A bulging disc is a fairly common degenerative spinal condition that affects millions of Americans each year. This condition is most often a result of the natural deterioration the spine undergoes as we age, and is more prevalent in individuals over the age of 50. A disc bulge can result when a spinal disc that has been subjected to many years of daily wear and tear becomes brittle and loses its elasticity. When this occurs, a weakened disc that is under pressure can develop a bulge due to the gel-like interior contents of the disc (the nucleus pulposus) pressing against its outer wall (the annulus fibrosus) until the wall is stretched by the constant force. If a bulging disc isn’t treated and the pressure persists, it’s possible for the disc to rupture, allowing its inner contents to escape into the spinal canal.
In many cases, a disc bulge doesn’t produce any noticeable symptoms and the individual is unaware of its existence. However, pain and other issues can develop if the damaged disc extends beyond its normal boundaries in the spinal canal and causes the compression of the spinal cord or a nearby nerve root. This can result in symptoms such as pain that is localized at the site of the bulging disc, pain that radiates along a nerve pathway to other areas of the body, muscle weakness, numbness, tingling and muscle spasms. The location of the symptoms will depend on the area of the spine that has been affected. If the damaged disc is located in the cervical spine (neck area), symptoms can manifest in the neck, shoulders, upper back, arms and hands. A disc bulge in the lumbar spine (lower back area) can cause symptoms in the lower back, hips, buttocks, legs and feet.
Bulging disc diagnosis
If you suspect that a bulging disc may be the source of your lingering discomfort, you should see a physician to receive a full diagnosis. There are several types of physicians who may be able to diagnosis a bulging disc, including:
- Your primary care doctor — who practices general medicine and can refer you to a specialist if needed
- An orthopedic doctor — who is trained in the treatment of disorders, injuries and diseases of the musculoskeletal system
- A neurologist — who specializes in the diagnosis and treatment of all categories of conditions involving the central and peripheral nervous systems
- A physiatrist — who can treat a wide variety of conditions affecting the brain, spinal cord, bones, nerves, joints, muscles, tendons and ligaments.
- A chiropractor — who specializes in the diagnosis and treatment of mechanical disorders of the musculoskeletal system, especially the spine
The diagnostic process will likely involve a review of your personal and family medical history to determine if you are predisposed to a degenerative spinal condition, as well as a physical exam to evaluate your pain, flexibility and reflexes. An imaging procedure, such as an X-ray, MRI or CT scan, may be performed to confirm the diagnosis and pinpoint the location of the disc bulge.
Many individuals who have been diagnosed with a bulging disc have a variety of treatments to choose from. Your physician will likely consider the severity of your symptoms and the effects they are having on your quality of life, your age, the location of the damaged disc and a variety of other factors while determining the best course of treatment. Options may include conservative and alternative therapies, which are designed to reduce the inflammation at the site of the disc bulge while also lessening the pressure on the spine. Surgery may be a consideration for more severe cases, but only after nonsurgical treatments have failed to produce the desired results.
Conservative bulging disc treatment
If your physician suggests you try conservative treatment, there are several different options that may work for you. These treatments should be attempted for a period of several weeks or months to give them sufficient time to provide symptom relief.
Some treatments you may want to try include:
- Over-the-counter pain and anti-inflammatory medications. Nonsteroidal anti-inflammatory drugs (NSAIDs) can help block the production of enzymes that trigger inflammation in the body, while pain medications such as acetaminophen can temporarily reduce the pain itself. Prescription pain killers may be recommended in cases involving chronic pain or severe nerve compression.
- Alternating hot and cold compresses. Limited periods of applying ice to the affected area of the spine can temporarily reduce pain while also helping to minimize inflammation by decreasing the blood flow in the area. The application of heat can relax tense muscles while also promoting the healing process by increasing the blood flow to the area.
- Corticosteroid injections. Medications can be injected directly into the epidural space of the spine and can be administered once or in a series over several weeks or months. These injections can provide immediate pain relief through a numbing agent, and also contain a corticosteroid that can provide relief for several days or months.
- Periods of rest. Activities such as sitting or standing for long periods can put a significant amount of stress on the spine and make the symptoms of a bulging disc worse. Periods of rest may be needed to allow the muscles supporting the spine to relax.
- Physical therapy and exercise. Working regularly with an experienced physical therapist can provide multiple benefits for individuals experiencing painful bulging disc symptoms. By strengthening the muscles supporting the spine, it may be possible to shift enough stress away from the affected disc to allow it to return to its normal shape, thus reducing the nerve compression. Frequent stretching can also reduce the tension in the spine.
Another important part of any conservative treatment plan is to adjust your lifestyle to reduce the pressure on your spine and promote better overall spine health. Some considerations may include losing excess weight, avoiding alcohol and tobacco use, using better posture and avoiding motions that could further aggravate your back, such as heavy lifting and frequent bending. It’s also important that you avoid high-impact activities, such as running, gymnastics and contact sports.
Alternative treatment options
While the clinical effectiveness of alternative bulging disc treatment is still being debated, many individuals choose these therapies as a supplement to their traditional treatment plan. However, it’s important to always consult your physician before attempting any form of treatment.
Alternative treatment options include:
- Chiropractic treatment — to realign the spine and help reduce pain and inflammation
- Massage therapy — to relax the muscles supporting the spine
- Pilates or restorative yoga — to strengthen the core muscles supporting the spine and improve overall flexibility
- Acupuncture — to help reduce pain and muscle tension
- Herbal therapies — which can serve as a natural alternative to pain and anti-inflammatory medications
Bulging disc surgery
If you have attempted conservative and alternative bulging disc treatment for several weeks or months and your symptoms have persisted or even worsened, making it hard to enjoy a normal day-to-day life, you may be a candidate for surgical treatment. While your physician may suggest open neck or back surgery, which typically involves a lengthy hospital stay, large incisions and a potentially difficult recovery period, USA Spine Care performs minimally invasive bulging disc surgery that is a safer and effective alternative to open spine surgery.^
The outpatient surgical treatments we offer are performed in our state-of-the-art surgery centers and are designed to relieve the symptoms of a bulging disc. Options include:
- Discectomy. In this procedure, surgeons utilize muscle-sparing techniques to remove a portion of a damaged disc that is compressing a nerve. This can relieve the symptoms at their source.
- Laminotomy or foraminotomy. These procedures may be an option when removing tissue to open up enough space in the spinal canal or nerve root exits to stop a bulging disc from putting pressure on nerves.
- Stabilization. A stabilization procedure may be recommended to add support and stability to the spine.
If you would like additional information about USA Spine Care, our state-of-the-art surgery centers or our minimally invasive bulging disc treatments, please contact us today. Our board-certified surgeons+ have helped more than 75,000 patients find relief from neck and back pain, and we’re proud to have a 98 out of 100 percent patient recommendation score.^ We will be happy to assess your symptoms and provide a free MRI review* to help determine if you are a candidate for our outpatient procedures.