Are you living with the persistent pain of a bulging disc? Have you tried everything from rest to medication, but still find yourself in discomfort? Finding the right treatment isn't always straightforward, but understanding your options is the first step towards relief.
A bulging disc, often confused with a herniated disc, occurs when a disc in the spine bulges outside its usual boundary, potentially irritating nearby nerves. In a large number of people these bulges are asymptomatic (cause no pain) whilst in others they can be painful. This can lead to varying degrees of pain and discomfort, impacting daily activities and quality of life. As our population ages and leads increasingly sedentary lifestyles, back-related issues are on the rise, making it more important than ever to explore effective treatment options.
Fortunately, you don't have to simply endure the pain—multiple treatment options are available, ranging from conservative methods to more advanced medical interventions. Understanding these options, from physical therapy and lifestyle changes to medical procedures and alternative approaches, can help you make an informed decision about your health.
What is a bulging disc?
A bulging disc occurs when one of the discs located between the vertebrae of your spine flattens or extends beyond the normal edges of the vertebrae. Think of the discs as cushions between the bones in your spine. Each disc has a tough outer layer and a soft, gel-like centre.
With age, occupational hazards, lifestyle factors and certain comorbidities, the disc can bulge outwards. While the outer layer remains intact, the bulge can irritate nearby nerves, leading to various symptoms.
A bulging disc vs a herniated disc
It's important to distinguish a bulging disc from a herniated disc. In a herniated disc, the outer layer cracks or tears, and the gel-like centre leaks out, potentially causing more direct irritation to the nerves.
Common symptoms of a bulging disc
-
Pain: This can range from a dull ache to sharp, shooting pain in the back, neck, arms, or legs. In the lower back, it can cause sciatica, pain that radiates down the buttock and leg.
-
Numbness or tingling: You might feel a pins-and-needles sensation in your limbs.
-
Weakness: Muscles in the affected area might become weak.
- Stiffness: Your back or neck might feel stiff and have a limited range of motion.
5 Non-surgical treatments for a bulging disc
These are usually the first line of defence and are successful for many people.
1. Relative rest and activity modification
Relative rest from activities that worsen your pain is important. However, prolonged bed rest isn't usually recommended, as it can lead to stiffness. Gentle movement is encouraged.
2. Physical therapy
This is a cornerstone of treatment. A physical therapist can teach you exercises and stretches to:
- Directional preference exercises - finding comfortable, pain alleviating movements
- Strengthen the muscles around your spine for better support.
- Improve flexibility and range of motion.
- Temporary postural modification/changes
3. Heat and/or cold therapy
- Applying ice packs can help reduce inflammation, while heat can soothe sore muscles and increase blood flow.
4. Manual therapy
-
Mobilisation: Spinal mobilisation aims to relieve pressure on the nerves and improve spinal motion.
- Massage therapy: Can help relax muscles and ease tension, providing short-term pain relief.
5. Other conservative treatment options
-
Dry needling: Some people find this helpful for managing chronic back and neck pain.
-
Traction therapy: Aims to reduce pressure on the disc by gently stretching the spine.
-
Braces and support devices: Can provide stability and reduce pain.
- Lifestyle changes: Maintaining a healthy weight, quitting smoking, and practising good posture are important for long-term management.
Surgical treatments for a bulging disc
Surgery is rarely performed for a disc bulge and is only considered if conservative treatments haven't provided sufficient relief after several weeks or months, or if you have significant neurological symptoms like progressive weakness, numbness, or loss of bowel or bladder control (which is rare and requires immediate medical attention).
Common surgical procedures for a bulging disc
-
Discectomy or microdiscectomy: This is the most common surgery for a bulging disc. It involves removing the portion of the disc that is pressing on the nerve. Microdiscectomy is a minimally invasive technique using a smaller incision and specialised instruments.
-
Laminectomy or laminotomy: These procedures involve removing part (laminotomy) or all (laminectomy) of the bony arch (lamina) of a vertebra to create more space for the spinal nerves.
-
Spinal fusion (rare): This procedure joins two or more vertebrae together to stabilise the spine. It may be done after a laminectomy or for spinal instability. It can limit spinal mobility in the fused area.
- Artificial disc replacement: In some cases, the damaged disc is replaced with an artificial one to maintain motion in the spine. This is typically considered for single-level disc problems in the lower back or neck without arthritis.
Final thoughts
Exploring bulging disc treatment options is your gateway to reclaiming comfort and mobility.
The best treatment option depends on the individual's symptoms, the location and severity of the bulging disc, and their overall health.
It's essential to discuss your treatment options with your physiotherapist to determine the most appropriate approach for you. We can provide a personalised plan based on your specific situation.
Book an appointment with one of our highly qualified physiotherapists at Enhance Physio before starting a rehabilitation program. We can advise you on the best course of action for your condition.
