughnut. The dough may bulge outwards, but the jam remains contained inside.

Disc prolapse (herniation)

A disc prolapse occurs when the inner material of the disc pushes through a weakness or tear in the outer layer.

Using the same analogy, this is more like squeezing the jam doughnut firmly enough that some of the jam pushes out.

 

Do disc findings always correlate with symptoms?

Not always. Many people with these findings feel completely fine.

When symptoms are present, they may include:

Disc degeneration:
Often no symptoms at all. Some people may experience stiffness, aching or discomfort, particularly with prolonged sitting, standing or reduced movement.

Disc bulge:
Often no symptoms. In some cases, it may contribute to localised back pain or irritation of nearby structures.

Disc prolapse:
May cause back pain that travels into the leg (sciatica), along with symptoms such as numbness, tingling or weakness if nerves are affected.

In rare cases, changes affecting the nerves of the lower spine can result in loss of bladder or bowel control. This requires urgent medical assessment.

 

What do MRI findings actually tell you?

MRIs are highly sensitive and can reveal changes in the discs between your spinal bones. However, one of the most important things to understand is that many people have disc bulges or even disc prolapses on MRI without experiencing any pain or symptoms at all.

Research has shown that:

• Around 20–28% of healthy adults have a disc prolapse visible on MRI, even when they have no back pain (Boden et al., 1990).
• As we age, these changes become increasingly common. By age 50, up to 36% of people may have a disc prolapse and 60% may have a disc bulge — often without symptoms (Brinjikji et al., 2015).

It is natural to identify with what is written on an MRI report. After all, it sounds very specific and medical. But these findings are often simply part of being human — they are not, in themselves, a sentence to pain or disability.

Having a disc bulge or prolapse does not mean you will always have pain, or that your pain will never improve.

An MRI is a tool, not a crystal ball. It can provide valuable information and help guide decisions, but it cannot predict your future.

 

A gentle invitation to curiosity

If you have felt anxious or discouraged after reading your MRI report, you are not alone.

But what if your scan is only one part of your story? What else might be contributing to your experience of pain beyond what is written in a report?

Your experience of pain and your path forward are shaped by many factors — not just what appears on an image.

Curiosity and understanding can transform the way we relate to our bodies, even in the face of daunting scan results.

In the next post, The Buttafly Technique for back pain and sciatica, I’ll explore how this gentle approach can support your spine’s natural alignment, ease discomfort and help rebuild trust in your body — no matter what your MRI report says.

 

Sources: Boden et al. (1990), Brinjikji et al. (2015)