A bulging disc is an intervertebral disc that has moved out of normal position along the spinal column. Unlike a herniated disc, the inner material (nucleus) does not seep/leak out of the disc. Bulging discs can produce significant chronic back pain.
What are the symptoms of a bulging disc?
Not every patient with a bulging disc has back pain or symptoms. However, several nerves supply the outer covering of the intervertebral discs. When a disc bulges out of position, it can compress one or more of these nerves, producing pain, numbness, and tingling down one of the extremities. Back pain is a common symptom of a bulging disc, and it is usually worse with activity.
Are bulging disc a common occurrence?
Around half of adults have one or more bulging discs, so the condition is quite common. According to statistics, 80 percent of adults will experience some type of back pain during their lives. The typical age range of people with one or more bulging discs is 20-60 years of age. The most common spine region for a bulging disc is the very low lumbar (low back) spine.
What causes a disc to bulge?
A bulging disc often occurs due to an injury, fall, or automobile accident. They also are caused from aging, repetitive movement, and poor posture. Certain people are more at risk than other individuals. Risk factors include:
- Being tall
- Advancing age
- Improper lifting
- Eating unhealthy
- Not wearing a brace when lifting
- Spinal arthritis
- Degenerative disc disease
- Excessive weight
- Not exercising
How is a bulging disc diagnosed?
When a patient experiences back pain, the doctor may consider a bulging disc as the cause. The doctor will take a medical history, ask questions about your condition, and conduct a physical examination. Diagnostic tests are used to confirm the bulging disc, such as x-rays and magnetic resonance imaging.
What are the treatment options for someone with a bulging disc?
The treatment of a bulging disc depends on the associated symptoms, the severity of the problem, and the health of the patient. Options are:
- Acupuncture – To stimulate release of endorphins and restore normal body energy, a practitioner can insert tiny, fine needles into the skin and muscles over the bulging disc region of the back. This traditional Chinese therapy has proven useful for spine-related back pain.
- Spinal decompression therapy – This procedure involves the use of a unique table that exerts slight force to decompress the disc and lengthen the spinal column. This allows the bulging disc to migrate back into normal position.
- Facet joint injection (FJI) – To alleviate pain associated with nerve compression, the pain specialist will use x-ray guidance to insert a needle into the facet joint space and instill a long-acting anesthetic. According to research, this procedure has an 85% success rate for back pain.
- Radiofrequency ablation (RFA) –To destroy a portion of the nerve root, the doctor will use radiofrequency energy on the nerves near the bulging disc. RFA is usually done after the patient responds to a nerve block procedure. In a recent study, the majority of participants reported 50 percent or more pain relief following the procedure.
- Medications – The pain management specialist often uses a combination of medications to relieve pain. These include nonsteroidal anti-inflammatory drugs (NSAIDs) for mild pain, narcotic analgesics for moderate-to-severe pain, anticonvulsants for nerve pain, and mild antidepressants for pain associated with nerve compression.
Ferrante FM, et al. (2004). Radiofrequency sacroiliac joint denervation for sacroiliac syndrome. Pain Medicine, 5(1), 26-32. doi: 10.1111/j.1526-4637.2004.04009.
Vikers, AJ, Cronin, AM, Maschino, AC, Lewith, G et al. (2012).Acupuncture for chronic pain: individual patient data meta-analysis. Arch Intern Med, 172(19), 1444-1453. doi: 10.1001/archinternmed.2012.3654.