Bulging Discs And Lower Back Pain
Although it sounds like a serious problem, bulging disc lower back pains are usually not severe, and bulging disc treatment options are often very effective at resolving any back pain that you might be suffering with.
Like all disc problems though, it can be very hard to determine exactly what is causing back pain, and often the differing terms (disc bulge, herniation, degeneration) are used interchangeably. In particular, a disc bulge is often confused with a disc herniation, but they are actually different things. We will be covering this in more detail as you read through.
Another thing that might be somewhat of a surprise is how common bulging discs are, even if you are not experiencing any symptoms. A study that was published in the highly regarded New England Medical Journal in July 1994 by M.C. Jensen titled ‘ Magnetic Resonance Imaging of the Lumbar Spine in People without Back Pain.’ examined scans of people who had no symptoms of back pain.
They found that 52% had disc bulges! That is, over half of people with no back pain had a bulging spinal disc! And this number increases with age.
A bulging disc occurs when the discs inner material, the nucleus pulposus, starts to squeeze out into the outer ring of the disc (annulus fibrosis). This can cause the disc to swell and bulge. It is thought to be a natural part of the ageing process, like Degenerative Disc Disease. This process will happen quicker if their has been an injury to the disc through trauma, or long term spinal stress and strain as a result of things like poor posture and prolonged sitting. Smoking is also known to speed up disc problems.
It is worth mentioning that discs do bulge very slightly when we are standing as they absorb our body weight.
A bulging disc is not necessarily a sign that anything serious is happening to your spine, and they often do not cause any pain.
But, if the bulge is large enough it can press into the spinal canal. This can directly irritate the spinal nerves, resulting in pain. If there is any calcification or spurs (also known as osteophytes) in the area the problem can become much worse.
The easiest way to think of a bulge is as a generalised swelling of the disc. A herniation is different, and occurs when the gel like nucleus pulposus actually squeezes through cracks in the fibres of the annulus fibrosis and pushes out into the spinal canal. The gel like nucleus can even squirt out into the area behind the disc, and this can result in severe pain and neurological problems if it compresses the nerves.
The best way to diagnose a bulging disc is with an MRI. Because the discs are soft tissue, they can not be seen effectively on an X-ray.
This MRI shows a disc bulge at the L4-L5 spinal level. In the centre of the picture you will see the vertebra of the spinal column like a stack of blocks. The lighter coloured pancakes in between are the discs.
You will notice that one of the discs is darker in colour, and is bulging to the right, into the spinal canal where the spinal nerves are. This is a disc bulge. The darker colour of the disc is generally indicative of dehydration of the disc, a result of Degenerative Disc Disease. Bulging discs and degenerative change usually go hand in hand.
Symptoms of Bulging Disc Lower Back Pain
Like Degenerative Disc Disease, the symptoms of a bulging disc vary. As mentioned above, 52% of people with no back pain at all have a disc bulge. Some people may only experience occasional back ache in the mid-line.
However, if the bulge is large enough to irritate a spinal nerve you can experience severe back pain on one side that may even extend into your buttocks or down your leg. You may even have some numbness or tingling, or muscle weakness. (Although the more severe signs are usually due to a disc herniation.)
Bulging Disc Treatment Options.
In severe cases where the disc bulge is compressing nerves, spinal surgery may be an option. A Laminectomy (removing the posterior, bony portion of the vertebra) or a Discectomy (removing the disc) can be performed to take the pressure off the nerves. However, all surgery is risky, and should only be performed in exceptional cases where all other options have been exhausted.
As per the treatment for Degenerative Disc Disease, there are several other, more conservative options.
Medications such as pain killers and anti-inflammatories can relieve the pain, but do not fix the underlying problem.
Chiropractic manipulation can increase spinal range of motion, relieve nerve pressure, restore blood flow and reduce muscle tension. It is low risk and has a very good success rate.
Ultrasound and massage can help to restore blood flow and reduce muscle tension.
A specific exercise program designed to progressively stabilise the spine and increase flexibility, such as the Total Back Pain Solution, is often the only way to achieve long-term healing for most sufferers of a bulging spinal disc.
Hot and cold therapy, losing weight and quitting smoking are all known to be beneficial as well.
Once you understand that spinal problems like a disc bulge, or facet joint pain are all the end result of an underlying spinal instability, it becomes obvious that it is ultimately up to ourselves to protect our spine by looking after it correctly. Only by doing this and making a little effort can we look forward to a life that is not limited by whether by the level of our back pain.
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