About Bulging Discs
A bulging disc arises when the outer wall of the disc weakens and the internal disc contents protrude beyond the usual boundary. Bulging discs commonly occur with aging, but can also occur after a back or neck injury.
It is common that a bulging disc will be confused with a herniated disc. Herniated discs develop from a bulging disc when the outer layer of the disc cracks, causing the inner disc matter to project into the nerve channel.
Common Symptoms of a Bulging Disc
The symptoms of a bulging disc depend on the severity of the condition, but they are often asymptomatic. If the disc bulge applies pressure to a nerve root or the spinal cord, it can cause pain and other symptoms. Symptoms from the disc pressing against your spinal cord include:
- Tingling in the hands
- Loss of hand coordination or strength
- Spastic movement
- Problems with bladder or bowel control
Symptoms from the disc pressing on an individual nerve include:
- Pain radiating into an extremity, in the area supplied by the nerve
- Numbness/weakness in an extremity, in the area supplied by the nerve
A disc bulge can also lead to neck or back pain, with radiation into the shoulders or buttocks, without compression of a nerve. This pain may get worse over time or while participating in certain activities.
Diagnosis of a Bulging Disc
A series of tests may be ordered by the doctor to properly diagnose a bulging disc. While an X-ray will not show signs of a bulging disc, it can be used to rule out other conditions that may produce similar symptoms. Other tests used include MRI scans, CT scans, and myelogram.
Treatment Options for a Bulging Disc
Conservative treatments are usually encouraged once symptoms develop. Over time, the inflammation associated with the disc bulge can subside, leading to improvement in pain or other symptoms. Some nonsurgical treatments include:
- Physical therapy
- Pain medications
- Strengthening exercises
- Cortisone shots
- Activity modification
Surgical options will be considered after 4 to 12 weeks of failed attempts at conservative treatments, or if neurological deficits are progressing or prominent. Some options include:
- Minimally-invasive microdiscectomy – removal of the herniated portion of the disc
- Anterior cervical decompression – removal of disc material through the front of the neck
- This requires either a fusion or arthroplasty to be performed in addition to disc removal
- Posterior cervical laminectomy – removal of the nerve channel roof to provide more space