One of the most common expressions that we hear from our patients is that they are having back pain because of a bulging disc. This is one of the most common pathologies to show up on imaging with an MRI. While it is true that you might have a bulging disc, it is not always the cause of your symptoms. Here’s some information about bulging discs, more commonly known as disc herniations so hopefully you can have a better understanding of what these are and how they are usually not as scary as they sound.
Whenever you hear your physician tell you that you have a herniated disc, they are referencing one of the small cushions that sits in between each level of vertebra in the spine. An easy way to think of the structure of the disc is to compare it to a water balloon that has a rubber casing.
Essentially if you have a dysfunctional movement taking place anywhere in your spine it can cause a shift in the position of the disc over time. This is how your spine typically adapts to the load being placed on it with whatever activities you are doing. If enough stress is placed on the disc, the nucleus of the disc can push through the outer coating.
If this is taking place it can irritate the nerve structure near the involved level of the spine. When the nerve becomes irritated you can have numbness, burning, weakness, or shooting pain into the arm or leg. However, we don’t frequently see a pattern of symptoms that indicate a true disc dysfunction and symptoms. Most of the time there are several different factors involved with what you may be feeling so the bulging disc is just one small part of the issue.
As I just mentioned it is pretty rare to actually have symptoms strictly because of the disc dysfunction. The most important thing that needs to happen is to identify which movements are causing the symptoms you may be experiencing. One of the best ways to do this would be to do a quick 15 minute screen. Then based on different patterns that we see; we can tell you if you are experiencing a significant nerve dysfunction due to a disc bulge and what we should do to address it. It is rare for the disc bulge to be the main issue but, if it is we will quickly identify if conservative treatment will be the most effective option for you at this time.
One of the most common concerns that we hear in the clinic is that patients believe that they need surgery for their symptoms. The MAJORITY of the time we can get a positive response in your symptoms with conservative treatment. This means that most of the time we can avoid surgery entirely! We can also identify if there are other structures influencing what you may be feeling such as the joint or muscle tissue around the area.
Here are some symptoms that you may experience if a nerve is being impacted by either a disc or joint dysfunction in the spine:
Arm or leg pain: Depending on which segment of the spine is affected
Weakness: Because of the potential nerve irritation, certain muscle groups may be inhibited.
Burning, numbness, or tingling in the extremities: These are all classic signs and symptoms consistent with nerve irritation and pain.
Something else we get asked frequently is if the actual disc herniation will go away. There have been studies that show that it CAN change over time with the right treatment progression. As I mentioned earlier a significant amount of the disc composition is water, so it is very adept to changing with movement. We typically like to see significant changes in patient symptoms relatively quickly with what we do. Again, usually these are asymptomatic, so the priority is to address the muscle imbalance and movement impairments to relieve stress on the spine. The emphasis isn’t necessarily on changing the position of the disc as it may just be an adaptation to the activities you perform in your daily life.
If you happen to be going to a visit to your doctor for back pain, here are a couple of things to know. It is extremely common to see disc herniations, disc bulges, or prolapsed discs on MRI results. Sometimes it is scary to hear the results without knowing what it truly is. You may get told you have something called “degenerative disc disease.” As concerning as this may sound it is actually a normal process that our disc tissue goes through over time. If you are not experiencing any “red flags” then there is a good chance your symptoms can be resolved with the appropriate treatment interventions.
If you do happen to get these results, there is a good chance that it can be relieved with conservative treatment that we do here at Curnyn Physical Therapy. If the symptoms are relatively recent, we like to see a quick turnaround for most of our patients and their back or neck pain.
Here are a couple of symptoms that may indicate you do need to seek medical attention immediately (red flags):
- Bowel or bladder changes
- Sensation loss in the inner thighs or groin area
If you happen to be experiencing these symptoms it may indicate a severe compression of the nerve by either the joint or disc tissue at a specific level of your spine.
On our Facebook page we have a video discussing a couple of straight forward exercises you can do to address nerve irritation due to a disc herniation. We will also have an in-depth video discussing what we can do for you and what to look out for. Thanks for reading and please let us know if there is anything, we can do for you. If you happen to be suffering from back or neck pain, please give us a call at (817) 923-9000 and we will get you set up with a FREE 15 minute screen to see if PT is the right choice for you. You would be surprised how often it is!