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The Battle of the (Disc) Bulge

The Battle of the (Disc) Bulge

July 2, 2021
By Next Level Physical Therapy

According to the American Academy of Orthopaedic Surgeons (AAOS), 60-80% of us will experience lower back pain during our lifetimes. For many of us, the pain will be the result of a bulging or herniated lumbar disc. A herniated disc in the lumbar spine is one of the most common causes of low back pain and leg pain (sciatica).  But did you know that you can drastically reduce your chances of herniating a disc by paying attention to some key warning signs?  Let’s paint you a picture of the disc bulge from a typical story, who is at risk, symptoms and possible treatment.

Here’s a typical disc-injury story:

John is a lawyer, father and golf enthusiast. A month ago he noticed a warm, tingly sensation in his right foot. “Strange,” he thought. Three weeks later, John lifted the golf flag on the 6th hole and felt a twinge in his right buttock. It was resolved with rest. A week passed. John bent down to put on his socks and... BAM! Pain shot into his right leg. “I’ll be alright,“ he thought, ``I'm just going to be sitting at work today.” By the end of the day, John could not stand up straight. His pain finally forced him to the doctor’s office. 

To John’s surprise, the doctor focused on his back. “Wait,” John said, “I don’t have pain in my back!” One x-ray and MRI later, John had his diagnosis: a bulging disc. What did this mean? 

Quick Anatomy: The Jelly Donut Theory

Your vertebral column is made up of a stack of bones called your vertebrae.  These bones create a canal that surrounds and protects the spinal cord.   The disc is a cushion between these vertebrae and is like a jelly donut; the outside (annulus) of the disc is fibrous and the inside (the nucleus) is like jelly. When you hold a jelly donut between your hands and push on it, what happens?  The jelly pushes the fibrous layers of the donut outward. If you push too hard, or repeatedly, on the donut, the jelly can leak out through the fibrous layers, making a big mess.  In the case of the disc, this is what we call a disc herniation. 

Too much force or repetitive pressure on your disc (from activities like bending forward or slouching) will cause a disc bulge (deform outward) or herniate (the nucleus leaks out of the annulus).  When this happens, you are at risk of compressing your spinal cord and nerve roots. These nerves go down from your back, through your buttocks and legs, and to your toes.  Symptoms of nerve compression include tingling, numbness, weakness, loss of balance, and/or pain. Most people chalk these symptoms up as an “episode” of back pain and unfortunately will put off getting help until these “episodes” become more frequent, severe, or longer lasting. Waiting to get help makes recovery more difficult and less effective. 

Addressing your symptoms, even after the “episode” can:

  1. Reduce your risk of ever having an episode again
  2. Reduce your healing time
  3. Save you from a future surgery
  4. Keep you living a pain-free life

This is why the best thing you can do is listen to your body. If something feels strange or painful, your body is telling you something is wrong.  See a medical professional or Schedule an Appointment with a Next Level Physical Therapist. There are plenty of preventative and recovery treatments that get you back to pain-free living.

How do I know if my symptoms are due to a disc bulge or herniation?

If you have pain with bending forward, twisting, sitting, coughing or sneezing, you may have a disc bulge. If you pain is sharp, electric or burning and is easily traced with one finger, you may have a disc bulge. If you have tingling, numbness or weakness in one or both legs, you may have a disc bulge. 

An Ounce of Prevention:

While you can’t always prevent injury, there are things you can do to take care of your spine health to improve your odds of avoiding a slipped (herniated) disc:

  • Pay attention to your posture
  • Don’t smoke.
  • Make healthier food choices.
  • Get plenty of moderate exercise.
  • Learn how to lift and bend properly.

What Can Be Done?

If you think you have a disc bulge, it is important to reduce the bulge and to strengthen your core and hips.  You should also use ice to decrease inflammation at the low back (even if you don’t feel your symptoms at your back).  After 48 hours, heat can be used to increase blood flow to the area, relax muscles and flush out any toxins in the tissues. 

Try This:

To reduce a disc bulge, perform a press up. Lie on your stomach and press your upper body upward, keeping your hips on or close to the floor.  Do not press beyond pain. Repeat 10 times, perform various times throughout your day. 

YOU’RE INVITED!

Not sure what is causing you pain?  Want more information? Click here to register for our upcoming workshop: Freedom From Low Back Pain and Sciatica.

Experiencing back pain, but not sure it is from a bulge? Check out these articles:

  1. Diagnosis: Stenosis
  2. SI Joint
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