Having a bulging or herniated disc can be scary – and painful. Understandably, many people want to explore their treatment options and get back to a pain-free normal life as soon as possible.
As a licensed Doctor of Chiropractic trained in spinal biomechanics, I have helped many people understand what happens in their spine when they have a bulging or herniated disc.
Before deciding on a course of action to treat your bulging or herniated disc, it is important to understand what is going on in your spine. The first step in this is understanding the physiology of the spine, and why bulging or herniated discs occur.
Physiology of the Spine
The spine plays a couple of different roles in the body. First, it helps you to stand and supports the body’s movements. Second, it protects the delicate nerves of the spinal cord, which is a part of the central nervous system. These nerves include nerve roots, which are large nerves branching out from the spinal cord between the bones, or vertebrae.
To allow for maximum movement, the spine is divided into 33 different vertebrae in three different areas:
- Cervical: 7 vertebrae, located in the neck. This is the second most common location for bulging and herniated discs.
- Thoracic: 12 vertebrae, located in the upper and mid-back. Bulging and herniated discs rarely occur in this area.
- Lumbar: 5 vertebrae, located in the lower back. Most bulging and herniated discs occur in this area.
The discs in your spine separate each vertebra, supporting your spine by moving slightly along with the vertebra and providing cushioning. The discs are made of two different parts:
- Nucleus pulposus: This is the elastic part of the disc that absorbs the shock of movement. It has a jelly-like consistency and is made of water as well as collagen fibers for support.
- Annulus fibrosus: This part of the disc is made of multiple layers of curved fibers that surround and protect the nucleus pulposus.
What Are Bulging and Herniated Discs?
When a disc bulges, it protrudes into the space of the spine meant for the spinal cord and the nerve roots. The disc itself remains intact, with the nucleus pulposus center of the disc still kept inside an intact annulus fibrosis. Bulging discs are sometimes also called prolapsed discs. It is common for multiple discs to bulge at the same time.
With a herniated disc, the annulus fibrosus tears, allowing the nucleus pulposus to spill out. Then, it puts pressure on the spinal cord or nerve root, leading to an array of symptoms.
Herniated discs are also called slipped discs, extruded discs, or ruptured discs. Sometimes, a portion of the herniated disc can tear off. These pieces are known as free fragments or sequestered discs, and they can be extremely painful.
As previously mentioned, bulging and herniated discs in the lumbar (lower back) area of the spine are most common, followed by the cervical (neck) area. Further, both herniated and Bulging discs are classified depending on where they protrude:
- Central: This refers to a disc protruding into the spinal cord itself.
- Subarticular: This refers to a disc protruding in the space between the spinal cord and the foramen, which is where nerves leave the spinal canal
- Foraminal: This refers to a disc protruding into the foramen
- Extraforaminal: This refers to a disc protruding beyond the bounds of the foramen
Bulging and Herniated Disc Symptoms
Bulging and herniated discs often occur in a progressive, gradual manner. A bulging disc may have no symptoms – you may not even be aware that you have it. However, this can change if the bulge worsens and begins to approach herniation.
When this happens, you may experience a variety of symptoms depending on the area of the spine where the herniation is taking place. These symptoms can be mild or severe. Also, symptoms may be difficult for you to separate from other conditions and can cause low back pain, like sciatica.
Depending on the area of the spine where your bulging or herniated disc is located, you may experience a variety of symptoms. These include:
Cervical (neck):
- Shooting pain all the way down the arm towards the fingers
- Arm, hand, or shoulder numbness, tingling, or weakness in the shoulder
- Problems walking or balancing
- Difficulties with your grip
Thoracic (upper and mid-back):
- Pain that radiates from the lower part of your neck to the middle of your back
- Chest pain
- Headaches when you lie down
- Problems walking
- Sensations in the legs like tingling, numbness, or burning
- Leg weakness
- Bowel or bladder problems
Lumbar (lower back):
- Pain or cramping in your lower back, buttocks, hamstrings, calves, and/or feet
- Sensations in the legs like tingling, numbness, burning or shooting pains
- Leg weakness
- Leg pains that get worse when you stand for a long time
- Bowel or bladder problems
- Problems walking
- Poor reflexes and coordination in the legs and feet
- Problems lifting your feet
Bulging and Herniated Disc Causes and Risk Factors
Age-related wear and tear, termed disc degeneration in the medical world, is the main cause of bulging and herniated discs and is a major cause of pain and inflammation in the spine. Traumatic injury like whiplash from a car accident can also cause a herniated disc.
Factors that can increase your chances of experiencing these conditions include:
- Family history of bulging or herniated discs
- Male gender
- Lifting objects that are heavy
- Being obese or overweight
- Repetitive movements that involve bending or twisting the lower back
- Sitting or standing in the same position for extended periods
- Leading an inactive lifestyle
- Smoking, as this reduces blood flow to the spine
Treating Bulging and Herniated Discs
Your doctor will diagnose a bulging or herniated disc after a careful physical exam. They will assess you for any numbness in your body as well as your reflexes, muscle strength, and posture.
They may have you perform certain activities during the physical exam, like walking across the room or raising your arms. Sometimes, imaging tests like MRIs, CT scans may be ordered to make a diagnosis.
Bulging discs can get better on their own, a process that can take around 6 to 8 weeks. Similarly, herniated discs can also improve on their own – except the healing process can take a lot longer and is often several months in duration. That said, complications are possible, including painful spinal stenosis (a narrowing of the spinal column) and even spinal fracture.
Experts recommend lifestyle modifications when you first begin to experience symptoms of a bulging or herniated disc. These include:
- Reducing your activity level for a few days, then slowly restarting
- Starting exercise after 2 to 3 weeks
- Avoiding lifting heavy objects or twisting motions for 6 weeks
Medications for pain and muscle spasms can also be used, including some medications that are injected directly into the spine. As a last resort, disc removal surgery can be an option as well if your condition does not improve over time.
Chiropractic Care for the Treatment of Bulging and Herniated Discs
Many different treatments exist to help you through the pain of bulging and herniated discs during the healing process. The North American Spine Society’s guidelines on spinal care specifically support chiropractic care as an option for people suffering with pain from a herniated lumbar disc.
If you are seeking conservative care for disc herniations or bulges, it is important to choose a doctor who is specifically credentialed in spinal biomechanics. These providers will be able to perform a biomechanical spine assessment and give recommendations on how best to treat your condition.
My experience and expertise in herniated and bulging discs allows me to competently and safely address your condition. I am trauma and hospital-qualified and have credentials in MRI spine interpretation, spinal biomechanical engineering and orthopedic testing through the Academy of Chiropractic. I am also a fellow in Spinal Biomechanics and Trauma which is recognized through the SUNY Buffalo Jacobs School of Medicine.
At Precision Spinal Care we are happy to help you determine the best way to treat your herniated or bulging discs. Call our office at (757) 382-5555 to speak with me or set up a consultation. You can also set up an appointment through our webpage.
