Bulging disc or herniated disc: what's the difference?
Picture the disc as a cushion with a tough outer ring and a jelly-like center. In a bulge, the center presses that ring outward. In a herniation, it can push all the way through. Same disc, different degree.
Research papers sort these changes into finer bins (bulging, protrusion, extrusion, sequestration), and those labels matter for a reason we'll come back to. If your report says herniation, the herniated disc treatment page is the closer match.
Is the bulge on your MRI actually causing the pain?
Maybe not.
In 2015, Brinjikji and colleagues pooled 33 studies covering 3,110 people with no back pain and looked at what their scans showed anyway. Disc bulges turned up in 30% of the pain-free 20-year-olds and 84% of the pain-free 80-year-olds, and the authors concluded that many of these findings are likely normal aging with no link to pain.
So a bulge on the report is a clue, not a verdict. What connects it to you is how the pain behaves, and the patterns Mecham Chiropractic associates with a disc are specific: worse sitting or driving, pain that runs below the knee, trouble bending forward or getting up from a seat, and flare-ups that fade and come back.
Sitting is hard to miss in this valley. A stop-and-go I-15 commute can turn a quiet ache into a loud one before you're off the exit ramp.
Why decompression gets considered for a bulge
On the DRX9000 you lie with a harness at the pelvis while a computer pulls, eases off and pulls again. It cycles on purpose, because a steady pull makes the muscles along the spine clench against it. The goal, and it's a goal more than a proven effect, is to take some load off an irritated disc.
University of Utah Health lists bulging discs among the conditions it offers decompression therapy for. The table's maker describes it for low back pain and sciatica tied to herniated discs, degenerative disc disease and radicular pain. Our DRX9000 overview explains what its 2006 FDA clearance does and doesn't mean.
Does decompression work for a bulging disc?
Honestly, nobody has shown that it does, and the stronger research leans toward traction not adding much.
The biggest look at traction for low back pain is the 2013 Cochrane review by Wegner and colleagues: 32 randomized trials, 2,762 people. Manual or mechanical, alone or combined with other care, traction made little or no difference to pain, function, overall improvement or return to work. That evidence was low to moderate in quality, so it's not the last word, but it's the heaviest one on the scale, and 7 of the 32 trials reported side effects such as increased pain, worsening neurological signs or later surgery.
Now the part specific to bulges. Remember those finer labels? In research that Wang's 2020 review cites, sequestrations regressed 96% of the time, extrusions 70%, protrusions 41% and plain bulges just 13%, so a plan that hinges on the bulge shrinking hinges on the change that happened least often.
Bleak? Not quite. Set that 13% beside the scan research above and another reading appears: a bulge may not need to shrink for pain to settle, because it may never have been the whole story. That's our inference from two separate bodies of research, not a conclusion either paper states.
And the DRX9000 study clinics like to quote? Christian Apfel's group reported average pain falling from 6.2 to 1.6 among 30 patients, but without a comparison group there's no telling what time alone would have done. We don't know of a controlled trial of decompression for bulging discs by themselves, and we'd rather say so than stretch herniation data to fit.
That's why Mecham Chiropractic treats decompression for a bulge as a trial with an exit, and why our honest look at whether spinal decompression works is worth reading before you commit to anything.
Who shouldn't have decompression
It's ruled out for anyone with a fractured or unstable spine, hardware from a fusion, cancer currently in the spine, osteoporosis past a safe limit, a pregnancy or an aortic aneurysm. Dr. Cody Mecham checks for these before the first session. If decompression isn't right for you, you'll get a straight no.
Don't wait for an appointment if you lose control of your bladder or bowels. That can signal cauda equina syndrome, a medical emergency, so go to an emergency room. A leg that keeps getting weaker also needs a physician soon, not a decompression table.
What a bulging disc plan looks like at Mecham Chiropractic
First comes the exam: history, orthopedic testing and a review of relevant imaging, including the report that likely sent you searching.
If a disc looks like the real problem, the usual plan fits 20 to 30 table sessions into 8 to 12 weeks, roughly 20 to 30 minutes each, with chiropractic care and advice on sitting and movement built around the table time. A little next-day soreness early on isn't unusual. Real pain during a session means stopping to rethink.
No table shortens the drive home on I-15, which is why the sitting advice counts for something. Treatments 8 to 12 are the checkpoint; without meaningful improvement by then, the plan gets reconsidered, and the session-by-session guide to spinal decompression covers what that looks like.
Paying for it
Plan on self-pay: Medicare hasn't covered vertebral axial decompression since 1997, and Aetna, which last reviewed its policy in March 2026, still calls it unproven. For a national reference point, a 2020 FairWarning report put a full DRX9000 course at about $3,500.
More on what spinal decompression costs in Salt Lake City and whether Utah insurance covers it. If the pain has moved into one leg, try the sciatica and pinched nerve page.