What is a Bulging or Herniated Disc?

Discs in the spine, or intervertebral discs, are tough cushions located between each vertebrae which protect the spine from compressive forces and allows the spine to be flexible.  You can think of them as water balloons made of a tough rubber. 

A disc bulge is an over stretching of a disc over time from long term compression, similar to a hamburger patty outgrowing the bun when you squish a hamburger.  As the disc bulges out beyond the rim of the vertebrae, the nerves inside the disc also get stretched, causing discogenic pain. 

A disc herniation (rupture) is when the disc bursts, similar to if you squeeze a water balloon too tight or hard.  Not only does herniating the disc hurt similarly to tearing a ligament, but the contents inside that rupture out are toxic to nerves, often resulting in intense nerve pain.

If the disc bulges/herniates out far enough to hit or the spinal cord or spinal nerves, nerve pain may be experienced down an arm or leg, depending on the nerve involved.  In more severe cases, such as when there is muscular weakness, extreme pain not responding to traditional treatments or loss of bladder/bowel control, surgery may be necessary.

What Causes Bulging or Herniated Discs?

Increased pressure or stress to any of the discs can leave them vulnerable to injury or overstretching.

Potential causes of Disc Bulges or Herniations include but are not limited to:

• Recent Trauma
• Previous Trauma
• Poor Posture
• Poor Sleeping Position
• Poor Lifting Mechanics
• Improper Ergonomics When Working
• Restricted/Altered Joint Motion
• Muscular Imbalance
• Muscular Weakness
• Repetitive Motion

Often, there are a combination of factors increasing pressure/stress on discs.   Our doctors work hard to determine these factors and come up with individualized treatment plans to reduce your pain as quickly as possible.  Reducing these factors also helps to decrease the risk of future flare-ups or additional problems from developing.

How are Disc Injuries Diagnosed?

At CSMC, your first visit will start with a consultation and physical exam in order to determine which tissue/structure is causing your pain, how severe the condition is, what is causing the problem, and any contributing factors that may slow down or prevent proper healing.

This involves discussing your symptoms, when they are at their worst, the impact it is having on your life and putting together a set of treatment goals you would like to accomplish (examples: picking up kids or sleeping without pain).  It is important to bring any previous medical notes or images for the doctor to review and take into consideration for your case.

Next, a physical exam will be performed, physical exams typically consist of:

• Neurological Evaluation
• Orthopedic Testing
• Postural Assessment
• Chiropractic Evaluation
• Functional Assessment
• Range of Motion Measurements
• Referral to Imaging/Advanced Diagnostic Testing (When Necessary)
• Radiographic Biomechanical Analysis (When Necessary)

These tests may aggravate your symptoms, so let your doctor know what you are feeling.

For imaging and additional testing, CSMC coordinates referrals to specialty radiologists as needed.

What Treatments are Available?

CSMC takes a customized, comprehensive approach to care for all types of back pain. Your doctor may recommend one or more of the following treatments to address your disc injuries:

• Various Chiropractic Adjustment Techniques
  • Based on Preference/Condition
• Flexion/Distraction
• Decompression Therapy
• Physiotherapy
• Ergonomic Training
• Massage Therapy
• Postural Correction
• Topical Analgesics
• Anti-Inflammatory Supplements

These therapies may be recommended individually or together to relieve your pain, decrease pressure on tissues/structures, improve your range of motion, strengthen your core, improve posture and/or stabilize your condition depending on your needs.

For more severe/complicated cases, our doctors may decide to co-manage with another specialist to get a second opinion or additional treatments, such as medications, injections or surgery (last resort).  In these cases, our doctors will communicate with all specialists involved to ensure all your doctors are on the same page, while providing therapies to help speed up your recovery process when appropriate. 

You can find the help you need at CSMC. Book your appointment today.