What is a Bulging Disc?

Suffering from bulging disc pain? You’re not alone. This common condition is affecting more and more people, simply as part of the aging process, but also from injury and accidents. Some people with bulging discs feel next to nothing, while others seek help because the pain is close to unbearable. Thankfully, DISC Spine Institute performs minimally invasive surgical procedures like discectomy that provide relief for even the most painful conditions.

Symptoms of bulging discs

The disc is the shock absorber between the individual vertebrae (spinal bones). It is 90 percent water and has a rubbery consistency. With time, age, and wear and tear, the discs can begin to collapse and bulge out from between the two vertebrae. The disc itself is innervated and therefore can cause pain. Often, this is from a tear in the disc called an annular tear. The disc can also bulge back into the spinal canal or into the opening for the spinal nerves. This results in a pinched spinal cord or pinched nerves. A narrowed space in the spinal canal is referred to as spinal stenosis.

Unlike a herniated disc, which often comes on quickly with acute, sharp pain, the pain from a bulging disc tends to be more gradual but, it can send you through the roof when it pinches a nerve or if the disc tears and causes inflammation. Depending on where the affected nerve is located, the pain can be felt in the lower back (lumbar region), middle back (thoracic region), the upper back/neck (cervical region), or into the arms or legs.

A bulging cervical disc can present with symptoms including dull or sharp pain, tingling or a pins-and-needles feeling, numbness, and weakness in the neck, radiating down to the shoulders, arms, and hands and fingers. Dangerous symptoms of myelopathy can also develop if the disc is causing spinal cord compression; they can include difficulty walking (imbalance), leg heaviness, and issues with fine motor skills in the hands and fingers or bowel/bladder dysfunction.

A thoracic bulging disc is less common. This area is less affected and less symptomatic largely due to the fact that the vertebrae are supported by ribs that attach at the sternum. This provides the thoracic vertebrae and discs with more support and stability relative to the cervical and lumbar regions. If thoracic bulging discs do become symptomatic, they can cause pain in the upper back or pain that radiates around the rib cage or into the abdomen.

The lumbar region includes the area in the low back, so bulging disc issues here can create excruciating lower back pain shooting into the buttocks, legs, and feet. Symptoms can include overall weakness, numbness, and a tingling feeling in the legs and hips, with the potential for muscle spasms. Various positions, from sitting to standing, can cause an increase in low back or leg pain. The nerve pain in your leg created by a lumbar bulging disc is referred to as sciatica.

Dangers of delaying treatment

Some bulging discs get better with no or little treatment, while some respond well to conservative treatments. But, those who choose to just “see how it goes” and hope they’ll improve on their own run the risk of developing more dangerous conditions, such as permanent and irreversible nerve damage leading to chronic pain and weakness, not to mention having to suffer day and night.

A bulging disc can rupture, causing increased pain and more nerve compression. It can also extend into the spinal canal.  A narrowed space in the spinal canal is referred to as spinal stenosis. If the spinal cord becomes damaged through severe spinal stenosis, it can cause symptoms of myelopathy, which can be serious and permanent. Serious cases of spinal stenosis can cause a dangerous condition called cauda equina syndrome, with symptoms including severe weakness or loss of bladder or bowel function. Cauda equina syndrome requires immediate surgery.

Are you a candidate for surgery?

At the Disc Spine Institute, we typically recommend several weeks or months of conservative treatments for bulging discs, which have shown promise in treating the condition. They include:

• Time for your body to heal itself
• Over-the-counter, non-steroidal anti-inflammatory medications (NSAIDs) like Advil
• Doctor-approved exercises
• Physical therapy, massage, and chiropractic care
• Steroid injections

If patients do not see significant relief from these conservative, non-surgical treatments, they may then become a candidate for a minimally invasive procedure like a discectomy.

What is a discectomy?

A discectomy at the Disc Spine Institute is a minimally invasive procedure that is performed through a very small incision less than one-inch long. A small tube is placed in between the muscle fibers to preserve muscles, tendons, and ligaments. Through the small tube, specialized instruments and microscopes are used to create a small window in the bone. The nerves are gently moved to the side and the portion of disc material that is compressing the nerve is removed. This is typically only five percent of the disc; the rest of the disc is left intact. This is an outpatient procedure that involves minimal blood loss and is sutureless.

Recovery

If you’re expecting to spend days and weeks in bed after surgery, think again! After minimally invasive discectomy surgery, patients can expect to be up and walking the same day. Your doctor will lay out a plan for you that may include several short walks per day and other exercises as time passes. You’ll typically come in for a check-up after two weeks to assess your progress and examine your incision, but you’ll want to beware of any issues including swelling, fever, signs of infection, and prolonged pain all along the way.

Your spinal surgeon may increase your activity level at this time, but don’t expect to be doing any heavy lifting or strenuous activity yet—that will come later. You can expect to feel stronger and any remaining discomfort should subside within a few days to a week or two. Soon, your doctor may release you to go back to work. Most people return to work just days after the surgery, or you may need a few more days or a week or two of recovery. Be patient! Following doctor’s orders is critical to your recovery and long-term health.