Bulging / Herniated Disc

WHAT IS A BULGING OR HERNIATED DISC?

If you have been diagnosed with a bulging disc, you are not alone. Bulging discs, also known as a disc protrusion, is a very common occurrence. They differ from disc herniation or even extruded discs in that that Nucleus Pulpolsus (i.e. the inner part of the disc) has not broken through the outer fibrous rings to possible press on an adjacent structure. Bulging discs can be thought of as a pancaking effect or flattening of a normal healthy spine. The structure is supposed to be able to disperse pressure up the spine when jogging for example. An unhealthy disc will not be able to do this and thus leads one more susceptible to injury. If the disc is herniated, the spinal cord, small nerve endings and larger nerve roots can become compresses causing Radiculopathy (i.e. numbness caused by spinal nerve root pressure).

HOW DID I HERNIATE MY BACK?

Sometimes a simple lifting motion or twist is all that’s needed for the structure holding the disc material to fail. It’s wasn’t the trauma per say, but the weakening of the structure through years of wear and tear that eventually led to the injury. As mentioned above bulging discs are a lesser form of herniated discs in that the fibrous rings are still intact. However, bulging discs take time to form and are weaker than a healthy disc, which can lead to injury more easily. Trauma (i.e. motor vehicle accident) can cause immediate herniations due to the sudden increase in loading force placed on the spine.

HOW DO I KNOW IF IT’S A DISC PROBLEM?

Any disc problem has the ability to cause pain. Every spine is different and the subtle changes can mean the difference between chronic pain and none at all. Complicating factors thought such as obesity, diabetes & lifestyle can all play a role in how often a flare-up occurs though. Numbness can be a sign of nerve pressure, but it all depends on how the distribution of the numbness and also what elicits the pain. For example, if pulling the leg up causing the numbness down the leg, there must be a problem coming from the low back. Likewise, if putting pressure on the neck causes pain down the arm, a carpal tunnel diagnosis can be ruled out. Please see the Pinched Nerve page to learn more.

An MRI is the definitive way to tell if there is a disc problem. However, there are many clinical signs and symptoms that can point to this diagnosis. Treatment can safely be administered without an MRI in most cases. An X-ray can show a decreased height between vertebrae’s, but it will not allow the practitioner to see what structures are being affected and how bad the herniation is.

LUMBAR DISC PROBLEM

There are unique differences between a cervical and lumbar disc herniation. This is due to the surrounding structures located near the disc and also the orientation of the joints. The main take away is that the numbness follows a distinct pattern down the leg depending on which level or disc is affected. Just like sciatica causes numbness only down the back of the leg, the same is true for the nerve roots. This distribution is called Dermatomes.

TREATMENT OPTIONS

Our office has specialized equipment specifically geared towards treated disc related problems. Treatment is broken up into three parts. The first being the acute phase where inflammation and muscle guarding is managed. Phase two starts when the body is able to handle a Chiropractic adjustment and other muscle related therapies. Phase three is all about rehab and making sure the ligaments surrounding the injury site are strong, which will prevent future injuries. Please note that this is an inflammatory condition and is made worse with heat. Ice will calm the area down and also provide analgesics / bracing. Heat will relax the muscle, but inflame the area more cause the body to recruit more muscles to brace. If a disc problem is suspected in the low back, a brace might be recommended in order to keep the muscle that we are guarding against overworking

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