A bulging disk can be very painful.
What is a Bulging Disk?
A bulged disc (disk) is sometimes used in conjunction with terms like pinched nerve and herniated disc, as well as torn and ruptured disc, slipped disc, disc protrusion and collapsed disc. Any of these labels identify the cause of the leg pain, arm pain, back pain, or neck pain the patient is feeling. Patients can have a bulging disk in the neck or bulging disk in the back. Sometimes a herniated disc, which may not be painful in and of itself, leaks out material that irritates a nerve, causing radicular pain that radiates out. For example, sciatica is leg pain that is caused by a pinched nerve. If a disc degenerates to cause leg or lower back pain, for another example, then “it is the disc space itself that is painful and the source of pain”. This is referred to as axial pain. Either of these scenarios can occur in the neck (cervical), upper back (thoracic), or lower back (lumbar). The lower back is the most common area of pain.1 There is a difference between a herniated disc and a bulging disk. In the case of a herniated disc, a crack in the outer disc layer (annulus) allows the inner material to rupture out. A bulging disk is a situation in which the disc has not ruptured, and it is more common than having a herniated disc, although the latter is “more likely to be painful”. It is possible that a bulged disc is not painful. It is a normal part of the aging process, but it is a serious matter when it bulges to the point where the spinal canal is narrowed. If combined with bone spurs, this is more likely, and that situation is “referred to as segmental spinal stenosis”. A physical job, athletics, and overuse/misuse of the disc weakens it. Smoking also causes the disc to deteriorate.2 A disk can be thought of as “a slice of an onion” having a “jelly center”. If an injury makes that center “punch through successive rings”, then that is a disc protrusion. If it “punches all the way through the outer ring” but is “still connected to the disc”, that is a disc prolapse. However, “if the jelly center punches through the outer ring and breaks off and settles in the spinal canal, it is called a sequestered disc”. In the case of a bulging disk, there is “hope for recovery without surgery” if the body heals itself.3
Bulging Disk Symptoms
Both young adults and people who are older can experience the bulged disc, and symptoms, if any, depend on where a nerve is pressed. Generally, symptoms include muscle weakness, numbness, and pain. It could even feel as if “it is coming from another part of your body, such as your heart, abdomen, or kidneys.” If the disc bulges in the thoracic area, the legs may experience symptoms such as numbness, tingling, or weakness, spastic reflexes, or even paralysis below the waist or bowel and bladder dysfunction. If the bulging is in the cervical region, a patient may have pain when moving the neck, shoulder blade pain, or even radiating pain down the arm to the fingers. Usually, after taking a complete history, a doctor will order X-ray, MRI, or a myelogram with CT scan.4 Patients with the best chance of recovering from a disc bulge likely have no arthritis, decent bone density, healthy tendons and ligaments, good flexibility in the spine, and have “well-conditioned spinal musculature, and (are) not overweight”.5
Bulging Disk Treatment
Most patients can be managed with conservative care, such as physiotherapy and pain medications. Symptoms may resolve on their own over months, but if they do not, surgery may be recommended. Procedures for this condition include discectomy, decompression, and laminotomy, as well as other, newer procedures. Spinal fusion may also need to occur, if a large amount of material is removed, leaving the spine unstable.6 To avoid additional problems from a bulging disk, and to give it the best chance to heal, it is important to try a few things. First, a patient should try “movement restrictions for at least a few months”, such as no prolonged sitting, no frequent bending, and no jumping or heavy lifting. Eating a healthy diet of non-processed foods may also help. The body should get enough ”vitamins, minerals, and anti-oxidants”. In addition, it will be helpful to lose weight, if the patient is overweight. They should also stretch the back often. Some patients may benefit from an inversion table.7 Chiropractors could be useful allies in dealing with disc problems, such as a slipped disc (another term for “bulging, ruptured, or herniated discs”). Unless a patient has cauda equina syndrome, or another emergency medical condition, chiropractic is a generally a safe, drug-free, alternative to medications and surgery. Spinal manipulation, manual therapy, and therapeutic exercises are often provided.8
Find out more about slipped discs and chiropractic care.