What Is Bulging Disc Syndrome?
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The intervertebral discs in the spine provide support, absorb shock, and help to maintain the proper shape and structure of the back. Even though the outer layer of the intervertebral disc is tough, it may wear down or break. When this happens, the inner layer pushes outwards and can protrude into the space between the vertebrae. The result of this process is known as a bulging disc.
Bulging disc syndrome is quite common and often patients have no symptoms. However, if the inner layer protrudes close enough to a spinal nerve, a patient may report discomfort and may have debilitating symptoms. Because the bulging disc is constantly pressing against the nerve or is at least in close proximity to the nerve, patients also often experience constant pain. Most bulging discs occur in the lumbar (low back) or cervical (neck) region. Pain is often felt in these areas but may radiate into other areas of the body, including the arms and legs.
Causes Of Bulging Disc Syndrome
Oftentimes, bulging discs occur for no reason. However, they are commonly associated with increasing age and wear and tear over time. Additionally, bulging discs can occur because of improper bending and repeated poor body positioning (poor posture while sitting or standing). Normal spinal movements place relatively low pressure on the spine, whereas stressful movements (such as heaving lifting) can increase pressure on the various regions throughout the spine. This pressure can cause tearing of the outer layer of the intervertebral disc. The inner layer of the disc then bulges out towards the intervertebral space where it may compress or irritate a spinal nerve, resulting in pain. The pain can be caused by the disc’s location in relation to the nerve or by the molecules that are released by the inner layer as it bulges outward.
Intervertebral discs in the neck or lower back are most at risk for disc bulging. When discs bulge in the neck, chronic pain may occur in the neck, head, or face. Additionally, chronic pain may also be felt in the shoulders, arms, or fingers. When discs bulge in the low back, chronic pain may occur in the lower back, pelvis, or buttocks. Additionally, chronic pain may also be felt in the legs, feet, or toes. Numbness and tingling may also occur when a bulging disc is present. Bulging disc syndrome is diagnosed by physical exam as well as by special imaging, such as magnetic resonance imaging (MRI) or disc fluoroscopy (discography).
Treatment For Bulging Disc Syndrome
Various treatments exist for bulging disc syndrome. A common and effective treatment is an epidural injection, which involves injecting an anesthetic into the space where the affected nerve is located. The injection also includes a steroid that helps to reduce the inflammation that can be caused by the bulging disc. While epidural injections are relatively conservative, the use of steroids can impair the immune system and may also lead to weight gain and diabetes in some individuals.
If there is no relief from an epidural injection, more specific treatment methods may be offered. One option is disc denervation, which involves reducing pain signals by disrupting the affected nerve. The area surrounding the disc will be numbed with medication and then a probe is inserted into the area of the nerve. This probe delivers radiofrequency waves that help to reduce the signals from the nerve, thereby decreasing the sensation of pain.
A discectomy, also known as percutaneous disc decompression, is another surgical option that may be offered that targets the disc. This surgery involves removing the damaged and protruding disc tissue.
The Styker Dekompressor® is a tool that is used to perform this procedure. It is inserted via the skin to remove the damaged and protruding disc material without damaging the nerves. This procedure has been shown to significantly reduce pain for up to two years post-operatively. The main risks that are associated with this procedure include bleeding, infection, and nerve damage. Because this procedure involves the use of anesthetic, there are also side effects that can be caused by the anesthetic, which include chest pain, nausea, and nerve damage.
ConclusionWhen the outer layer of an intervertebral disc breaks down, the inner layer may protrude outward resulting in bulging disc syndrome. This can cause chronic pain if the protruding disc is in close proximity to a spinal nerve. Most commonly, discs in the low back and neck region are affected resulting in chronic low back or neck pain that can also radiate to the extremities.
There are various treatment options for bulging disc syndrome that range from relatively conservative measures to more invasive procedures. The invasive procedures that are available carry more risk but they also provide more effective pain relief and are longer lasting. Speaking to your doctor will help to determine the best treatment option for your condition.
- 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.
- Maus T. Imaging the back pain patient. Physical medicine and rehabilitation clinics of North America. 2010;21(4):725-766.
- 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.
- Buy X, Gangi A. Percutaneous treatment of intervertebral disc herniation. Seminars in interventional radiology. 2010;27(2):148-159.
- Birnbaum K. Percutaneous cervical disc decompression. Surgical and radiologic anatomy : SRA. 2009;31(5):379-387.
- 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.
- 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.
- 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.