Discs are cushion-like materials in between vertebrae in the vertebral column of an individual. They serve many functions like assisting the spine in different movements, distributing the body weight evenly, and absorbing any kind of mechanical stress put on the vertebral column.
With age or trauma, discs can be worn out and it may lead to different conditions of the intervertebral disc. One condition is called a bulging disc. In the bulging disc, the outer layer of the intervertebral disc protrudes out and the entire circumference of a disc can be involved. A bulging disc can occur anywhere in the spine but most commonly, it occurs in the lumbar spine. It can be distinguished from herniated disk by looking at a tear or a hole in the outer layer of the disc. In herniated disk, the outer layer has a hole and the inner layer of the disc is herniating through it.
Causes of Bulging discs
Several factors can play a role in the development of a bulging disc. Some of the reasons behind the presentation of the bulging discs are mentioned below.
- -Motor vehicle accidents and falls can cause bulging discs due to a traumatic injury.
- Working conditions in which the individual has to do heavy lifting, bending, or twisting can cause torsion of the intervertebral disc.
- Certain contact sports professionals are at increased risk of developing bulging discs due to forceful motions and their impact on the spine.
- Increased abdominal fat, poor leg strength, and poor core stability can also put one at an increased risk for bulging disc development.
- Genetic predisposition to the lesser density of fibrocartilaginous joints can inherently weaken the discs.
Diagnosis and treatment options
It is important to visit a medical professional to have your medical history and physical examination completed and to reach a conclusive diagnosis. The doctor may order a few radiologic tests like X-ray or MRI to reach a diagnosis. There are many treatment options available for people struggling with bulging discs. The decision to use a treatment or a combination of many treatment options is based upon the level of severity of symptoms, pain level, and severity of disc-related changes. These treatment options include surgical, nonsurgical, and many alternative treatment options. Depending on the severity of the disease, the doctor may use one of the mentioned nonsurgical treatments, go for a combination of these treatments or he/she may opt for a surgical treatment option.
Here, we will explore nonsurgical treatments for a bulging disc. Common nonsurgical treatment options include bed rest, pain medications, muscle relaxants, physical therapy techniques, chiropractic techniques, and few alternative treatment options.
Bed rest: If you are suffering from back pain originating from a bulging disc, the doctor may recommend complete bed rest with minimal physical activity for two to three days and complement that advice with prescribing some medications. Many patients do not need any further treatment and they recover just with bed rest and medications.
Pain medications: Many groups of medications can be used. Some are available over the counter while others require a prescription from a medical professional. These medications are usually the first-line treatment option for a bulging disc. Commonly, non-steroidal anti-inflammatory drugs like ibuprofen are used initially and if the pain does not settle, an opioid medication can be used by visiting a doctor’s office and getting a prescription.
Muscle relaxants: In addition to painkillers, the doctor may prescribe muscle relaxant medications to help ease the tension in the back muscles. Common muscle relaxants are, baclofen, metaxalone, carisoprodol, and cyclobenzaprine. Usually, these medications are prescribed if the pain is not relieved by painkillers. A muscle relaxant can ease muscle tightness and relieve the spasm which helps in pain-free movements.
Physical therapy: There are mainly two types of physical therapy techniques that are used to relieve pain from bulging discs, passive and active therapy techniques.
Passive techniques: Passive techniques mainly relax the tissues of the body.
- Deep tissue massage: this technique is beneficial in relieving deep muscle tightness and muscle spasms. Muscles become tight when the disc bulges to restrict movements.
- Transcutaneous electrical nerve stimulation: It is also called TENS. The electrodes are attached to the skin surface and this machine is turned on. An electrical signal travels from the electrode into the skin and stimulates nerves to decrease muscle tightness. This technique is also believed to stimulate the release of endorphins.
- Hydrotherapy: This technique involves sitting or standing in a body of water for an optimum time. It can be done by taking a warm shower.
- Hot therapy: in hot therapy, heat is used to improve the blood supply of an area that translates into increase oxygenation of the tissue and increased nutrient supply to that tissue.
- Cold therapy: It slows down circulation. It is used to treat inflammation, pain, and spasms.
Active techniques for physical therapy: these techniques mainly improve flexibility, develop core stability and strength, and enhance joint movement.
- Stabilization of the core: It is very important to have core strength and strong abdominal and weak muscles to help support the key function of weight-bearing of the spine. Core stabilization exercises are used to increase the strength of these muscles.
- Flexibility: many exercises can be done to improve flexibility, decrease stiffness in joints and improve movements.
- Hydrotherapy: In active hydrotherapy, a person enters the water pool and performs different sets of exercises to develop strengths in muscles.
- Muscle strength development: It is very important to keep a regular exercise routine and develop your muscles regularly. Increased muscle strength always helps in tackling back issues.
- Chiropractic treatment options: These include different techniques of spinal manipulation. Manual therapy, therapeutic exercises, manipulation under anesthesia, and pelvic blocking techniques are also included in chiropractic techniques. Chiropractic techniques are usually used along with other treatment options like pain medications and physical therapy.
- Manipulation under anesthesia: In this treatment option, a person is sedated for a short period like 5-6 minutes, and while under sedation, his/her affected area is manipulated and stretched.
- Pelvic Blocking Techniques for herniated disks: This involves placing wedged cushions under both sides of the pelvis that allows the affected disc to move away and the impingement of nerves is inhibited.
Alternative treatments: Many alternative treatments can help deal with symptoms of bulging discs. Some of these treatments are acupuncture, acupressure, and different massage techniques.
- Acupuncture: In this technique, many needles are inserted into the body and they are left in there for 20-40 minutes. The release of endorphins and Gate control theory explains the principle behind acupuncture.
- Acupressure: It is similar to acupuncture and it involves using hands, fingers, and elbows to put pressure on different parts of the body.
- Massage: There are over 100 massage techniques that can be used. It is not a proven treatment option, but it is safe and has no side effects. Massage involves gentle strokes and manipulation of tissues that increase blood flow to the affected area. Massage can be deep or superficial.
American association of neurological surgeons, Herniated disc, Accessed April 13, 2021, https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Herniated-Disc