Bulging Disc – What is it? What Causes it? What are the symptoms?

David Donald

A bulging disc is a very common spine condition. Most people have bulging discs. While some bulging discs never cause any problems, some are rather bothersome. Years of wear and tear, aging, and physical activity can result in a bulge in any one of 23 discs in the back.

A disc with a bulge is similar to a tire with a bulge; but instead of air trying to burst through a weakened part of the sidewall, it is a jelly-like substance trying to burst through the outer wall of the disc. That’s where the similarities end. You don’t have to replace the disc-like you do with the tire.

It may help to know the parts of a disc to understand how a bulging disc can cause pain and affect movement.

There are two parts of a disc – an outer layer called the annulus fibrosus and an inner core called the nucleus pulposus. The annulus fibrosus is made up of a bunch of ligament fibers. These fibers form tight rings around the nucleus pulposus – a jelly-like inner core made up of water and collagen. The rings also connect to the vertebral body above and below the disc. Together, the outer and inner layers of the disc help to absorb compressive forces caused by physical activity like walking, running,  lifting, etc.,.

Vertebrae and Disc

 

What Causes a Bulging Disc?

The common cause is age. As we get older, the discs in our back can lose the ability to retain water. This is a common degenerative change called disc desiccation, which simply means to lose water. When the discs lose water and dry out they shrink and the out layer becomes weak and brittle. The jelly-filled inner core of the disc is now more prone to bulge out into the weakest part of the outer layer. People who are not active or smoke can often speed up the rate of deterioration in the discs.

  • General “wear and tear” – When the discs deteriorate over time, a bulging disc may result simply by performing everyday activities, such as twisting and bending.
  • Injury or trauma – The way you sit, stand or sleep make strains the neck and back, resulting in a bulging disc.
  • Bad posture – The way you sit, stand or sleep make strains the neck and back, resulting in a bulging disc.
  • Occupational hazards – Repetitive tasks such as lifting, bending, standing, or sitting for long periods of time can increase your risk for a bulging disc.
  • Overweight – Being overweight can put a great deal of pressure on the vertebral discs, increasing the chances of developing a bulging disc.
  • Sports injury – Athletes involved in contact sports are more prone to developing back problems. Even non-contact sports, such as running can result in a bulging disc problem if the shoes you are wearing have no orthopedic support.  

Bulging Disc Symptoms

A disc bulge can happen to any part of the spine: cervical, thoracic, or lumbar. Symptoms can include one or a combination of neck pain, spasms, stiffness, tingling, leg numbness, and leg weakness.

The symptoms someone experiences can often indicate the area of the spine where the bulge lives.

  • Tingling and pain in the neck, shoulders, hands, and arms can mean the bulging disc is irritating the nerves or spinal cord in the neck (cervical spine).
  • Pain in the middle to the upper part of the back that radiates to the chest and stomach can mean the bulging disc is causing some trouble in the mid-back (thoracic spine).
  • Pain and muscle spasms in the lower part of the back or shooting pains from the buttocks to the legs can mean the bulging disc is affecting the nerves and spinal cord in the lower back (lumbar and sacral spine).

The lower back is where most bulging disc problems occur. A bulging disc that presses on the sciatic nerve can cause a condition commonly known as sciatica. A more serious problem can occur when the bulging disc pinches the cauda equina nerve causing bladder and bowel control issues.

Bulging Disc Treatments

There are several surgical and conservative treatment options available for a bulging disc. Your doctor will determine what treatment option is best based on medical history and symptoms.
Conservative treatments for Bulging Discs

Rest – Reducing the level of activity and getting some rest is often enough to relieve bulging disc symptoms.  

Medications – Paired with rest, taking an over-the-counter pain reliever like Tylenol, Naproxen or Ibuprofen can reduce pain and inflammation in the back. For more severe symptoms, your doctor may prescribe a painkiller or muscle relaxers to reduce pain and muscle spasms.

Physical Therapy – Taking steps to improve your overall back health through exercise can help relieve symptoms related to back problems like a bulging disc. Taking short walks several times a day to loosen the back and stretch to strengthen the muscles in the back. 

Minimally invasive spine surgery for bulging disc

When conservative treatment options fail to produce results, your doctor may recommend minimally invasive spine surgery to reduce or eliminate bulging disc symptoms.

When a bulge forms it can push the nerve root against bone. This is often called a pinched nerve. One of the ways to relieve a pinched nerve is by performing a decompression surgery like a laminectomy. During a laminectomy, a portion of the vertebrae called the lamina is removed to give the nerve root more room and eliminate the pinched nerve that is causing the pain.

You can learn more about the different types of procedures used to treat a bulging disc below.

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