Could your back pain be a bulged disc?
“Done my back in” “put my back out" "tweaked my back” “pulled a muscle” are all common references to back pain, which can also be a common description for the pain felt when you have a bulged or herniated disc.
Not everyone is an anatomy buff, that's my job. So lets go through what a disc is.
What is a disc and vertebrae?
The bones that make up our spine are called vertebrae, and in between these vertebrae are dense gell-filled pads that provide cushioning between the bones. Each disk is like a mini shock absorber, which allows for movement and flexibility of the spine. These mini shock absorbers are composed of a tough outer layer of cartilage that protects the softer inner layer.
Now we have an idea of what a disc is, where it is, and its purpose, let's get a little more specific.
Bulged vs herniated disc. What's the difference?
These terms are commonly (and incorrectly) used interchangeably, even though they are technically two different conditions.
A bulging disc is where a disc loses its original shape and expands (bulges), which can place pressure on a surrounding nerve root and cause pain.
When a disc “bulges,” part of its tough outer wall can protrude into the spinal canal and press on a nerve, which causes pain. Depending on which nerve is pressed by the disc, the pain can appear in an arm, leg, glute (butt cheek) or other areas of the body depending on which nerve is being affected.
Different types of disc bulging
There are three different distinctions for disc problems:
Disc protrusion: The disc’s outer wall remains intact, and the disc protrudes 180 degrees or less of the disc’s circumference.
Bulging disc: The disc’s outer wall remains intact, and the disc protrudes more than 180 degrees of the disc’s circumference.
Herniated disc: A bulging disc’s outer wall tears, allowing the inner fluid to escape.
A disc that is damaged may bulge, pushing into the spinal canal and causing pain. However, a bulging disc has not broken through the outer wall of the disc (ruptured). If the outer layer of the disc tears and the soft inner contents of the disc leaks out, the result is a “herniated disc.” So a bulging disc may progress to a herniated disc without correct care and prevention.
"A bulging disc may progress to a herniated disc without correct care and prevention."
- Kate Retallack, Remedial Massage & Soft Tissue Therapist
Possible causes
Strictly speaking, discs aren’t what we would usually think of as a moving part like an arm or leg. However being shock absorbers, they still receive a lot of wear and tear. Not just from the spine, but the whole body. Over time, disks dehydrate and their cartilage stiffens, causing weakness and degeneration to varying degrees. These changes can cause the outer layer of the disk to bulge out fairly evenly all the way around.
A majority of disc injuries occur in the lumbar (lower) region of the back because the lower back bears most of the torque and force of daily movements. About 10% of disc injuries affect the upper portion of the spine. The most common location for a bulging disc is between the fourth and fifth lumbar vertebrae in the low back. This area continually absorbs the impact of bearing the weight of the upper body. The lower back is also critically involved in the body’s movements throughout the day, such as the twisting of the torso (rotating side to side), bending, and lifting. Performing these movements incorrectly, putting unnecessary strain on your back and spine is a large contributing factor for injuries.
Other causes and risk factors
Degenerative disc disease is the most common cause of a bulging disc which can result in spinal osteoarthritis. Other factors that can cause or contribute to bulging discs include:
Strain or injury.
Obesity.
Smoking.
Poor posture.
Inactivity.
Seek medical attention immediately
Please seek medical attention immediately if you experience any of the following:
Severe limb weakness where or close to the site of pain.
Unusual/uncharacteristic loss of bowels or bladder.
Difficulty in performing basic daily tasks due to pain or weakness.
Pins and needles, loss of sensitivity in the limb.
Quality of life is severely impacted due to ongoing pain or weakness.
These are all signs of serious nerve or spinal cord involvement and if left undiagnosed can lead to permanent damage.
At home treatments
The good news is it's not all doom and gloom if your back pain is a result of a bulged or herniated disc. Roughly only 5% - 10% of diagnosed disc injuries require surgeries. That means at least 90% DON"T need surgery, HOORAY!!
Apart from treatment at the clinic, there is a wide variety of treatments you can try at home to help reduce the pain between your appointments. Some will help more than others, so if something INCREASES the pain, stop it immediately.
To reduce the pain, often it is a multifaceted approach that works best and not any single suggestion. There are no hard and fast rules, but you can try the following:
Stop doing any movements or activities that aggravate your symptoms. Such as bending over, lifting, and poor posture.
Braces and support devices. These devices can help by providing compression and stability to help reduce pain.
Heat or cold. Initially, cold packs can help relieve pain and inflammation. After a few days, switch to gentle heat for relief.
Approved stretches to help reduce the compression of the spine.
Medication. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen are the first-line medications for bulging discs. For more severe pain, prescription medication may be necessary. In some cases, a muscle relaxer like Voltaren can help if there are muscle spasms. it is not recommended to mix different types of medications. if you are unsure, speak to your doctor or local pharmacist.
Treatment at the clinic
Often clients make an appointment as a last resort, after being disappointed with the lack of relief or results from other treatment options. At Aspire Clinic WA, the goal of treatment for a bulged disc is to give you relief from the initial pain, while supporting your body to repair as it goes through the healing process.
Research suggests a consistent, intensive, multi-faceted approach is the most successful treatment plan. This includes regular appointments, exercise homework, modifying daily tasks, and at-home therapy. There are no quick fixes, but the aim is to achieve results within a 12 week period (pain relief often within your first few appointments) and get you back to your normal daily living and activities pain free.
Specific treatment and success largely depends on how long you have been experiencing symptoms and the severity of the pain. Other considerations include the type of symptoms (such as weakness or numbness) your age, and lifestyle factors.
At your appointment, you will be asked a range of different questions to help design your treatment plan.
These questions include:
When did the pain start?
Was it a sudden or gradual onset?
Does the pain change in severity during activities or time of day?
What increases and decreases the pain?
Have you seen your doctor or other professionals for a diagnosis?
Have you tried or received other treatments, and what were the results?
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