THE TWO KEY PARTS OF THE SPINAL DISC EXPLAINED

Because they share many symptoms and even sound similar in their most basic descriptions, one could easily mistake a bulging disc for a herniated disc. The distinction between the two is located in the relationship between the two parts of the disc, and how their relationship changes when a disc goes from bulging (non-protruded) to herniated (protruded).

Spinal discs resemble the wheels of a car. They rest between each of the vertebrae in the human spine to provide cushioning for the spinal column’s composite parts, and to allow for greater flexibility of movement. As humans age, and subject their bodies to wear and tear, these discs naturally degenerate. In some cases, this natural degeneration can result in spinal diseases, such as degenerative spine disease, an affliction particularly pronounced in elderly patients.

The round spinal disc consists of two parts: the nucleus pulposus (inner part of the disc) and the annulus fibrosus (outer ring of the disc). The gelatinous nucleus pulpous, consisting primarily of water but also collagen and proteins called proteoglycans (which are commonly found in connective tissues), serves the shock absorption function of the spinal disc.

To extend the car wheel analogy, the nucleus pulposus is the “air” that fills the disc and allows it to insulate the vertebrae from each other. The annulus fibrosus is the firmer, cartilaginous outer ring that encases the nucleus pulposus.

When a disc herniates, part of the nucleus pulposus breaks through the cartilage of the annulus fibrosus. This protrusion may not cause immediate pain, and symptoms may not present for some time afterward. But quite often, the herniation of the nucleus pulposus puts pressure on the sensitive nerves that run along the spine, which can cause a range of symptoms including pain, numbness, tingling, and other nerve-related presentations.

On the other hand, a bulging disc does not involve a full breaching of the annulus fibrosus by the nucleus pulposus. Nevertheless, it still can cause the disc to press against nerve fibers in the spinal column which can result in pain.

Part of the nucleus pulposus will start to press against an increasingly worn-down annulus fibrosus – in other words, the outer layer starts to wear down, and as it does the inner “core” of the disc will cause the disc to stick out from its normal resting place.

SYMPTOMS OF A BULGING DISC

The symptoms of a bulging disc will vary depending on how much pressure the disc places upon the surrounding nerves. These symptoms look similar to those experienced by herniated disc patients. They include, but are not limited to:

• Back pain at the site of disc bulge

• Spinal pain

• Leg weakness and numbness

• Sciatica

• Limited back and leg mobility

• Reduced back flexibility/coordination

• If left untreated, reduced nerve sensitivity

As with any spine condition, early detection is paramount in preventing a bulging disc from causing any further complications, including a herniated disc.

WHAT CAUSES A BULGING DISC?

Unfortunately, as is the case with other spinal conditions, bulging discs typically come about due to the unavoidable process of aging. The spine does tremendous work in supporting human upright posture, and over time the jelly-like interior of the spinal discs lose their original shock absorption capacities, and the annulus fibrosus will begin to thin.

Athletes, manual laborers, and other individuals who subject their spines to additional stresses beyond normal daily movement are at a higher risk of facing disc-related conditions such as bulging discs. But anyone can face disc issues as they age, simply as a result of going about their regular lives.

Other potential causes of bulging discs include a family history of spinal conditions and trauma resulting from spinal injury.

In certain cases, a patient’s weight may be a contributing factor to spinal degeneration; though there is no one single healthy body type or size, depending on a patient’s specific spinal features, certain weight marks could cause strain on the spine. Smoking has also been shown to contribute to spinal disc degeneration.

WHEN SHOULD I BE WORRIED ABOUT A BULGING DISC?

Most bulging discs cause no symptoms, require no treatment and should be no cause for worry. Many times they will heal on their own.

However, if the disc puts pressure on your spinal cord or the nerves that surround your spine, it can cause pain, numbness, or weakness in your extremities. Daily, longterm back pain is not normal. If you experience any of these symptoms over the course of several weeks, it's important to see a doctor so they can diagnose the problem and recommend treatment options.

HOW DO YOU TREAT A BULGING DISC?

Even if you start to feel some of the symptoms associated with bulging discs, there’s no need to panic. There are a range of non-surgical and surgical options alike for treating this malady. Often, more serious interventions like surgery may not even be necessary.

In the short-term, you can always do what is universally advised to alleviate spinal pain: exercise regularly and do stretches to ensure maximum flexibility of the muscles that support the spine. Along with maintaining good posture while sitting and standing, these basic moves can help improve a disc problem in its early stages.

If a bulging disc is causing a patient only minor or infrequent symptoms, a spine doctor will likely recommend non-surgical options, which include anti-inflammatory medications, physical therapy, applying heat to the affected area, and cortisone injections. These basic treatments alone can, over time, be enough to relieve the pains caused by bulging discs.

Should the bulging progress into more severe symptoms, a spinal specialist may seek out surgical intervention. Thanks to advances in surgical technology, however, surgeons are able to perform minimally invasive spine surgery (MISS), an approach to operating on patients that utilizes minimal incisions (and smaller-sized incisions) that rely on as little interference as possible with the spinal column. This approach lowers the risk during the procedure for the patient, and sets them up with a lower time to recovery post-operation.

Surgery may become necessary for some afflicted by bulging discs – particularly if those discs are near herniation – but it is far from the first thing that should cross your mind if you are concerned that you may be dealing with disc problems. You could be walking around for quite some time with a bulging disc without even realizing it. The best treatment for counteracting the effects of this disc problem is early detection and diligent consultation with your spinal specialist.