Information on a Bulging Disc

Discs are made of a soft, gelatinous material surrounded by an outer layer of cartilage that cushion vertebrae in the spine. A bulging disc, usually caused by aging, is one that gradually shifts and bulges outside of the layer of cartilage it usually occupies. Bulging discs are common and usually don't cause any pain.

Symptoms

• Many people never know they have a bulging disc as there are often no symptoms when the disc expands past the space it normally occupies. Symptoms occur when a bulging disc presses on nerves or other tissues in the area. According to the Laser Spine Institute, about 90 percent of bulging discs are in the lumbar, or lower back area, causing symptoms such as lower back pain, muscle spasms and weakness and tingling or numbness in the legs. Sciatica is a condition that occurs when a lumbar bulging disc presses on the sciatic nerve. Cervical bulging discs in the neck area can cause tingling, numbness, pain and weakness in the neck, shoulders, arms, hands and fingers. A thoracic bulging disc that occurs behind the chest area can cause upper back pain that can radiate to the chest and stomach.

Diagnosis

• The doctor will take a physical history, ask questions about your condition and do a physical exam. Tests may be ordered, including x-rays, a CT scan or an MRI. If your condition is a bulging disc, it won't show up on x-rays, which show bones, but it will be seen on a CT scan or MRI. The doctor will look at the images to determine if a bulging disc is pressing on soft tissue and causing pain.

Treatment

• You and your doctor will decide on a treatment plan. For a bulging disc, treatment usually involves rest alternated with exercises designed to relieve pain. You should rest by lying on your back on a firm mattress with a pillow under your knees. Medications, such as NSAIDS to relieve pain and inflammation, are usually recommended and muscle relaxers may be prescribed for muscle spasms. Epidural steroid injections can reduce swelling caused by bulging discs. Physical therapy may include strength and flexibility training, pool therapy, posture training, alternating heat and ice, massage, ultrasounds and electric stimulation. Transcutaneous electrical nerve stimulation, or Tens, units can be prescribed and sent home with patients, so they can give themselves electric stimulation at home.

Surgery

• Surgery is not usually recommended for a bulging disc. Surgical procedures may temporarily relieve problems at best, but they usually doesn't last and often make problems worse than they were in the beginning. If weakness and pain from a bulging disc in the lower back is disabling and other treatment doesn't help, a doctor may recommend surgical procedures that include removing the disc and connecting the two vertebrae or removing the part of the disc that is bulging.