Bulging Discs

What are bulging discs?

Healthy vertebrae and discs are crucial to movement. The spine consists of 33 vertebrae, each separated by an intervertebral discs. These intervertebral discs are composed of a tough, fibrous outer layer called the annulus fibrosus.

Discs have three roles:

• Connect and form the spine
• Absorb weight placed on the spine
• Allow for movement

When discs are compressed, they become misshapen and press down on the nerves of the spinal cord. If you imagine a disc as a jelly donut, a bulging disc has jelly being pushed out on either side. It isn’t a fun image, but it is accurate. That “jelly” is actually a soft, gelatinous inner layer called nucleus pulposus. The tough outer layer keeps the disc together, but the nucleus pulposus may press on the nerves near the disc as it bulges.

This compression can cause bulging disc symptoms that include:

• Sciatic pain, which is pain that radiates across the buttocks and down the hip to the lower leg
• Numbness or tingling in extremities
• Back pain that worsens with too much sitting or movement

Some people may not experience pain unless the bulging disc is untreated and the disc herniates. Once herniation occurs, more aggressive treatment may be required.

What causes bulging discs?

Most bulging discs occur in the lower back, but they can also occur in the neck and upper back, too. An estimated 52% of those patients with a bulging disc in any area of the spine experience no symptoms or pain.

For the other 48% of people, your doctor can determine which disc or discs are bulging with an MRI or CT scan. Diagnostic imaging is suggested for those who have had four to six weeks of severe pain and haven’t benefited from conservative therapies.

Bulging discs are most often caused by time. As we age, the muscles of the back and abdomen weaken, and gravity takes its toll. This simple action of increased gradual pressure on the intervertebral disc can cause the disc to bulge.

This disc bulging due to aging is often referred to as degenerative disc disease, but certain risk factors can speed it up. Obesity, genetics, smoking, and certain repetitive motions can increase your chances of degenerative disc disease and the bulging discs that come with it.

As noted above, many people with bulging discs will not require treatment, but for those that do, there are options.

6 bulging discs treatments

While bulging discs can cause pain, most doctors start with conservative care that includes lifestyle changes and exercise.

Here are six bulging disc treatments from least to most interventional.

1. Rest: While long-term rest for back pain can be counterproductive, in acute flare-ups rest can be supportive
2. Exercise: This helps reach and maintain a healthy weight for optimal spine health
3. Diet: An anti-inflammatory diet can help ease inflammation caused by bulging discs
4. Physical therapy: Targeted exercises help strengthen the core and back muscles to provide support
5. Over-the-counter anti-inflammatory pain relief medications: Ibuprofen and naproxen sodium taken in conjunction with exercise and diet can help ease pain and improve movement
6. Epidural steroid injections: These minimally-invasive injections can help if pain and inflammation restrict movement and makes other treatments impossible

Acupuncture and chiropractic care are also proven strategies for lower back pain management.

Surgical treatment is usually not necessary. If all conservative treatments do not relieve pain or improve the condition, your doctor may want to discuss surgical options. A percutaneous discectomy is typically restricted to herniated discs but may be an option if your pain is not responding to other treatments.

References

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