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What Is a Bulging Disc? Causes, Diagnosis, and Treatment Options Near You in New Jersey and Florida
Patients with back injuries may be wondering whether the cause is a bulging or herniated disc or another condition. A bulging disc is a common cause of back pain, occurring when the disc protrudes from its normal position without rupturing. At Centers for Neurosurgery, Spine & Orthopedics (CNSO), New Jersey’s most comprehensive brain and spine center, patients can access compassionate care for spinal injuries and conditions, including disc disorders like bulging discs. Learn more about this condition and its causes, symptoms, and treatment options available near you in New Jersey and South Florida.
Key Takeaways
- A bulging disc is a spine condition in which a spinal disc moves out of alignment, resulting in pressure being placed on the surrounding nerves, leading to pain radiating from the nerve, weakness, numbness, and tingling.
- Bulging discs are different from herniated discs because they do not involve a torn annulus fibrosus, whereas herniated discs do.
- Bulging discs are often caused by age-related wear and tear, injury, or improper lifting mechanics.
- Diagnosing a bulging disc involves a physical exam, neurological and musculoskeletal exam, and confirmation is made with an X-ray, CT, and magnetic resonance imaging (MRI).
- Most bulging discs can be treated with conservative professional care, such as physical therapy and activity modification, and may require an epidural injection.
What Is a Bulging Disc?
A bulging disc occurs when a spinal disc moves outside of its normal position, irritating nerves. The spine is composed of 33 vertebral bones, each separated by soft discs of cartilage that help cushion these bones and absorb shock from movement. Each disc has a tough outer ring, called annulus fibrosus, and a soft, gel-like center, called nucleus pulposus.
As people age, the discs tend to weaken and can cause the annulus fibrosus to extend outside its normal position. When it is out of alignment, the disc can put pressure on surrounding nerves and cause symptoms like localized back or neck pain, numbness, and tingling. Some people will not have any symptoms unless a nerve is compressed.
How Does a Bulging Disc Differ from a Herniated Disc?
Many people get a bulging disc confused with another common disc disorder called a herniated disc, also known as a slipped or ruptured disc. Both conditions affect a spinal disc, but they have differences in their structures, symptoms, and causes. A bulging disc does not tear the annulus fibrosus, but it causes it to move out of alignment. In contrast, a herniated disc causes the annulus fibrosus to tear, enabling the nucleus pulposus to leak out into the spinal canal. This leakage irritates nearby nerves, resulting in sharp pain, numbness, and weakness.
Bulging vs. Herniated Disc Comparison Table
Disc Disorder | Bulging Disc | Herniated Disc |
Description | Annulus fibrosus is not torn, but moves out of alignment and can press on surrounding nerves | Annulus fibrosus is torn, causing the nucleus pulposus to leak out and irritate nearby nerves |
Symptoms |
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Causes |
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Diagnosis |
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Treatments |
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Where Do Bulging Discs Most Often Occur?
A bulging disc can occur anywhere along the spine, and it can cause different symptoms depending on where it is located. The three types of bulging discs include:
- Bulging discs in the neck area (cervical bulging disc)
- Bulging discs in the lower back area (lumbar bulging disc)
- Bulging discs in the mid-back region (thoracic bulging disc)
However, the most common area where bulging discs occur is in the lower back. This is because the lumbar spine experiences constant stress from carrying the weight of the upper body. The second most common area is the cervical spine, often at C5-C6 and C6-C7 levels, because of the weight and movement of the head. Bulging discs are rare in the thoracic spine because the rib cage helps stabilize the area.
What Are the Symptoms of a Bulging Disc?
When a bulging disc occurs, many people do not know they have one because they do not experience symptoms. Symptoms are typically only noticeable once the misaligned disc starts to press on surrounding nerves. When this happens, symptoms can include:
- Localized pain in the neck or back, depending on where the affected disc is
- Radiating nerve pain (sciatica/radiculopathy)
- Numbness or tingling
- Weakness
Certain types of bulging discs may also have distinct symptoms. Lumbar bulging discs can cause worsening pain with movement, such as bending or lifting, and leg weakness, while cervical bulging discs can cause arm pain or difficulty gripping objects.
If a person is experiencing symptoms such as severe weakness, numbness, or a loss of bladder control, they should seek immediate medical attention.
What Are the Causes and Risk Factors of Bulging Discs?
Bulging discs are typically caused by three main factors, although certain risk factors can make a person more vulnerable to developing one. The three primary causes of bulging discs include:
- Age-related wear and tear: As people get older, their spinal discs gradually lose water and flexibility, weakening them and making them more likely to push outward.
- Injury or trauma: When a person experiences a sudden fall, car accident, or heavy impact, their spinal structure can get damaged and make the discs vulnerable to bulging.
- Improper lifting: If an individual lifts heavy items with their back muscles instead of their legs, high pressure is put on the spine, increasing the risk of a bulging disc.
The risk factors that can make a person more susceptible to a bulging disc include being overweight, sitting for long periods, working a physical job with heavy lifting or bending, smoking, and having a family history of disc problems. These factors do not automatically mean a person will develop a bulging disc, but they can increase their risk.
How Does CNSO Diagnose a Bulging Disc?
When a patient comes to CNSO with symptoms of a bulging disc, they will undergo a comprehensive diagnostic process to determine if a bulging disc is the cause of their symptoms. The process typically includes:
- Physical exam: The spine specialist will ask the patient about their medical history, symptoms, and any previous conditions or injuries they have had. They will also examine the spine and ask the patient to do a series of movements, such as straight leg raises, to see if they cause pain.
- Neurological exam: The spine specialist will also perform additional tests, including reflex tests, strength tests, and sensation checks, to see if nerve signals are affected.
- Imaging scans: To confirm the exact location of a bulging disc, imaging scans are used. The gold standard is a magnetic resonance imaging (MRI) scan, which allows for visualization of soft tissues. An electromyogram (EMG) may also be used to assess nerve damage.
Using the information gathered from the diagnostic process, a diagnosis of a bulging disc can be confirmed or ruled out.
What Are the Treatment Options for a Bulging Disc?
If a bulging disc is confirmed to be the cause of the patient’s symptoms, the multidisciplinary team at CNSO will develop a targeted treatment plan. The team consists of board-certified neurosurgeons, orthopedic spine surgeons, interventional pain management physicians, physiatrists, rehabilitation specialists, and certified physical therapists who collaborate to provide customized and compassionate care. Most bulging discs can be treated with conservative treatment methods, such as:
At-Home Care
At-home care is often a sufficient starting point for treating bulging discs. It typically includes:
- Activity modification: The patient should alter their daily activities, such as heavy lifting or twisting, to limit stress on the back. However, it is important to limit bed rest because it can cause the muscles to weaken and joints to stiffen.
- Over-the-counter medications: The patient can take over-the-counter (OTC) medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) to manage pain and inflammation.
Many people with bulging discs can recover fully with conservative, at-home care.
Physical Therapy
Physical therapy is also often used in bulging disc treatment. It involves targeted therapeutic exercises that help to strengthen the core, reduce pain, and improve mobility. The therapy is personalized for each patient, but it may include:
- Guided stretches
- Deep core movements
- Heat and cold therapy
- Gentle massage
These techniques help to relieve pressure on the affected disc and prevent re-injury. Many patients with mild-to-moderate cases will improve within four to eight weeks of conservative care like physical therapy.
Epidural Injections
To relieve localized pain caused by a bulging disc, the spine specialist may recommend epidural steroid injections or a transforaminal injection. This involves injecting a strong anti-inflammatory medicine next to the irritated spinal nerve, using X-ray imaging to guide the specialist to the right area. These injections can be repeated if the pain or discomfort returns or is only reduced. Repeating the injection will ideally further reduce the discomfort, and pain relief will last for a longer period. No more than four injections at the same level of the spine can be done within one year. Although the injections will not heal the bulging disc, they can reduce the swelling and inflammation of both the nerve and the disc, which will result in the patient feeling more comfortable and able to participate in physical therapy.
When Does a Bulging Disc Need Surgery?
At CNSO, the team takes a conservative approach to care, trying non-surgical treatment methods before resorting to surgical ones. However, sometimes a patient with a bulging disc does not experience relief from conservative treatments. If a patient is experiencing certain factors, surgery is often recommended. They include:
- Ongoing, severe pain after six to 12 weeks of conservative care
- Progressive muscle weakness
- A medical emergency like a loss of bladder control
In these cases, a procedure called a microdiscectomy may be performed to cut away the small part of the disc pressing on the nerve. A laminectomy, foraminotomy, or fusion may be used in severe cases.
Find Expert Bulging Disc Care Near You in New Jersey and Florida
Patients dealing with bulging discs can seek high-quality treatment at Centers for Neurosurgery, Spine & Orthopedics. CNSO’s multidisciplinary team collaborates to provide comprehensive care for patients in multiple offices across New Jersey and Florida. To learn more about bulging disc treatment near you, contact CNSO today.
Frequently Asked Questions About Bulging Discs
What is a bulging disc?
A bulging disc is a type of disc disorder that occurs when a spinal disc moves outside of its normal position, often irritating surrounding nerves.
What is the difference between a bulging disc and a herniated disc?
The main difference between a bulging and herniated disc is the extent of the damage to the disc. A bulging disc does not tear the annulus fibrosus (the tough outer ring), but it causes it to move out of place. A herniated disc does tear the annulus fibrosus, allowing the nucleus pulposus (gel-like center) to leak into the spinal canal.
Can a bulging disc heal on its own?
Yes, a bulging disc can often heal on its own or with conservative treatment methods, such as physical therapy and activity modification. Over time, the bulging part of the disc loses water, dries up, and shrinks, so it no longer presses on the surrounding nerves.
How long does a bulging disc take to heal?
Most bulging discs can heal with conservative treatments in four to 12 weeks. However, the complete structural healing of the disc can take three to six months or longer.
What does a bulging disc in the back feel like?
A bulging disc in the back can feel like localized back or neck pain, tingling, numbness, stiffness, or pain that radiates from the back to the legs or arms.
Can a bulging disc cause leg pain?
Yes, a bulging disc can cause leg pain, especially a lumbar bulging disc. This is because the disc presses on a nearby nerve root that travels down the leg, causing radiating pain to the legs or buttocks.
Is a bulging disc a disability?
A bulging disc diagnosis alone is not considered a disability, but it may be deemed a disability if it causes severe, chronic symptoms, such as nerve compression and muscle weakness, that prevent the individual from working for at least a year.
What is the best sleeping position for a bulging disc?
The best sleeping positions for a bulging disc are lying on the back with a pillow under the knees or sleeping on the side with a pillow between the knees. These positions help keep the spine aligned and relieve pressure on the bulging disc.
When does a bulging disc need surgery?
Most patients with bulging discs do not require surgery, but surgery may be considered when the patient has severe pain after six to 12 weeks of conservative care, progressive muscle weakness, or a medical emergency like a loss of bladder control.
What exercises help a bulging disc?
Exercises that can help a bulging disc include core exercises like bridges and bird-dogs and mobility exercises like cobra stretches and cat-cow stretches.
A bulging disc is not easily detectable nor noticeable until it compresses onto a nerve or vertebrae, inflicting pain and inflammation.
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