If a disc bulge is not addressed it can of lead to herniation, severe, crippling pain, or even surgery. To prevent this from happening, you need to undergo physical therapy for bulging discs.
What is a Bulging Disc?
A bulging disc or a disc bulge is a condition in which the inner portion of the nucleus of a spinal disc protrudes to its outer layer. This can put pressure on the surrounding nerve roots. When this happens, you will feel pain that radiates down your back and other areas of your body depending on the location of the bulge within your spinal column.
What is the Difference Between a Bulging Disc and a Herniated Disc?
A bulging disc is a protruding disc that may occur in any section of the disc. In some cases, the whole perimeter of a bulging disc protrudes. There is no rupture or tear in the outer layer of the disc but there is a small “bubble” distending into your spinal canal.
A herniated disc or a slipped disc, on the other hand, has a section of the nucleus pulposus (the jelly-like inner core of the disc made up of about 80% water and collagen fibers), that leaks into your spinal canal through a tear or rupture in the annulus fibrosus (this is made up of seven to 15 layers of fibers that surround and protect the nucleus which provides traction and structural support for the disc).
What are the Symptoms of Bulging Discs?
You don’t always have symptoms when you have a bulging disc. However, if the disc bulges enough to press on spinal nerves or narrow the spinal canal, it can lead to symptoms including pain, pins and needles, numbness, uncomfortable burning and tingling, muscle spasms, muscle weakness, or overactive reflexes. A disc bulge can be a precursor to a herniated disc.
What Causes Bulging Discs?
General “Wear and Tear”
The vertebrae and the discs deteriorate over time due to the aging process. Disc protrusion and wear and tear may be caused by changes in the distribution of your body weight.
People who smoke, people who are obese, and those who participate in contact sports are more likely to develop bulging discs.
Men and women who have a family history of disc disease are more susceptible to bulging discs.
Improper standing, sitting, or sleeping can put a strain in your back and neck which can result in developing bulging discs.
Employees whose work requires repetitive bending, lifting, driving and standing have an increased risk for bulging discs.
Injury or Trauma
Some people get involved in accidents that can cause a long-term injury which, in turn, causes a disc or discs to bulge.
How are Bulging Discs Diagnosed?
Medical History Review
The first thing that your doctor will do is to obtain your full medical history. He/she will ask you if you’ve had any past treatments and surgeries, whether you are taking any medications at present, if you have other health concerns, and if you have a family history of illness. The doctor will also ask you to describe the type of pain or discomfort you are experiencing, and what triggers the pain.
Depending on symptoms you may be describing or exhibiting, your doctor will conduct a physical exam which may include one or more of these tests:
- Muscle strength: The doctor may conduct a neurological exam to determine whether there is spinal nerve root compression from a disc. He/she will check if you have muscle atrophy, twitching, or any abnormal movements.
- Determining pain with touch or motion: The doctor may want to determine where the pain is originating by touching the parts of your body where you indicate pain or discomfort.
- Nerve function: The doctor may conduct a reflex test on the legs or arms to help determine whether your nerves produce a reaction. This test helps to determine if there is nerve root compression in your spine.
After your doctor has obtained your medical history and has completed a physical exam, he/she may have you take diagnostic tests to confirm his/her initial findings. These tests will also help him determine the location of a bulging disc and which nerve roots are being compressed.
- Spinal X-Ray: A standard X-ray can’t show if you have a bulging disc but it can show the outline of your spine. This can help your doctor rule out other causes of pain such as a fracture or tumor. A spinal X-ray provides detailed images of the bones of the spine that will help the doctor with the diagnosis and treatment of your back or neck pain. It can also help doctors evaluate a back or neck injury. It can be taken separately for the three main parts of the spine – cervical (neck), thoracic (mid-back), and lumbar (lower back).
- Magnetic Resonance Imaging (MRI) Scan: An MRI of your spine involves using a computer, radio waves and a magnetic field to generate detailed images of your spinal cord and surrounding tissues. MRI can help your doctor evaluate different sections of your body – in this case, your spine – to diagnose certain diseases or medical conditions.
- Computed Tomography (CT) Scan: A CT scan, just like an X-ray, generates several pictures or images of the inside of your body. It creates cross-sectional images of your spine and helps the doctor locate and evaluate the disc bulge.
- Discogram: A discogram is a mildly invasive diagnostic test using x-rays to examine your spine’s intervertebral discs. Your doctor will inject a special dye into the injured intervertebral disc or series of discs. The dye will make the disc visible in an x-ray film or monitor and the doctor will be able to identify precisely which disc or discs are damaged and causing you pain.
How are Bulging Discs Treated?
For many people, the symptoms from a disc bulge will diminish over time. There is no one-size-fits-all treatment for bulging discs. However, the main goals of treatments are to ease the patient’s pain and to allow the patient to return to normal life as much as possible.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are typically part of the initial treatment for bulging discs to help reduce the patient’s pain. If you experience muscle spasms, a muscle relaxer can help. For severe pain, however, your doctor may give you prescription medication.
Limited bed rest
Spending too much time in bed can stiffen your joints and weaken your muscles and these can delay and complicate your recovery. Every few hours, rest in a comfortable position in bed for 30 minutes, and then go for a short walk or do some light work making sure to avoid activities that will make the pain worse.
Warm and Cold Compress
Cold packs can help relieve pain at the beginning of treatment. After a few days, switch to warm compress or relief.
Massages provide short-term pain relief for patients who have bulging discs, especially those experiencing lower back pain.
Cortisone injections can provide longer-term pain relief. Your doctor will inject the medicine into the area around your spinal nerves. Oral steroids can also help reduce swelling and inflammation.
Physical Therapy for Bulging Discs
Physical therapy is often preferred by patients suffering from bulging discs due to the non-invasive nature of the treatment. Your physical therapist will use both active and passive methods of physical therapy to reduce the pain and improve your mobility.
Active physical therapy treatments
- Core strengthening exercises
- Active hydrotherapy
- Spine exercises
- Exercises to strengthen the legs and arm
- Passive physical therapy treatments
- Hot and cold therapy
- Electrical stimulation
- Deep tissue massage
- Passive physical therapy treatments
How can you Prevent Bulging Discs?
You can prevent bulging discs by doing some lifestyle changes:
- Exercise for 30 minutes at least 5 days per week (e.g. walking, dancing, biking)
- In addition to your regular exercise, add moderate aerobic exercise that will help increase blood flow to the back (e.g. swimming, elliptical training, yoga). These exercises also help relieve lower back pain.
- Add strength training exercises at least twice per week for your back, stomach, and legs. This will help increase the strength and flexibility of your muscles and lessen the risk of bulging and herniated discs (e.g. crunches, pelvic tilts, planking)
- Stretch your back and your legs regularly.
- Avoid improper and/or excessive exercise.
- Maintain a healthy weight. Having excess body weight can put extra strain on your back and spine which can result in injuries.
- Wear the right shoes for every activity you perform. For example, running shoes are good for exercise and everyday use. High heels may look sexy but they can put stress on the lower back.
- Stop smoking. When you smoke, the oxygen flow to your intervertebral discs will decrease. As a result, your intervertebral discs will not absorb the nutrients they need to function normally and they will degenerate more quickly and become brittle.
- Lift things properly. Always lift from your legs instead of lifting from your back. Ask for help if an object is too heavy for you to lift on your own.
- Maintain good posture.
- When traveling long distances or for long periods (e.g. traffic), try to stop and walk for a few minutes every hour, if possible.
- Sleep on a firm mattress or bed. Sleep on your back or on your side instead of on your stomach as this will reduce your risk for a bulging disc.
If you have been diagnosed with a disc bulge, however, physical therapy for bulging discs is your best option.
Exercising may help reduce the pain but this is best done with a licensed physical therapist who is an expert at developing a regimen specifically for you.
At Vigor Physical Therapy & Rehabilitation, we provide excellent service to all our patients. We are a therapist-owned physical and occupational therapy practice focused on giving each patient personalized care.
If you have questions or if you want more details about physical therapy for bulging discs, contact us today and we will be happy to help.