What Is A Bulging Disk In Lower Back

The Difference Between Bulging Disc And Herniated Disc

Before we dive into the details of a bulging disc and herniated disc is important to understand the basics of the spine and disc anatomy.

Spine Anatomy: Your spine serves the essential functions of providing your body support and structure, allowing you to stand, bend, and twist. The spine also protects your spinal cord which is a highway of nerve signals allowing you to move and feel sensations. The spine is comprised of 33 bones which are divided into three major sections:

• Cervical: seven vertebrae that form the neck
• Thoracic: twelve vertebrae that form the upper and mid-back
• Lumbar: five vertebrae that form the lower back

Each vertebra is separated by a fibrous intervertebral disc which is made up two parts:

• Nucleus pulposus: This is the jelly-like inner core of the disc. It is made up of roughly 80% water as well as collagen fibers. Its elasticity allows each disc to act as a shock absorber for the spine.
• Annulus fibrosus: The annulus is made up of seven to 15 layers of fibers surrounding and protecting the nucleus. Each has a slight arch or curvature of about 30° that provides traction and structural support for the disc.

When your spine moves the discs in your adjust slightly to support the vertebrae. For example, when you bend over the anterior compresses and the posterior stretches.

What Are The Symptoms Of A Slipped Disc

You can have a slipped disc in any part of your spine, from your neck to your lower back. The lower back is one of the more common areas for slipped discs. Your spinal column is an intricate network of nerves and blood vessels. A slipped disc can place extra pressure on the nerves and muscles around it.

Symptoms of a slipped disc include:

• pain and numbness, most commonly on one side of the body
• pain that extends to your arms or legs
• pain that worsens at night or with certain movements
• pain that worsens after standing or sitting
• pain when walking short distances
• unexplained muscle weakness
• tingling, aching, or burning sensations in the affected area

The types of pain can vary from person to person. See your doctor if your pain results in numbness or tingling that affects your ability to control your muscles.

Signs Of A Herniated Disk

One sign may be where the pain is. Although herniated disks can happen in any part of your spine, they are most common in the lower part of your backbone , just above your hips. The pain may spread from your back to your buttocks, thighs, and even to your calves.

Discomfort from a herniated disk usually gets worse when you’re being active and lessens when you’re resting. Even coughing, sneezing, and sitting can worsen your symptoms because they put pressure on pinched nerves. A herniated disk also can give you a feeling of tingling or numbness. The affected part of your back may also feel weak.

Age also plays a role. As you get older, your disks tend to break down and lose their cushioning. That makes a herniated disk more likely.

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Symptoms Of A Bulging Disc

A bulging disc can cause symptoms like pain in your neck, shoulder, arm or chest, leading to numbness, tingling or weakness in your arms or fingers. A bulging disc can cause sciatic pain, which is a kind of pain that shoots down your lower back, buttocks, legs and feet.

Pain and other symptoms arise from the bulging disc rubbing against one or more of the nerves that branch out from the spinal cord. Because the disc may bulge to the left or right, you may feel symptoms in one side or both.

Causes Of Bulging Vs Herniated Discs

Bulging discs and herniated discs have very similar causes. The most common cause is degeneration. As we age, the discs in our spine tend to dehydrate and stiffen, which often results in the discs becoming slightly compressed or flattened. Because of this, protruding discs are considered to be rather common as we age.

Other causes of bulging or herniated discs may include:

• A spinal injury or trauma
• Repetitive spinal stress

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Types Of Herniated And Bulging Discs

Herniated and Bulging discs can occur in the Cervical, Thoracic, or Lumbar regions of the spine.

• Cervical disc herniation: This is when a disc herniates in the neck. It is one of the most common causes of neck pain.
• Thoracic disc herniation: This is when a disc herniates in the upper or mid-back.
• Lumbar disc herniation: This is when a disc herniates in the lower back. It is a common cause of lower back pain.

Herniated and Bulging discs can also be classified by the area of the disc they protrude into .

• Central: When the disc extrudes into in the spinal cord.
• Subarticular : When the disc extrudes between the spinal cord and the foramen .
• Foraminal : Disc extrusion into the foramen.
• Extraforaminal : Disc extrusion beyond the foramen.

Exercise #: Plank To Strengthen Core/abs

This exercise is ideal for strengthening both your deep core and gluteal muscles.

How to do it:Begin lying on your stomach with your forearms against the mat. Engage your core and lift your body so that you are resting on your forearms and toes. Ensure that your spine is in a neutral spinal position . Hold the plank position for 20-30 sec, Then lower down to floor. Aim for 2 to 5 repetitions of this exercise.** Ensure to keep your back straight throughout the entire exercise.

Notes:

Other forms of exercise that may help, that were not mentioned above include core strength, walking, pilates, and yoga.

Seeing a primary musculoskeletal care provider is the best approach if your symptoms are not resolving. This includes DO/MD/DC/DPT.

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Dr. Smith earned his Doctorate In Physical Therapy from the University of Miamis Miller School of Medicine and currently practices as a home care therapist in the Tampa Bay area. He uses his eclectic background of working with everyone from those in the ICU to elite athletes to customize care for each one of his patients and progress them toward their personal goals.

Prior to being a Physical Therapist, he earned a masters degree in public health and managed big pharma clinical trials worldwide. He enjoys CrossFit, Animals, and helping people live a pain free and active lifestyle

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How Serious Is A Disc Bulge

A bulging disk can cause severe pain and mobility issues by pressing against the spinal cord and nerve roots. You may require medication, physical therapy, or self-care in order to treat a patient with this condition. It is possible for someone to require surgery in severe cases.

Stretching To Ease Herniated Disc Symptoms

Stretching can help to alleviate the symptoms of a herniation in the discs. The muscles in the back can become more flexible, allowing the discs to heal more quickly and stabilizing the herniation area. Internalized disc herniation exercises can also help reduce symptoms, as well as improve endurance and circulation. If you are experiencing back pain or stiffness, stretching may be beneficial to your health.

Nerve Conduction Studies And Electromyogram

These studies use electrical impulses that measure how much your nerves might be affected by compression from a herniated disc. NCS and EMG are not routine tests to diagnose herniated disc, and are only used if you have symptoms of nerve trouble like numbness and radiating pain. These studies are typically only used if MRIs and a physical exam are inconclusive and your doctor thinks other conditions are a possibility.

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So What Are Spinal Discs

There are 24 moveable bones in your spine. Between each of these vertebrae are flat circular cushions called intervertebral discs. These discs create a gap between each of the vertebrae. This space is where the nerves exit from the spinal cord to travel through the rest of your body.

All the vertebra and discs together form your spinal column. These discs make up one fourth of your spinal columns length.

Bulging Disc Vs Herniated Disc

If youre wondering about a bulging disc vs. , you should know there is a subtle difference, even though the terms are often used interchangeably. In a herniated disc, the inner layer has actually punched through the outer layer, With a bulging disc, the outer layer is still containing the inner layer, but its deformed.

The distinction between a bulging disc and herniated disc is a technical one with many gray areas, Dr. Shah says. In broad categories, a herniated disc is one in which the jelly material inside of the jelly donut escapes the confines of the outer donut. When jelly escapes the inner portion of the donut to migrate through the donut walls, the definition turns from being a bulging disc to a herniated disc.

A bulging disc can be compared to a jelly donut that’s been squeezed.

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Potential Causes For A Bulging Disc

• People who have led a sedentary lifestyle or those who smoke increase the chances for bulging disc.
• Continuous strain on the disc from injury or heavy lifting and strain can wear them down throughout the years.
• Weakened back muscles can accelerate the process and may lead to a sudden herniation of the weakened disc.
• Although bulging discs occur over time, herniated discs may occur quickly by trauma.
• Bad posture including improper body positioning during sleep, sitting, standing or exercise are all risk factors which may contribute to the development of a bulging disc.
• High contact sports or activities are also risk factors.
• Runners who fail to use shoes that provide orthopedic support may also develop bulging discs.
• Activities that place stress and strain on the spine can lead to the weakening of the discs.

Treatment For Disc Problems

Most disc problems will resolve with time, regardless of treatment, just like soft tissue sprains in other parts of the body. Short-term bed rest for a few days may help in the initial management of severe sciatica. However, most people can stay active, with some restrictions, according to their level of pain. Appropriate pain relief and allowing the person to stay active within their pain limits is usually the best approach.

Some treatments used for pain relief include:

• gradually increasing activity levels within pain limits
• an exercise program designed to improve strength, flexibility and fitness
• a short-term trial of massage, spinal mobilisation or manual therapy
• non-steroidal anti-inflammatory drugs or steroids
• pain-relieving medications, such as paracetamol.

Sciatica pain may be treated with an injection of anti-inflammatory steroids into the area of the affected spinal nerve. In severe cases of sciatica caused by a large disc protrusion, pain may be relieved by surgery to trim the protruding disc. This may be done to relieve pressure on the affected spinal nerve.

In severe cases of degenerative disc disease, surgery may be considered to remove the disc and fuse together the two vertebrae on either side.

However, severe cases of both sciatica and degenerative disc disease are uncommon.

Remember, most disc problems resolve without specific treatment.

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How Are Slipped Discs Treated

Treatments for a slipped disc range from conservative to surgical. The treatment typically depends on the level of discomfort youre experiencing and how far the disc has slipped out of place.

Most people can relieve slipped disc pain using an exercise program that stretches and strengthens the back and surrounding muscles. A physical therapist may recommend exercises that can strengthen your back while reducing your pain.

Taking over-the-counter pain relievers and avoiding heavy lifting and painful positions can also help.

While it may be tempting to refrain from all physical activity while youre experiencing the pain or discomfort of a slipped disc, this can lead to muscle weakness and joint stiffness. Instead, try to remain as active as possible through stretching or low-impact activities such as walking.

If your slipped disc pain does not respond to over-the-counter treatments, your doctor may prescribe stronger medications. These include:

• muscle relaxers to relieve muscle spasms
• narcotics to relieve pain
• nerve pain medications like gabapentin or duloxetine

Your doctor may recommend surgery if your symptoms do not subside in six weeks or if your slipped disc is affecting your muscle function. Your surgeon may remove the damaged or protruding portion of the disc without removing the entire disc. This is called a microdiskectomy.

A Bulging Vs Herniated Disc

Bulging and herniated discs are sometimes interchangeable terms to define a condition that affects the intervertebral discs. However, they are several differences between these two conditions.

A bulging disc is not a broken disc, meaning the outer wall of the intervertebral disc remains intact but bulged. Whereas for a herniated disc, there has been a partial rupture or complete collapse of the outer wall of the intervertebral disc and the gel-like material inside the disc has spilled out causing pressure on the spinal cord or spinal nerves.

In the end, the primary difference between a bulging and a herniation comes down to whether they are contained or non-contained.

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Causes Of A Herniated Disc

The most common cause of disc herniation is age-related wear and tear. This is known as disc degeneration. As your body ages, the amount of water in your vertebral discs decreases, making them less flexible and more prone to tearing. Certain motions, such as twisting, turning, or lifting can also cause a herniated disc. Although less common, an injury such as a car accident or a blow to the back can cause a herniated disc.

How Is Lumbar Disk Disease Treated

Typically, conservative therapy is the first line of treatment to manage lumbar disk disease. This may include a mix of the following:

• Education on proper body mechanics

• Physical therapy, which may include ultrasound, massage, conditioning, and exercise programs

• Use of a lumbosacral back support

• Medicine to control pain and relax muscles

If these measures fail, you may need surgery to remove the herniated disc. Surgery is done under general anesthesia. Your surgeon will make an incision in your lower back over the area where the disc is herniated. Some bone from the back of the spine may be removed to gain access to the disc. Your surgeon will remove the herniated part of the disc and any extra loose pieces from the disc space.

After surgery, you may be restricted from activity for several weeks while you heal to prevent another disc herniation. Your surgeon will discuss any restrictions with you.

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What Can Cause A Disc Bulge

The vertebrae are bulging due to poor posture and body mechanics. Repetitive work results in disc twisting and bending, as well as lifting. Long hours spent sitting, standing, driving, or working. A severe fall is likely to cause a back injury.

Most Common Discs To Rupture

Despite the fact that L5-S1 discs are the most common type of ruptured disc, they are also the least common. If any of the symptoms listed below do not go away, it is important to see your doctor for an MRI to determine whether or not you have a bulging disc. Back pain that does not go away with rest br> It is usually accompanied by severe back pain or difficulty gripping your spine. Any activity can cause sudden and severe pain. If you experience any of these symptoms, it is best to schedule an MRI scan as soon as possible. If your doctor discovers a bulging disc during an MRI scan, you may require surgery to correct it.

What Causes Lumbar Disk Disease

Lumbar disk disease is caused by a change in the structure of the normal disk. Most of the time, disk disease happens as a result of aging and the normal break down that occurs within the disk. Sometimes, severe injury can cause a normal disk to herniate. Injury may also cause an already herniated disk to worsen.

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Symptoms By Region Of The Spine

Herniated Cervical Disc: Pain shooting down the arm to the fingertips, numbness, tingling, or weakness in the shoulder, arm or hand, difficulty walking or maintaining balance or problems gripping or handling things.

Herniated Thoracic Disc : Pain from the lower neck to the mid-back, chest pain, headaches when lying down, difficulty walking, tingling, numbness, or burning sensation in the legs, weakness in the legs or problems with the bladder or bowels.

Herniated Lumbar Disc : Pain in your lower back, buttocks, hamstring, calf, or feet, numbness or tingling in the affected leg, shooting pain down you leg, weakened leg muscles, burning or sharp pain in your leg that worsens when standing long periods of time, difficulty controlling the bladder or bowels, difficulty walking, abnormal ankle and knee reflexes, poor coordination, difficulty lifting the feet or cramping in the lower back or legs.

Herniated Disc Neck Symptoms

A herniated disc in the neck can cause symptoms of pain, numbness, and weakness in the neck, shoulders, arm, and hand. The pain is often worse with movement, and may be accompanied by muscle spasms. Numbness and weakness occur when the disc presses on a nerve.

A cervical herniation can cause a variety of different types of pain, as well as no symptoms at all. The pain can range from an aching in the neck, arm, and/or hand to electric-like sensations in these same areas. It is possible that numbness or weakness in the arm or hand is present. In a herniated disc, the nucleus pulposus, which contains inflammatory proteins, leaks from the disc and onto nearby nerve roots, causing the most pain. Herniated discs are sometimes discovered on the spinal cord.

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