Disc Bulge or Slipped Disc
A disc bulge or slipped disc is a condition in which part or all of the soft, gelatinous central portion of an intervertebral disc (the nucleus pulposus) is forced through a weakened part of its retaining ring, resulting in back pain and possibly nerve root irritation. The medical term for this is disc herniation.
Usually the disc bulge takes place in your lower back or lumbar area of your spine, between the base of your ribs and your hips, they are also more common in people in their 30s and 40s.
Research shows Lumbar disc bulges occur 15 times more often than cervical (neck) disc bulges, and it is one of the most common causes of lower back and leg pain.
Often nerve roots (the large nerves branching out from the spinal cord) will become compressed resulting in symptoms such as pain, pins and needles or loss of sensation in the legs or arms.
Symptoms of a lumbar Disc Bulge
The most common symptom of a disc bulge is sciatica, this is a sharp, “shooting” pain extending from your buttocks down the back of one of your legs. Sciatica is caused by pressure on a spinal nerve, often due to a bulged disc. Other symptoms which may be related to sciatica include:
- Severe low back pain, often to one side
- Pain radiating to the buttocks, legs and feet
- Weakness in one leg
- Pins and needles or numbness in a part of one leg
- Loss of bladder or bowel control (If you also have weakness in both legs, you could have a serious problem. Seek medical attention immediately.)
- A burning pain centred on one side of the back
Symptoms of Bulging Cervical Disc:
• Neck pain, especially in the back and sides
• Deep or burning pain near or over the Shoulder Blades on the affected side
• Pain radiating to the shoulder, upper arm, forearm and occasionally the hand, fingers or chest
• Pain made worse with coughing, straining or laughing
• Increased pain when turning your head to the side or bending it forward
• Spasm of the neck muscles
• Pins and needles or loss of sensation in the face, head or arm
• Weakness in arm
What Causes a Bulging Disc?
There are three (3) main causes of a bulging disc, slipped disc, disc herniation or disc rupture:
1. Accumulated Microtrauma
Repeated microtrauma over an extended period can lead to disc injury. Poor posture, bad lifting habits or constant repetitive movements all lead to overstretching and weakness of the posterior fibrocartilage (or annulus) of your spinal discs. Over time, this leads to poor disc integrity and displacement of the disc nucleus fluid posteriorly. This places your spinal joints and nerves under pain-causing pressure.
2. Sudden Unexpected Load
In traumatic situations, like a car accident or lifting a heavy object incorrectly, a sudden unexpected load can occur to the intervertebral discs in your spin or neck.
This unexpected load can result in tearing of the annulus fibres and hence a disc bulge. When lifting you should always use the correct lifting techniques. If you use poor lifting techniques, such as bending forward and pulling with your back, you may cause a sudden and unexpected loading of the disc.
3. Genetic Factors
As with most other medical conditions, spinal disc injury can have a genetic predisposition.
It is suggested the most susceptible people are those who are known to have a lesser density of and increased elastin component of the fibrocartiliginous fibres. These fibres make up the annulus of the intervertebral disc.
It is important to remember genetic factors are a very minor contributing factor in disc injuries. Disc injuries can almost never be put down to just ‘genetic factors’.
How do you diagnose a Disc Bulge or Slipped Disc
The Ashgrove Spinal Centre’s chiropractor, Dr Bailey, will suspect a spinal disc injury based on the history of your injury and your symptom behaviour. He will perform clinical tests to confirm a spinal disc injury and detect if you have any signs of nerve compression. The most accurate diagnostic tests, to confirm the extent of your spinal disc injury, are MRI scans.
X-rays and CT scans do not show acute disc bulging. However, X-rays of your spine are important to have taken as they will give Dr Bailey a lot of information about your overall spinal health and alignment. X-rays can also show signs of scoliosis and chronic disc injury such as degenerative disc disease and disc narrowing.
Disc bulges can be influenced by lifestyle factors including:
• Lack of exercise
• Being overweight or obese
• Sitting for long periods
• Nature of occupation (ie: heavy physical load versus light or no physical load).
• Stress
Treatment of Disc Bulges or Slipped Discs
Once all tests have been performed and serious medical conditions are ruled out, it is important to manage your condition in a conservative way. If Dr Bailey concludes your problem would benefit from the type of specialised treatment he is trained to provide, those treatments will be discussed with you and a treatment plan will be agreed upon.
For disc bulge treatments, please see Spinal Decompression and Cox Flexion Distraction Pages.
In the first couple of weeks after your onset of an episode, our treatment plan will be focused on reducing pain and maintaining movement. Treatment options include:
- Manual therapy – as qualified health professional, Dr Bailey may use Spinal Decompression, Cox Flexion Distraction, spinal adjustments, manipulation, traction or other manual therapies to help relieve pain and correct your condition.
- Heat and cold therapy – hot and cold packs applied to the area of pain may be helpful in relieving pain temporarily.
- Relative rest – this may mean temporarily reducing activity such as sport and heavy lifting.
- Exercise – Dr Bailey can prescribe an individual exercise program for you. Exercises may include stretching, mobility and strengthening exercises targeting the muscles that stabilise and support your back.
Dr Bailey is a fully qualified and registered health professional who is highly trained to diagnose and/or treat conditions of the neuromuscular skeletal system. Dr Bailey works with many other medical professionals and will always refer to your GP or other Medical Specialist if your condition is not one that is suitable to be treated with chiropractic care or if your condition requires further evaluation and/or more testing.
The following services are relevant to this condition:
Chiropractic Spinal Decompression