Bulging Disc

Intervertebral discs are the shock-absorbing structures between each vertebra. The discs have a thick outer layer surrounding a soft, gel-like center. A bulging disc is a condition in which the inner portion of the intervertebral disc begins to protrude from the outer wall of the disc. A bulging disc may be a precursor to a herniated disc, or one which has partially or entirely broken through the outer wall of the intervertebral disc.

Anatomy

About 90 percent of bulging disc cases occur in the lower back or lumbar spine. The most common bulging disc location sits between lumbar vertebrae L4 and L5 and between vertebrae L5 and S1.

Bulging discs are also common by vertebrae L3 through S3, which can lead to sciatica, causing leg pain and possible tingling, numbness, and weakness that originates in the lower back and travels through the buttock and down the large sciatic nerve in the back of the leg.

What Is A Bulging Disc?

A bulging disc occurs when protrusion or bulge can put pressure on the surrounding nerve roots, leading to pain that radiates down the back and other areas of the body depending on its location within the spinal column.

When a disc herniates, the contents may compress the spinal cord or the spinal nerve roots. In some instances, fragments from the outer disc wall (annulus) break from the parent disc and drift into the spinal canal.

a bulging disc of the spine

A Bulging Disc vs. Herniated Disc

Bulging disc and herniated disc are sometimes interchangeable terms to define a condition that affects the intervertebral discs. However, they are several differences between these two conditions.

A bulging disc is not a broken disc, meaning the outer wall of the intervertebral disc remains intact but bulged. Whereas for herniated disc, there has been a partial rupture or complete collapse of the outer wall of the intervertebral disc.

In the end, the primary difference between a bulging disc and herniated disc comes down to whether they are contained or non-contained.

Contained Disc vs. Non-Contained Disc Disorders in the Back or Neck

Contained Discs: these should be considered bulging discs. They have not broken through the outer wall of the intervertebral disc, which means the inner gel-like material remains contained.

Non-Contained Discs: these should be considered herniated discs. They have broken through the outer wall of the intervertebral disc.

A bulging disc may develop to herniated discs overtime. Bulging discs may protrude into the spinal canal without breaking through the disc wall. The disc remains intact except a small bubble appears on the outside of the disc.

On the other hand, when a disc herniates, it may compress the spinal cord or the spinal nerve roots. To complicate matters, sometimes fragments from the annulus (the outer disc wall) may break away from the parent disc and drift into the spinal canal.

Cervical Bulging Discs

A bulging disc in the cervical spine can occur at any of the vertebrae that compose the upper spine, described as C1 through C7. This condition occurs when pressure located in the inner portion of the cervical discs stretches out the outer layer of the intervertebral discs causing them to bulge.

Cervical bulging discs can cause symptoms such as pain, numbness, tingling, and weakness that radiates through the neck, shoulders, arms, hands, and fingers. Cervical bulging discs can also lead to myelopathy, injury to the spinal cord, which can cause a group of symptoms such as difficulty walking, loss of fine motor skills, and heaviness in the legs.

Thoracic Bulging Discs

The thoracic spine spans from the collarbone to the end of the rib cage and consists of 12 vertebrae labeled T1-T12. Even though bulging disc is rare in this area, they can inflict symptoms such as pain in the upper back that radiates to the stomach and chest.

Most of the time, thoracic bulging disc symptoms are misdiagnosed with gastrointestinal, lungs, or heart problems. This is why it is so vital to promptly consult with a specialized physician to obtain an accurate diagnosis.

Lumbar Bulging Disc

Bulging discs in the lumbar spine can occur through vertebrae L1-L5, which span from the waist to the top of the hips. Bulging disc is highly prevalent in this area and can lead to symptoms such as leg pain, numbness in legs, feet or toes, acute lower back pain, and other symptoms.

However, at the lumbar spine, bulging disc symptoms will vary widely from the specific vertebrae being affected. L1 or L2 symptoms include pain in lower back and groin area and/or pain that radiate to upper front and inside of thigh. L3 or L4 symptoms include pain in lower back and /or pain that radiates to the quadriceps in the front of the thigh. L5 symptoms include pain in lower back and/or pain in the outside of lower leg, down to toes, which may include numbness, weakness and tingling.

Causes

A bulging disc is more common than you think, especially as the outer layer of the disc weakens with age. While age is one of the most common causes of a bulging disc, many activities could lead to the development of disc bulges.

Common causes of a bulged disc include:

Trauma

Genetic

Poor posture

Repetitive motions, often linked to your occupation

Poor lifting techniques

Contact sports

Other factors such as smoking, being overweight and consuming too much alcohol could also speed up the process of the deterioration of a disc’s outer layer.

Symptoms

Some cases of a bulging disc are asymptomatic until the bulging disc begins to press on a nerve. When the nerves are pinched or compressed, bulging disc symptoms will vary based on where the compressed nerve is located. The majority of bulging disc cases are in the lumbar spine.

Cervical Bulging Disc Symptoms – A damaged disc in the cervical spine can cause pain that may radiate from the neck, down to the arms and fingers. People often experience symptoms similar to myelopathy, including loss of fine motor skills and difficulty walking.

Thoracic Bulging Disc Symptoms – Symptoms in this area are often confused for gastrointestinal issues, lung or heart problems, because in most cases signs experienced include pain the upper back that radiates to the stomach and chest.

Lumbar Bulging Disc Symptoms – A damaged disc in the lower back can cause pain in the hips, legs, buttocks, and feet. A bulging disc in the lower back can also lead to sciatica pain, which can cause debilitating pain and make it difficult to complete everyday tasks.

Diagnosis

Diagnosis for bulging discs starts with a complete family medical history assessment and a comprehensive physical examination. During the diagnosis for a bulging disc, physicians may inquire about the type of pain being experienced, possible related medical conditions, lifestyle habits, motor skills, and a full rundown of symptoms and what makes them worse to accurately diagnose a bulging disc.

Exams & Test

Once the initial diagnosis is completed, symptoms will be checked through different exams and tests to confirm the diagnosis; these tests might include:

Neurological tests

Range of motion tests

Vital signs monitoring

Gait monitoring

Bulging disc MRI

CT Scans

X-Rays

CT Myelogram

Electromyography

Treatment

When a bulging disc is compressing the spinal cord or pinching a nerve, surgery may be the best treatment option if you have already completed conservative therapies, such as physical therapy, without resolution of the problem.

Non-Surgical Treatments

The first course of treatment for a bulging disc might include a non-surgical approach that often is a combination of medication, exercise, and physical therapy. The most common surgical treatments used to treat bulging disc include:

NSAIDs medications

Steroid Injections

Physical therapy

Rest

Chiropractic care

Prescribed pain medications

Surgical Treatment

When non-surgical treatment proves ineffective, or symptoms associated with a bulging disc are moderate to severe, surgery may be recommended. Spine surgery can help assess symptoms linked to the condition, as well as treating the cause of bulging discs.

Some of the treatment options for a bulging disc include:

Foraminotomy/Foraminectomy

Laminotomy/Laminectomy

Disectomy

Prevention & Self Care

Bulging discs are primarily a result of the natural degeneration of the spine. However, there are prevention tactics you can implement to reduce the stress placed on the spine and avoid chances of developing a bulging disc. Some prevention tactics include:

Maintain a good posture

Avoid improper lifting of pushing movements

Practice regular stretching exercises

Stop smoking

Limit alcohol consumption

Maintain a daily exercise routine

Also, during a bulging disc treatment, or after a bulging disc, spinal procedure self-care is crucial to maintain a healthy spine and prevent further complications. To care for a recovering bulging disc, implementing self-care practices can help, such as:

Follow proper rest

Take NSAIDs if suggested

Avoid high-impact activities

Continue physical therapy

Use hot and cold therapy

Avoid repetitive sitting, standing, or bending

The doctors and staff at The Bonati Spine Institute will provide each patient with a comprehensive overview of how each procedure works and is completed.