Hard to tell just from that image as it is showing a side view of the spinal cloumn from the RH perspective. There is a left hand perspective as well.....that being said the most telling are the bird's eye view type images. You can see the bulge, and if it is entrapping any nerve roots or compressing the cord, and if so how much. Pain is subjective an 8 on your scale could be a 2 on someone elses and a 20 on yet another's.