The spine allows us to stand upright, practice good posture, engage in flexible movement, absorb and distribute mechanical stress. The spine’s optimal function is dependent upon its ability to maintain its natural curvatures and alignment, and the intervertebral discs facilitate this in multiple ways. Keep reading to learn more about the spinal discs and how to treat bulging discs.
The intervertebral discs are key to maintaining optimal spinal function. When a disc is bulging, it has changed shape and bulges outwards. Proactive treatment, based on the condition’s underlying cause, can help preserve disc function and prevent a bulging disc from becoming herniated.
Let’s start our discussion of bulging disc treatment with some basic spinal anatomy for a clearer understanding of how disc health affects the entire spine.
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The spine is made of bones called vertebrae, and in a healthy spine, they are rectangular in shape and stacked on top of one another in a neutral and healthy alignment.
A healthy spine will appear straight if viewed from the front and/or back, but will take on a soft ‘S’ shape when viewed from the sides; this is because the spine is naturally curved, and these natural and healthy curves are key to maintaining spinal alignment, health, and function.
The spine’s natural curvatures make it stronger, more flexible, and better able to absorb and distribute mechanical stress so no one section of the spine is exposed to excess strain.
The spine has three main sections: cervical (neck), thoracic (middle/upper back), and lumbar (lower back).
Each spinal section has its own characteristic curvature type, with the spine either bending inwards, towards the body’s center, or outwards, away from the body’s center, and the integrity of each curve is dependent on the others; a loss of one healthy spinal curve can disrupt the biomechanics of the entire spine.
The vertebrae of the spine are separated by intervertebral discs, key structures of the spine, so let’s explore the discs in more detail.
The spinal discs sit between adjacent vertebrae and perform many important roles; they work together to facilitate flexible movement, provide the spine with structure as adjacent vertebrae attach to the disc between, and act as the spine’s shock absorbers.
In addition, the discs provide cushioning between the vertebrae so friction generated during movement is minimized, which helps prevent spinal degeneration.
The discs consist of a tough and durable outer layer called the annulus, while the interior nucleus is soft and gel-like.
The discs are made of layers of collagen, proteins, and fluid, and generally, it’s the discs that are the first spinal structures to show signs of deterioration, partially due to the many roles they play, but also because the discs don’t have their own vascular supply.
Not having their own vascular supply means there is no direct pathway into and out of the discs for blood containing oxygen and important nutrients; instead the discs use a process akin to osmosis to absorb important nutrients needed for maintaining health and repairing cellular damage through their end plates.
Understanding how to treat bulging discs involves considering various factors such as the severity of the condition, the presence of symptoms like sciatic nerve pain, and the location of the bulge within the lumbar spine, as different types of bulges, such as disc extrusion or diffuse broad-based bulges, may require tailored treatment approaches.
At birth, the spinal discs have an approximate fluid level of 80 percent, but as we age, that level decreases, and if a disc becomes desiccated, it can easily progress to a bulging and/or herniated disc.
What is a Bulging Disc?
It helps to think of the spinal discs as marshmallows that sit between the bones of the spine, and to function optimally, they need to maintain their height and shape.
If you picture a marshmallow sitting between two structures and having pressure applied from above and below, you can imagine how the marshmallow would bulge outwards at the sides, this is what a bulging disc can look like as it extends into the spinal canal.
When a disc is bulging and protrudes into the spinal canal, it can affect the spinal nerves that facilitate brain-body communication and cause a variety of issues felt throughout the body.
Treatment options for bulging discs encompass a range of strategies aimed at alleviating symptoms and promoting healing. These may include conservative measures such as physical therapy, chiropractic care, and non-steroidal anti-inflammatory drugs (NSAIDs) to manage pain and inflammation associated with broad-based disc protrusion or circumferential disc bulge.
In more severe cases, when an annular bulge progresses to herniated discs with broad-based central disc protrusion, surgical interventions like discectomy may be considered to relieve pressure on the spinal cord or nerve roots affected by disc protrusion.
It's essential to tailor treatment plans to the specific location and severity of disc herniation, whether it's lumbar disc herniation or a herniated cervical disc, to ensure optimal outcomes for individuals with both bulging and herniated discs.
So what types of things can cause a disc to change shape and bulge outwards unnaturally?
Common Bulging Disc Causes
The fluid level of the discs is an important factor when it comes to disc degeneration, and in the majority of cases, a disc bulges, or becomes herniated, due to degenerative changes.
There is a natural degree of spinal degeneration expected with age, but certain lifestyle choices can either prevent, or cause, excessive deterioration.
As mentioned, the discs don’t have their own vascular supply, and the spine’s very design is based on movement, so leading a sedentary lifestyle, not maintaining a healthy weight, chronic poor posture, and/or repeatedly lifting heavy objects incorrectly can negatively impact the intervertebral discs over time.
For example, not staying active can affect the discs directly by causing poor circulation, meaning there is not a healthy flow of blood around the discs from which they can absorb fluid and nutrients needed for rejuvenation and repair.
Carrying excess weight doesn’t just mean more strain on the joints of the spine, it also causes many people to lean forward excessively to maintain balance, and chronic poor posture affects the spine’s natural curvatures and can cause structural changes over time.
Particularly for people whose occupation involves repeatedly lifting heavy objects, if the ergonomics of how to lift with the legs, rather than the back, aren’t understood and applied, this can cause excessive wear and tear on the spine, its discs, and increases the risk of spinal injury.
Once a disc becomes desiccated, degenerative disc disease can develop, and spinal injuries, such as a bulging disc, are more likely to occur.
So if a person is diagnosed with a bulging disc, what are the treatment options?
Treatment for a bulging disc will be driven by its underlying cause, as this involves treating the condition itself, and not just its symptoms.
Treatment needs for a bulging disc will depend on important patient/condition variables such as patient age and overall health, location of the bulging disc, severity, and experienced symptoms.
For example, a broad based disc bulge, also known as asymmetric disc bulge involves 25 to 50 percent of the disc’s circumference bulging outwards; the more a disc is bulging, the more severe the condition is, the more likely it is to cause noticeable symptoms, become herniated, and the more necessary treatment is.
There are different types of treatment for a bulging disc, both surgical and nonsurgical, but like all surgeries, surgical treatment comes with its share of risks and side effects.
Here at the Scoliosis Reduction Center, I specialize in nonsurgical treatment options for a variety of spinal conditions as they are less invasive and strive to preserve the spine’s natural function.
Part of effective treatment will involve the customization of treatment plans to address the specifics of a patient’s spinal health and their condition, such as how long they’ve been experiencing symptoms, and their severity.
For some patients, bulging disc symptoms can decrease over time, particularly if proactive lifestyle changes have occurred, but for others, symptoms can increase, and a bulging disc can become herniated: something I want to help prevent.
Here at the Center, treatment will involve comprehensively assessing and treating the entire spine, and not just the area with the affected disc; this is because, as mentioned, the integrity of each spinal section is dependent on the health of the others.
The main goals of bulging disc treatment involve providing pain management, when needed, preventing further disc damage (herniation), and preserving/improving disc function so a healthy activity level can be maintained.
Effectively treating bulging discs often involves addressing related conditions like retrolisthesis, levoconvex scoliosis, spinal stenosis, multilevel degenerative disc disease, multilevel spondylosis and disc desiccation through a comprehensive approach tailored to the individual's needs.
My conservative chiropractic-centered treatment approach combines different forms of treatment so the condition can be impacted on multiple levels: medication (when needed), chiropractic care, and physical therapy.
While not all patients experience pain requiring medication for a bulging disc, for those that do, while applying proactive treatment to address its underlying cause, anti-inflammatory drugs and/or muscle relaxants can address related muscle pain and spasms for short-term pain management.
When discussing bulging disc treatment, it's essential to explore effective options, just as we do when considering treatment for scoliosis in adults.
For long-term pain management, steroid injections can help reduce inflammation at specific locations, and can be particularly precise when guided by ultrasound.
Here at the Center, I apply condition-specific chiropractic care to impact the condition on a structural level and work towards making sure the spine is optimally aligned, adverse pressure and nerve compression is reduced, and as much of the spine’s healthy curves as possible are maintained.
In addition, I can work towards improving circulation in the discs’ surroundings so they can absorb what they need to restore and rejuvenate themselves, while maintaining their fluid levels.
There are also different spinal-manipulation techniques that can be helpful both with pain management and working towards repositioning vertebrae that have become misaligned due to a bulging disc and its change in shape.
When appropriate, corrective bracing can also be a component of treatment as it can help reduce pain and support the spine.
Spinal Traction
A form of intermittent spinal traction can also help with addressing symptoms and providing long-term pain relief, and with access to traction tables here at the Center, I can help stretch and open spinal joints which increases the space within the spinal canal, takes pressure off the affected disc and any impinged nerves, and can facilitate the return of the bulge to its central position between adjacent vertebrae.
Chiropractic adjustments can also be guided by ultrasound for focused treatment on specific areas of the spine; for example, treatment for bulging disc in neck would focus on the cervical spine, and as the cervical spine has to support the weight of the head, optimal spinal-disc function is important.
Through the use of precise chiropractic adjustments, I can apply low-force techniques that manipulate the spinal section most affected by the bulging disc, with the goal of improving spinal alignment and general spinal biomechanics.
To be clear, no form of exercise or physical therapy should be attempted without first consulting the medical professional providing the bulging disc treatment.
When physical therapy is custom-prescribed and condition-specific, it can help impact spinal health and function in different ways.
While the place of exercise and physical therapy has been questioned in the treatment of a variety of spinal conditions over the years, we now know that many forms of physical therapy can be highly effective when performed as prescribed and designed by a specialist to be condition- and patient-specific.
Condition-specific exercises/stretches and physical therapy, can help with pain management by relieving pressure on an affected disc and its surrounding nerves.
Again, as the discs don’t have their own vascular supply, exercise can help improve core muscle strength so the spine can be optimally supported and stabilized, taking less pressure off the spine itself, and increased circulation through movement improves the health of the discs by making nutrients more accessible, around the discs, so they can absorb what’s needed for restoration and repair.
So when it comes to effective bulging disc in back treatment, we are talking about pain management, when needed, applying condition-specific chiropractic care and physical therapy that can preserve disc function and work towards repairing disc damage over time.
When successful, condition-specific chiropractic care can help return the bulging disc to its central position between adjacent vertebrae, and the position of affected vertebrae can be adjusted back into a healthier alignment with the rest of the spine.
You’ve probably noticed a lot of prevention talk, and really, this is what most of my treatment is based on: preventing further damage, escalating symptoms, and the development of a more serious condition, such as a herniated disc.
Also known as a slipped disc, a herniated disc occurs when the inner nucleus pushes through a tear in the outer annulus, encroaching on the space within the spinal canal through which spinal nerves pass.
If a bulging disc is left untreated, deterioration would increase over time, putting increased pressure on the annulus to contain the nucleus within, and further disrupting the biomechanics of the entire spine.
While each case is unique, common herniated disc symptoms can include general and radicular back pain, arm and leg pain, and muscle weakness.
If a patient is diagnosed with a herniated disc, this is most commonly confirmed through X-ray or MRI imaging, and like a bulging disc, will require the design of a customized treatment plan.
Here at the Center, I would integrate similar forms of treatment for a bulging disc, while apportioning them differently and often applying more intense types of chiropractic adjustments.
While early detection doesn’t guarantee treatment success, it can increase its likelihood, so I apply proactive treatment as close to the time of diagnosis as possible in an attempt to prevent further progression/degeneration.
Again, prescription medications/steroid injections can play a role in short-term pain management, and when guided by ultrasound, the area surrounding specific spinal nerves that are impinged and causing pain can be injected to reduce swelling and inflammation.
My assessment of a patient with a herniated disc would include conducting a comprehensive physical exam that includes taking the patient’s medical history, including genetics, exploring important lifestyle factors, orthopedic, and neurological testing, as well as MRI imaging.
Once the underlying cause of herniated disc is determined, I can move forward with crafting a customized treatment plan that can include lifestyle guidance, medications when needed, exercise and physical therapy, condition-specific chiropractic care, and additional modalities such as heat, massage, and electric stimulation can also be helpful.
Many of the chiropractic techniques used for treating a herniated disc are similar to those used in the treatment of bulging discs and have similar goals: relieving pressure off the affected disc and surrounding nerves, adjusting the position of nearby vertebrae for better spinal alignment, preserving disc function, and preventing further damage.
A chiropractic technique that can be particularly helpful for treating patients with a herniated disc is flexion-distraction; this involves the use of a specialized table that gently stretches the spine so treatment can be focused on the affected area while the spine is gently flexed by a pumping rhythm.
The pumping rhythm can help facilitate the return of the nucleus inside the disc so the entire disc can reclaim its central position between adjacent vertebrae, restoring some lost disc height, and positively impacting the position of affected vertebrae.
When flexion-distraction is successful, it moves the disc away from a compressed nerve, thereby reducing the impinged nerve root’s inflammation and reducing related pain.
Flexion-distraction can be performed over a series of treatment sessions, can be guided by ultrasound for precise results, and combined with muscle stimulation, at-home exercises, and custom-prescribed physical therapy.
Pelvic blocking is another effective chiropractic technique with the goal of reducing herniated disc pain and does so through the use of cushioned wedges that are placed under the pelvis on each side.
When specific and gentle exercise and movement is applied during pelvic blocking, the change in mechanics can help draw the disc away from nearby nerves, opening up space within the spinal canal to reduce nerve impingement, compression, and related pain.
Anyone who has experienced back pain knows how disruptive and debilitating it can be, and when it comes to preserving spinal health and function, quality of life can be affected.
There are many different types of back pain, and nerve-related back pain is commonly regarded as the most debilitating form, and a bulging disc not only affects the disc itself, but also its surrounding nerves.
The spine’s intervertebral discs are integral spinal structures that impact its ability to maintain its natural curves and alignment; a misaligned spine is one that will not function optimally as this involves a loss of the spine’s healthy curves.
If a spine loses one or more of its healthy curves, it becomes weaker, less flexible, can cause muscle imbalance/weakness, is more prone to injury, and can’t absorb and distribute mechanical stress incurred during movement as effectively.
As the spine works in tandem with the brain to form the central nervous system (CNS) that facilitates brain-body communication, spinal conditions have the potential to cause a myriad of effects felt throughout the body
When a spinal disc becomes a bulging disc, this means the disc is deteriorating, has changed shape, lost height, and is bulging outwards.
As the intervertebral discs are often the first spinal structures to show signs of deterioration, positive lifestyle choices can help minimize age-related spinal degeneration and preserve their health and function: something that impacts the entire spine.
Staying active, maintaining a healthy weight, good posture, and understanding the ergonomics of heavy lifting can help reduce natural age-related spinal degeneration.
Here at the Scoliosis Reduction Center, I advise patients on spine-friendly lifestyle choices, and to treat a bulging disc, I integrate condition-specific physical therapy and chiropractic care to improve disc function, reduce nerve impingement, realign the spine, and prevent further damage.
