Bulging Disc Signs and Treatment Options

You can think of intervertebral discs as soft cushions that separate the vertebrae of the spine. When a disc’s jelly-like center protrudes out of its normal position between the vertebra, doctors refer to it as a bulging disc.

Read on to learn more about bulging discs, including signs and symptoms, causes, prevention measures and treatment.

What Is a Bulging Disc?

A bulging disc is a medical condition that occurs when the inner portion of an intervertebral disc slips out of place through a hole in the disc’s outer layer. Bulging discs, also called ruptured or protruding discs, become more common as the body ages.

The spine consists of 24 interlocking bones with spongy spinal discs nestled between them. Intervertebral discs serve four functions. They:

Keep the spine stable.
Allow for movement between the vertebrae.
Prevent bones from grinding against each other.
Absorb shock to prevent injury during movement.

Each disc has a thick outer membrane — the annulus fibrosis, which is made up of many fibrous layers — and a gelatinous inner membrane — the nucleus pulposus, which is made up of water and collagen. The outer layer can break down over time, while the inner layer can become tough and rigid as the body ages. The amount of gel inside the disc can also dwindle with age, making it easier for the spinal bones to compress it and push it out.

The disc can protrude all the way around its circumference evenly, like a hamburger patty that’s too big for its bun. While a bulging disc won’t always affect the entire circumference of the disc, a quarter to a half of it is usually involved.

When the disc bulges, it can make contact with a nerve and cause discomfort. Although symptoms progress slowly, the bulging portion of the disc can also compress the spinal cord and nearby nerves, causing pain and mobility problems. Treatment options for bulging discs can be short- or long-term and aim to relieve pressure on the spinal cord.

Bulging Disc vs. Herniated Disc: What’s the Difference?

While many people use the terms interchangeably, herniated and bulging discs differ. Unlike a bulging disc, which projects outward while the annulus remains intact, a herniated disc — also called a slipped disc — happens when a tear in a disc’s tough outer layer allows the soft center to bulge through.

A bulging disc can become a herniated disc as it progresses through four stages:

Degeneration: The annulus begins to break down and weaken. This stage is typically painless.
Prolapse: The disc begins to bulge, but the annulus is still intact. This stage can be painless unless the bulge presses on a nerve root.
Extrusion: Some of the disc’s nucleus slips out through a small tear in the annulus. At this point, the disc is no longer bulging but herniated.
Sequestration: The protruding jelly completely detaches from the disc and spills out. This stage — when the disc moves from herniated to ruptured — often comes with severe pain from irritation and inflammation.

While herniated discs can occur anywhere along the spine, they’re most common in the lower back, within the lumbar region.

Herniated discs are more severe than bulging discs. Since herniated discs typically protrude further and have a better chance of aggravating spinal nerves, they’re more likely to cause pain than bulging discs. With limited space in the spinal canal, a herniated disc can easily compress a nerve or cause nerve root inflammation.

What Causes Bulging Discs?

Several things can cause bulging discs, including:

Trauma from a car accident: The impact of a car wreck can force the vertebrae out of alignment, leaving spinal discs vulnerable to injury.
Age-related weakness: As the body ages, the spinal discs become less pliable and more prone to damage from even slight twists or strains.
Poor posture and body mechanics: Habitual slouching and careless movements put undue pressure on the spinal discs.
Torsion from repeated twisting and bending: Repetitive twisting can wrench the spinal column beyond its normal range of motion.
Prolonged periods of standing or sitting: Over time, the stress from remaining in one position for too long can weaken the walls of spinal discs.
Injury from a fall: similar to a car accident, the sheer force of landing from a fall can jar the spinal column.
Frequent forceful movements in certain sports: Any sport that involves bending, twisting or heavy contact — like football, gymnastics and golf — puts players at risk of a bulging disc.
Improper lifting techniques: Using your back instead of your legs to lift heavy objects places undue force on the spinal discs.
Weakness of the abdominal muscles: Weak core muscles cannot properly stabilize and support the body, leaving the spine to pick up the slack.
Weakness of the leg muscles: Weakness in the legs means that other parts of the body, like the spine, have to work harder during physical activity, making them more susceptible to strain.

In addition to these external causes, genetics can also increase the risk of injury. Some people are genetically inclined to have thinner, weaker fibers and cartilage that make up the spinal disc.

Signs and Symptoms of Bulging Discs

If your bulging disc is not yet severe, you might not have any symptoms. However, it will likely cause a range of symptoms as it progresses and presses on nearby nerves, especially if it begins to herniate. Many of these symptoms will depend on the location and severity of the bulged disc.

Symptoms of a Bulging Disc in the Cervical Spine

The cervical spine consists of the seven bones in your neck. A bulging disc in the neck can cause tingling, numbness or sharp pain in your neck, shoulders, arms, hands or fingers. These symptoms can affect one or both sides of your body.

Symptoms of a Bulging Disc in the Lumbar Spine

The lumbar spine consists of the five bones in your lower back. A bulging disc in the lumbar region will usually press on your spinal nerves, causing mild to severe pain, tingling, muscle spasms, numbness or weakness in the buttocks, thighs, calves, feet or toes. These feelings can occur on one or both sides of your body.

The sciatic nerve travels from your lower back through your hips and down each leg. A bulging disc compressing this nerve can cause sciatica, where pain or numbness travels down the affected leg. The pain can range from a mild ache to a sharp, burning throb.

How to Prevent Bulging Discs

While bulging discs aren’t always preventable, you can help lower your risk with the following tips:

Maintain good posture: Practicing good posture when you sit, stand, walk and even sleep helps distribute your body weight evenly over your muscles and bones instead of straining your back.
Take the proper approach to heavy lifting: Whether you lift heavy weights at the gym, on the job or around the house, using correct lifting techniques can save your back from injury. When picking something up from the ground, lower yourself by bending at the knees, then engage your leg muscles and core as you lift, keeping your back relaxed.
Stick to an exercise routine: Regular exercise helps build the muscles that support your spine. If you don’t already have a fitness routine, start by going for a light walk each day. For a more intense workout, incorporate weight-bearing exercises that strengthen your core, back and leg muscles to help keep your back in shape.
Stretch it out: If you find yourself sitting for long periods, take a few quick breaks to move around and stretch.
Quit smoking: You probably already know that smoking damages your health in many ways, and your back is no exception. The nicotine and carbon monoxide in cigarettes can speed up disc degeneration, increasing your chance of a bulged disc.
Get some rest: A solid eight hours of sleep gives our bodies time to repair and recover from the stresses of the day.
Eat anti-inflammatory foods: Inflammation can weaken our muscles and bones, making bulging discs more likely to occur. We can fight inflammation by cutting sugar, trans-fats and refined carbs from our diet and eating more anti-inflammatory foods like fruit, nuts, vegetables and fish.

Treatment for Bulging Discs

Treatment for bulging discs can vary based on the severity of your condition. Your doctor may prescribe medications and therapy or even suggest surgery.

Medications

The medication your doctor prescribes will depend on your symptoms and medical history:

Over-the-counter pain relievers: If you have mild to moderate pain, your doctor may advise you to take nonprescription pain medication, such as ibuprofen, acetaminophen or naproxen.
Neuropathic drugs: Your doctor may prescribe gabapentin, venlafaxine, duloxetine or pregabalin to suppress nerve activity, effectively relieving pain from nerve compression.
Muscle relaxers: Your doctor may prescribe muscle relaxers if you experience muscle spasms due to a bulging disc.
Opioids: If other measures don’t relieve your pain, your doctor may consider short-term use of opioids.
Steroid injections: If oral medications don’t work for you, your doctor may suggest a corticosteroid. You receive this medication via injection into the tissue surrounding the spinal nerves, decreasing pain and inflammation.

Therapy

Your doctor may suggest physical therapy as part of your treatment. A physical therapist can work with you to address things like posture, joint mobility, strength, flexibility and core stability. These measures can benefit your overall health in addition to helping prevent bulging discs in the future.

Surgery

Surgery is rarely necessary to treat bulging discs. However, your doctor may suggest surgery if conservative care measures do not bring you relief, especially if you have the following:

Persistent pain
Numbness or weakness
Trouble standing or walking
Decreased control over your bladder or bowels

While surgeons typically only remove the protruding portion of the disc, they may need to remove the entire disc in rare cases. The surgeon will then either use a bone graft to fuse the vertebrae or insert an artificial disc in its place.

How to Treat Bulging Disc Pain at Home

How do you relieve bulging disc pain at home? The following measures can help ease mild to moderate pain from a bulging disc. Try these techniques alongside the treatments your doctor prescribes.

Hot and Cold Therapy

Cold therapy reduces inflammation, while heat relaxes your muscles. You can use one or both of these techniques to help relieve back pain.

When the pain starts, apply an ice pack to the area as often as every two hours for 15-20 minutes for a couple of days. After you’ve thoroughly iced the area, follow the same schedule with a heating pad or patch.

Gentle Movement

You may be inclined to get plenty of rest when dealing with a painful bulging disc, but too much inactivity can lead to stiffness, weak muscles and even more discomfort. Instead, try to get up, walk around and stretch every hour to keep your body active.

It’s important not to overdo it, though. Keep walks to 30 minutes or less and refrain from lifting and bending over. Pushing yourself too hard will intensify the pain and prolong your recovery time.

Pressure-Relieving Sleep Positions

Back pain can worsen during the night, making for an unpleasant morning. You can try a couple of positions that may ease the pressure on your spine and keep those painful mornings at bay.

On your back, position a pillow below your knees to release tension in your lower back.
When lying on your side, place a pillow between your knees to balance your hips and align your spine.

The best pillow placement and sleeping position for you will depend on the location of your bulging disc. Try out a few different positions and pillow placements to find what works for you.

Get Treatment for Back Pain at the Spine Institute of North America

At the Spine Institute of North America, we offer many different treatment options to treat a variety of spinal concerns. Our team of experienced, caring, board-certified spine specialists strives to identify the cause of your pain and help relieve it so you can get back to your life.

We understand how limiting back pain can be, so we specialize in minimally invasive procedures with short recovery times and long-lasting results. If you’re ready to take charge of your back pain, schedule an appointment with us today. Together we will discuss your concerns and your options for treatment.

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Bulging Disc Signs and Treatment Options