FAQs on Bulging Disc and Treatment
A bulging disc is not the same as a herniated disc. With a herniated disc, the outer layer of the disc (annulus) cracks and allows the soft inner material (nucleus) to rupture out of the structure. With a bulging disc, the disc bulges outside of the space it usually occupies between two vertebrae, but the inner portion does not rupture from it.
What causes a bulging disc?
Discs tend to bulge as a normal part of age and wear-and-tear on the vertebral column. Some discs bulge due to the degeneration process that is associated with aging, but this is not always a serious thing. Many people with a bulging disc have no symptoms. A disc that is bulging becomes serious when it protrudes enough to cause narrowing of the spinal canal. Overuse or misuse of the back often leads to a bulging disc, such as with a physical demanding job or athletic events.
What are the symptoms of a bulging disc?
Commonly occurring in both young and older adults, bulging discs are not always painful. However, some people with a bulging disc experience back pain, muscle weakness, and numbness.
The symptoms depend on which area of the back is affected. When a bulging disc presses on the spinal cord of the thoracic (middle back) region, symptoms include increased reflexes in one or both legs, muscle weakness, tingling, and/or numbness in one or both legs, and changes in bowel and/or bladder function. If the disc bulges in the cervical (neck) region, symptoms include pain of the neck, as well as radiating pain to the upper arm, shoulder, forearm, and/or fingers.
How is a bulging disc diagnosed?
The diagnosis of a bulging disc begins with a detailed past medical history and history of present illness. The doctor will then conduct a physical examination and carefully evaluate the spine, reflexes, motor strength, and sensory function. Diagnostic tests will include x-rays of the spine, computed tomography (CT) scan (done with or without a myelogram), and/or magnetic resonance imaging (MRI) scan.
Who is at risk for a bulging disc?
Bulging discs are more common in people in their 30s and 40s, but they can affect anyone. Risk factors include:
- Participating in contact sports
- Working in an occupation that requires lifting, bending, twisting, pulling, and pushing
- Injury or trauma, such as with a bad fall or motor vehicle accident
- Alcohol and tobacco use
What are the treatment options for a bulging disc?
The goal of treatment for bulging disc involves alleviating the pain and preventing further problems of the spine. Depending on the severity of the bulging disc, treatment options include:
- Physical therapy – The patient works with a physical therapist to build strength, improve endurance, and enhance flexibility of the back and spine.
- Acupuncture – When performed by a skilled practitioner, acupuncture is effective for the pain associated with bulging disc. Small needles are inserted into acupoints, which are located on twelve meridians. In a review of randomized control trials of acupuncture for chronic pain, this treatment was found superior to controls for each pain condition.
- Epidural steroid injection (ESI) – With this procedure, the doctor injects a long-acting steroid with or without an anesthetic agentinto the epidural space, which is a layer of tissue outside the spinal cord. According to research studies, ESI is associated with a 90% efficacy rate.
- Transcutaneous electrical nerve stimulation (TENS) – Electrodes are placed on the skin near the painful disc to deliver tiny electrical impulses that relieve pain. Many studies involving the use of TENS for chronic low back pain have been conducted to develop clinical practice guidelines, and they show that TENS provides initial relief of pain in 70% to 95% of patients. However, the analgesic effect varies related to minutes of use and degrees of pain.