Bulging Disc Pain: Physical Therapists & Chiropractic Relief

Individuals dealing with back pain problems could be suffering from a bulging disc. Could knowing the difference between slipped and herniated disc symptoms help with treatments and finding relief?

Bulging Disc Pain

Back pain can become debilitating if not treated properly. A bulging disc is a common cause of cervical, thoracic, and lower back pain symptoms. It happens when one of the fluid-filled cushions between the vertebrae begins to shift out of place. Instead of being aligned with the edges, the disc bulges over. This begins to generate pressure on the nerves causing pain and inflammation.

• Bulging discs are often caused by age, but repetitive movements and/or lifting heavy objects can contribute to the condition.
• Symptoms can resolve on their own, but individuals are recommended to consult with a physical therapist and/or chiropractor to make sure the disc healed properly, otherwise, it can lead to worsening and/or further injuries.

Bulging Disc vs. Herniated Disc

Bulging and herniated discs cause pain symptoms.

• They both can be linked to injuries and degenerative disc disease but are not the same condition. (Penn Medicine. 2018)
• Sometimes the terms bulging and herniated disc are used interchangeably, which can be confusing. (American Academy of Orthopaedic Surgeons. 2022)

1. Bulging – the intervertebral disc moves out of place but stays intact.
2. Herniated – the thick outer layer of the disc ruptures, causing the cushioning gel inside to leak onto the spinal nerves.

Location of Symptoms

• A bulging disc can happen anywhere along the spine.
• However, most occur between the last five vertebrae in the lower back.
• This is the lumbar spine. (American Academy of Orthopaedic Surgeons. 2022)
• This is because the lower back is subject to all kinds of pressure and movement with daily activities, increasing the chances of pain and injuries.
• The next most common place is the neck/cervical spine where there are constant movements making it prone to injury and pain symptoms.

Causes

Bulging discs are most often caused by body aging and normal wear and tear. As time goes on the intervertebral discs naturally degenerate, known as degenerative disc disease. This can cause the discs to pull downward, causing them to bulge from their placement. (Penn Medicine. 2018) Factors that can cause or worsen the condition include:

• Practicing unhealthy postures.
• Repetitive motions.
• Lifting heavy objects
• Spinal injuries.
• Medical history of spinal or disc disease in the family.

Treatment

Treating a bulging disc takes time and patience. (American Academy of Neurological Surgeons. 2023)

Examination

Individuals with back pain that interferes with daily functions or has lasted longer than six weeks, should see a healthcare provider for a diagnosis. They will order a magnetic resonance imaging scan/MRI, which can show where a disc is protruding. (American Academy of Neurological Surgeons. 2023)

Rest

• For bulging disc pain, resting the back is necessary. However,
• Many patients benefit from a day or two of bed rest. (American Academy of Orthopaedic Surgeons. 2022)
• After that, start light activities like walking. Avoid any movements that make your pain worse.

NSAIDs

• NSAID pain medications like Advil, Motrin, or Aleve can keep pain symptoms and inflammation reduced.
• However, this is for short-term use, as the underlying cause still needs to be addressed.
• A healthcare provider will recommend safe dosage and how long these medications should be taken. (American Academy of Orthopaedic Surgeons. 2022)

Physical Therapy

• Individuals may be recommended by their healthcare provider for a referral to a physical therapist.
• A physical therapist will address the injury for rehabilitation and introduce strengthening exercises. (American Academy of Orthopaedic Surgeons. 2022)
• Chiropractic Adjustments (NIH. 2022)
• Non-surgical spinal decompression
• Traction therapy
• Therapeutic massage
• Muscle Energy Technique

Steroid Injection

• An epidural steroid injection can provide relief for individuals still experiencing symptoms after six weeks.
• A healthcare provider will inject cortisone into the spine to reduce inflammation and pain. (American Academy of Orthopaedic Surgeons. 2022)

Surgery

• If conservative treatments don’t work, a healthcare provider may recommend surgery, like a microdiscectomy.
• This procedure uses small incisions to remove all or part of a bulging disc.
• Most individuals with a bulging disc will not require surgery. (American Academy of Neurological Surgeons. 2023)

Inflammation: Integrative Medicine Approach

References

Penn Medicine. (2018) Bulging disc vs. herniated disc: What’s the difference?

American Academy of Orthopaedic Surgeons. (2022) Herniated disk in the lower back.

American Academy of Neurological Surgeons. (2023) Herniated disc.

National Institutes of Health. (2022) Spinal Manipulation: What You Need To Know.