What Is Bulging Disc Syndrome?

Bulging disc syndrome explained by San Antonio, Austin, Houston, Dallas Texas top pain doctors

Bulging DiscThe spinal column is a complex structure composed of various structures including intervertebral discs and vertebrae. These intervertebral discs separate the spinal vertebrae from one another. Each intervertebral disc consists of an inner and an outer layer. The inside layer is closest to the spinal canal, houses the spinal cord, and is soft and spongy, while the outside layer is strong and fibrous. The discs provide support and cushioning for the spine and also help to conserve the natural curvature of the spine. Disc bulging occurs when the outside layer of the disc breaks down allowing the inner layer to protrude outward.

Many times patients will have bulging discs but will be asymptomatic. On the other hand, if the bulging disc is close to a nerve it may cause pain, which is often chronic. The spinal column is made up of four regions including the cervical, thoracic, lumbar, and sacral regions. Intervertebral discs in the neck (cervical spine) and lower back (lumbar spine) are most at risk for bulging, thereby leading to chronic neck or low back pain.

Causes Of Bulging Disc Syndrome

Some patients have bulging discs for no particular reason but most are the result of wear and tear that coincides with aging. Additionally, repeated improper body mechanics including poor posture and incorrect lifting techniques are known to cause bulging disc syndrome. Improper spinal movements place excessive stress on the spine. Tears can occur in the outside portion of the disc with repeated excessive stress. Once this occurs, the inside layer begins to protrude toward the vertebral space.

Depending on the location of the bulge, nerve irritation or compression may occur, resulting in severe pain. The pain experienced may be the result of the location of the bulge relative to the spinal nerve or by the inflammation caused by the bulge.

As previously mentioned, bulging disc syndrome typically affects discs located in the cervical or lumbar regions. When a disc bulges in the cervical spine, it may cause chronic head, neck, or face pain. Additionally, the pain may radiate into the upper extremities resulting in chronic shoulder, arm, or finger pain. When a disc bulges in the lumbar spine, it may cause chronic lower back, buttock, or pelvic pain. Radiation of pain from the low back into the lower extremities can also occur, resulting in chronic thigh, foot, or toe pain.

Physicians diagnose bulging disc syndrome by performing an assessment and by ordering imaging tests when necessary, including magnetic resonance imaging (MRI) or discography.

Treatment For Bulging Disc Syndrome

Numerous treatment options are available for bulging disc syndrome. Epidural injections are often one of the first treatments offered to patients. The injection consists of an anesthetic in combination with a steroid. The injection helps to decrease pain and inflammation in the area of the affected intervertebral disc. Epidural injections are minimally invasive; however they do carry the risk of impaired immune response, arthritis, and weight gain.

Disc denervation is a targeted therapy where pain signals are dulled by altering the affected spinal nerve. A probe is placed near the affected nerve via the skin. The probe then sends radiofrequency waves to decrease the signaling from the affected nerve thereby decreasing pain.

Another targeted therapy option is a discectomy, which is a surgical procedure that removes the deteriorated and bulging disc material without injuring the nerve. The Styker Dekompressor® is an example of an instrument that can be utilized to perform a discectomy. It is put through the skin to take out the damaged disc tissue without injuring the affected nerve. There is evidence that suggests that pain relief after this procedure can last for a period of approximately two years. This procedure carries risks, including nerve damage, bleeding, infection, chest pain, and nausea.

Conclusion

Bulging disc syndrome is quite common and can result in chronic and sometimes unrelenting pain. It occurs because the outside layer of the intervertebral disc deteriorates, allowing the inside layer to protrude outward. Bulging discs tend to occur in either the lumbar or cervical regions. Bulging discs in the cervical spine may result in neck, head, face, shoulder, arm, or finger pain. If the bulge is located in the lumbar spine, pain may be felt in the lower back, buttocks, pelvis, thighs, feet, or toes.

Bulging disc syndrome can be treated with a number of therapies. Epidural injections, disc denervation, and discectomy are options to consider for bulging disc syndrome. Discussing all treatment options with your doctor will help to determine the best option for your bulging disc syndrome.

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References

  1. Igarashi T, Kikuchi S, Shubayev V, Myers RR. 2000 Volvo Award winner in basic science studies: Exogenous tumor necrosis factor-alpha mimics nucleus pulposus-induced neuropathology. Molecular, histologic, and behavioral comparisons in rats. 2000;25(23):2975-2980.
  2. Maus T. Imaging the back pain patient. Physical medicine and rehabilitation clinics of North America. 2010;21(4):725-766.
  3. Pinto RZ, Maher CG, Ferreira ML, et al. Epidural corticosteroid injections in the management of sciatica: a systematic review and meta-analysis. Annals of internal medicine. 2012;157(12):865-877.
  4. Buy X, Gangi A. Percutaneous treatment of intervertebral disc herniation. Seminars in interventional radiology. 2010;27(2):148-159.
  5. Birnbaum K. Percutaneous cervical disc decompression. Surgical and radiologic anatomy : SRA. 2009;31(5):379-387.
  6. Singh V, Benyamin RM, Datta S, Falco FJ, Helm S, 2nd, Manchikanti L. Systematic review of percutaneous lumbar mechanical disc decompression utilizing Dekompressor. Pain physician. 2009;12(3):589-599.
  7. Manchikanti L, Singh V, Falco FJ, et al. An updated review of automated percutaneous mechanical lumbar discectomy for the contained herniated lumbar disc. Pain physician. 2013;16(2 Suppl):Se151-184.
  8. Manchikanti L, Singh V, Calodney AK, et al. Percutaneous lumbar mechanical disc decompression utilizing Dekompressor(R): an update of current evidence. Pain physician. 2013;16(2 Suppl):Se1-24.