Bulging Disc

What Is A Bulging Disc?

The spinal discs rest between each vertebra and provide shock absorption, support, and mobility to the spine. A bulging disc, or herniated disc, is a condition where the gel-like material that fills the spinal discs herniates or leaks out. The disc material may then put pressure on (aka “impinge”) onto nearby spinal nerves, which can cause pain to be felt in the back or down the leg.


What Are The Causes Of A Slipped Disc?

Often times disc bulges are caused when someone does a motion where the spine is in an unstable position. This often happens when one lifts something heavy while they are bent over and rotated. Many individuals also have pre-injury weakness in the core musculature.


What Are The Signs And Symptoms Of A Bulging Disc?

Common symptoms are pain radiating down one buttock/leg, numbness or tingling down the leg, and weakness in the affected extremity. Pain may also be felt in the back itself. Pain is often worse when there is an increase in intra abdominal pressure, like during coughing, sneezing, or going to the bathroom. Pain may also be worse with forward bending or bringing knees to the chest when laying on your back. Patients with severe disc herniation may experience symptoms down both extremities. Some patients present with all symptoms, some patients may only present with one.


What Are The Risk Factors Of A Herniated Disc?

Risk factors include high BMI, occupations that require heavy lifting, occupations that require a lot of sitting.


How Is Bulging Disc Diagnosed?

It may be diagnosed by a physical therapist when the patient exhibits the signs and symptoms of a disc injury. At times, MRI imaging can assist in making the diagnosis.


What Are The Possible Treatments For A Bulging Disc?

Conservative treatment, like physical therapy, is the first line of treatment that should be sought with a disc herniation. PTs will utilize a combination of manual therapy, exercise, and neuromuscular re-education during treatment. The goal is to provide symptom relief, reduce inflammation around the disc/nerve, promote healing, improve spinal mobility or stability (which depends on how the patient presents), improve core strength, improve body mechanics, and correct impaired movement patterns. Many times the patient initially avoids activities that require spinal flexion and they participate in exercises/stretches involve positioning into neutral alignment or spinal extension. If patients continue to exhibit symptoms, they may benefit from a spinal injection to further reduce inflammation and promote healing. Severe cases may require surgery. Your PT will speak with your doctor and help form a plan of care to decide if injections or surgery may be beneficial.


Are There Preventative Steps Or Measures To Avoid A Bulging Disc?

You can avoid slipping a disk through maintaining a strong core, utilizing proper body mechanics, maintaining a healthy weight, and maintaining good spinal mobility.


What Are The Risks If A Bulging Disc Is Left Untreated?

Without treatment, a serious disc injury can lead to permanent nerve damage, causing chronic pain, weakness, numbness, and tingling. A mild-moderate disc injury can cause future spinal instability or stiffness at the site of herniation.


Key Takeaways About Ruptured Disc

-Typically initial treatment involves avoiding positioning into spinal flexion (bending forward) and focuses on treatment while the spine is in neutral or an extended position. Eventually, the patient should perform strength/stability exercises in all positions.
-It is important for the patient to learn proper body mechanics and build their core strength and stability to avoid future re-injury.
-Patients should try physical therapy for at least 12 weeks before considering surgical intervention
-Each patient’s recovery will be unique. Sometimes numbness/tingling is the first symptom to reduce, other times pain reduces first. It is important for the patient to keep the PT updated on how the symptoms are changing with treatment.


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