Bulging Disc
What is a Bulging Disc?
Before we tackle the bulge, let’s examine what an intervertebral disc actually is: An intervertebral disc is a rubbery pad that sits in-between each vertebra of your spine. These cushions, made primarily of cartilage, function as shock absorbers and flexible connectors that allow for the optimal mobility of your spine. Likened to the structure of a jelly donut, intervertebral discs are composed of a rubbery outer layer (the pastry) that is filled with a gel-like internal substance (the jelly).
When the rubbery outer layer of a disc suffers damage—whether from age or injury—the disc may swell beyond its typical boundary. Usually, this swelling occurs at a single point of exterior weakness in the outer shell of the disc. Known as a bulging disc, this phenomenon is actually a rather common occurrence. In fact, many people walk around without any knowledge of—or symptoms associated with—their bulging disc!
However, it is when this disc protrusion pushes on adjacent nerves or on the spinal cord itself that symptoms can emerge. In these situations, people can experience a wide range of symptoms—anywhere from minor aching to agonizing and debilitating pain.
Common factors that contribute to the development of a bulging disc may include:
- Aging: As a result of the natural aging process, our discs lose their moisture content and elasticity over time. Everyday activities and forces—like gravity—can compress a compromised disc and make it more vulnerable to bulging.
- Genetics: A family history of spinal issues can play a role in disc degeneration.
- Lifestyle Choices: Choices such as smoking, drinking, unhealthy eating, and associated weight gain can lead to the degradation of disc tissue.
- Chronic Strain: Repetitive lifting, bending, or twisting associated with professions such as nursing or construction can lead to increased strain on the lumbar spine and disc bulging.
- Trauma: Bulging discs can result from trauma to the spine, such as a car accident, a fall, or an exercise or sports injury.
- Posture: Continuous poor posture, such as the slouch that is often associated with craning your neck over a computer or working at a desk, can promote disc degeneration.
Concerned that a bulging disc is causing your symptoms of neck and back pain? Dr. Frazier—board certified orthopedic surgeon and surgical technology consultant—combines gentle therapies with minimally invasive surgical solutions to ensure that his patients receive the highest quality of conservative care.
What are the Symptoms of a Bulging Disc?
Although a bulging disc can go unnoticed, symptoms do occur when these discs compress a nerve root—or even—pinch the spinal cord itself (aka spinal stenosis). Symptoms of a bulging disc can vary widely and are often incredibly individualized. For some, the pain may be a dull localized ache in the neck, back, or head. For others, a debilitating pain could radiate from a point on the back and outward to one or more of their limbs. Possible signs of a bulging disc could include any of the following:
- Local Pain: Localized pain at the site of the bulging disc in the back or neck
- Radiating Pain: When the bulging disc protrudes in such a way that it clamps down on a nerve root, radiating pain can be a result. Depending upon the location of the disc, the pain can either radiate from the lower back through the legs or from the neck through the upper limbs. If the bulging disc is located in the lumbar spine, pain will most likely radiate to the hips and legs. (This is known as sciatica.) If the disc is located in the cervical spine, the pain will most likely radiate to the shoulders, arms, and head. (This is referred to as cervical radiculopathy.)
- Muscular Spasms or Weakness: With a compromised disc, the adjacent muscles can often overcompensate to stabilize the spine. This compensatory mechanism leads to muscular cramps and spasms. If a pinched nerve becomes severe enough, nerve signals to the extremities may become interrupted or intermittent. This interference makes coordinating the muscles of the limbs extremely difficult.
- Tingling or Numbness: Much like pain, tingling and numbness can be caused by the compression of nerve ends.
- Emergency Symptoms: If you are noticing weakness or paralysis in limbs, loss of bowel or bladder control, or excruciating pain, please seek immediate medical attention.
If you are experiencing any of these troubling symptoms, rest assured: Dr. Frazier has over 20 years of experience in diagnosing and treating symptoms just like these. Contact our office today and allow our team of experts to get you back on the path to relief!
What are the Treatments for a Bulging Disc?
For most who are experiencing a bulging disc, the first steps to recovery will be the least invasive treatment options available. Because many bulging discs can heal without surgical intervention, seeking professional help and knowledge regarding where to begin can be crucial to this nonsurgical healing. Strategies for aiding in the relief of a bulging disc could include: ice packs or heat application, various medications such as pain-relievers or anti-inflammatories, acupuncture, massage, physical therapy, chiropractic intervention, or lifestyle changes.
Although these methods are often successful in treating a bulging disc, a few individuals will require some form of surgery to alleviate their pain and promote healing. For those individuals who do require surgical treatment, our Harvard-trained, board certified surgeon, Dr. Frazier, may recommend one of the following minimally invasive techniques:
- Endoscopic Foraminotomy: A minimally invasive procedure in which the surgeon will access your spine through a small 1 to 3-inch incision in the back or neck. This procedure also allows the surgeon to bypass any muscle, resulting in shorter recovery times and less pain. The surgeon will remove part of the foramina (vertebral passageways for nerves), widening it so that pressure can be taken off the nerves that are causing your pain.
- Endoscopic Discectomy: Much like the Endoscopic Foraminotomy, the Endoscopic Discectomy is a minimally invasive procedure that utilizes a small incision and has little to no disruption of muscle. The primary difference is that a discectomy involves the removal of the disc tissue that is causing nerve compression.
- Artificial Disc Replacement: An artificial disc replacement is an outpatient procedure that optimizes bulging disc relief while minimizing postoperative recovery times. During an artificial disc replacement, your surgeon removes a degenerated or bulging disc and replaces the intervertebral disc with a flexible, prosthetic model that mimics the function of the original.
As a master of minimally invasive spine surgery, Dr. Frazier has performed hundreds of consultations and procedures in his 20 years of practice. Whether surgery is something that you need to relieve your back pain, or alternative therapies may be your route, Dr. Frazier will be an ally in finding the appropriate procedure and therapies that work for you.
Meet Dr. Daveed Frazier
Dr. Frazier is a Harvard-trained, board certified orthopedic spine surgeon. He’s held an academic appointment at Columbia University College of Physicians and Surgeons and New York’s SUNY Downstate. Dr. Frazier is also a respected lecturer, accomplished researcher, published author on spine disorders and treatment, and a consultant for several international spine companies.
After completing his undergraduate education at Brown University, Dr. Frazier attended Harvard Medical School, where he graduated cum laude. He completed a Harvard internship based at the New England Deaconess Hospital in Boston, MA, followed by a Harvard combined residency before becoming chief resident at Massachusetts General Hospital.