FAQs on Bulging Disc

The spine is an important body structure. This bony column houses the spinal cord, which is a communication carrier that transfers messages to and from the brain. Many nerves branch off the spinal cord, and when one of these nerves becomes pinched (compressed), back pain occurs. A bulging disc can lead to a compressed nerve, which causes long-term pain.

What is a bulging disc?

A bulging disc is a common spinal injury. The discs are cushions between each vertebra. Also called a slipped disc or protruding disc, a bulging disc is a disc that has moved out of normal position. When the inner fluid seeps out of the disc, it is called a herniated disc.

What causes a bulging disc?

A bulging disc is caused by:

  • Aging – The most common reason a disc bulges is aging. With age, the vertebral discs lose water content, become stiffer, and are more damage-prone. Due aging, the disc will balloon out of alignment.
  • Accumulated microtrauma – This is repeated injuries that lead to poor posture. Over time, slouching and repeated movement causes loss of disc integrity and displacement of the central gel-like material.
  • Sudden unexpected load – Bulging discs occur from trauma, such as a motor vehicle accident. This unexpected load (torsion) of a disc can lead to tearing of the tough, outer disc layer.
  • Genetic factors – New research suggests that genetics play a role in development of a bulging disc.

What are the risk factors for a bulging disc?

Most bulging discs are caused by age, and usually occur when a person is in his/her 30s or 40s. Other risk factors are smoking, excessive alcohol consumption, improper lifting maneuvers, participation in sports, severe trauma, and working in a labor- intensive occupation.

What are the most common sites for a bulging disc?

Bulging discs are most common in the lower back area, which is the lumbar spine. The top (neck) portion of the spine is the cervical region, and the middle section is the thoracic spine.

What are the symptoms of a bulging disc?

A bulging disc can lead to pain with forward bending, sitting, lifting, coughing, or sneezing. When nerve compression occurs, the patient may complain of leg pain, leg numbness, and/or leg weakness.

How is a bulging disc diagnosed?

The doctor will first take some x-rays and conduct a physical examination. To confirm a bulging disc, the doctor will order a magnetic resonance imaging (MRI) scan or computed tomography (CT) scan.

How is a bulging disc treated?

Treatment for a bulging disc depends on the severity of the bulge, the patient’s current physical activity level, the patient’s age, and the area of bulging. Treatment options include:

  • Medications – Medicines used for the pain associated with a bulging disc include narcotic analgesics and anti-inflammatory agents.
  • Physical therapy – The therapist uses heat, cold packs, ultrasound, and electrical stimulation to control the pain and associated symptoms.
  • Epidural steroid injection (ESI) – This involved injecting the space around the spinal cord (epidural space) with a steroidal agent. According to studies, the efficacy rate for ESI is 80-90%.
  • Sympathetic nerve block – For patients with associated nerve pain and nerve compression, the doctor can “block” the sympathetic nerves. This procedure involves instilling an anesthetic or neurolytic agent onto the affected nerves.
  • Intradiscal electrotherapy therapy (IDET) – With this procedure, heat is used to shrink and repair disc tears. The doctor inserts a small catheter and wire near the disc to emit heat and to thicken collagen. According to studies, IDET has a 70% success rate.

Resources

Staehler RA Epidural Steroid Injection Pain Relief Success Rates. Retrieved from: http://www.spine-health.com/treatment/injections/epidural-steroid-injection-pain-relief-success-rates

Pauza KJ, Howell S, Dreyfuss P, et al. A randomized, placebo-controlled trial of intradiscal electrothermal therapy for the treatment of discogenic low back pain. Spine J. 2004 Jan-Feb. 4(1):27-35.