By Dr. Adam J. Friedman – Coconut Creek, Florida – Because back pain affects at least 40 percent of people over the age of 40, it’s common for patients to come to me with a variety of back pain-related issues. Disc issues fall into three common conditions – disc bulges, disc herniation, and disc degeneration. Let’s discuss what exactly is meant by the diagnosis of a “bulging disc”.
I explain to my patients that the spinal column is made up of stacked vertebral bones. Between the discs in our back there is soft cartilage which cushions them as we flex and move. Each disc has an outside skin of a tough outer layer that precisely fits each disc. As we age, discs may lose their shape to fit precisely into the area where the vertebrae is cushioned. They may begin to protrude beyond their proper position. These protruding discs are what we refer to as “bulging discs.”
Bulging discs can occur anywhere along the spine from the neck to the lower back. Many people do not experience pain from a bulging disc. For some, a bulging disc is frequently painless, but for others, under stress, and sometimes because of one simple movement such as a sneeze or even a hearty laugh, a bulging disc can impact the nerves in your back and become extremely uncomfortable. Pain from a bulging disc can be difficult to identify because patients do not always experience this pain at the source. A bulging disc in the neck can cause a headache, as well as numbness or a pins-and-needles feeling in the face, neck, shoulders, arms and even hands. Should the bulging disc be located in your lower back, the very same symptoms can exist in either one or both legs.
Because it involves neither drugs nor injections, chiropractic care is a preferred treatment method for many patients with bulging discs. I work with my patients to verify their diagnosis through a review of their medical history, an on-site spinal assessment and other tests that involve nerve function, reflexes and muscle tone. Just to be on the safe side – and to be sure all bases are covered – I may refer a patient out for X-rays or even an MRI, if I believe it is warranted.
It’s important for patients to remember that as a chiropractor, I look at the entire spine, not just the area that you are telling me is painful. Pain travels within the body. Along with office treatments, I provide my patients with self-care options, at-home exercises and nutritional suggestions that will enable them to live pain-free. By getting to the root of your problem and treating the entire spine, I can relieve their pain, which enables their spine to heal and give them more mobility and flexibility. I believe that chiropractic care is also attractive to many patients because it is “holistic” in nature – I look at many things that can affect your back, including, but definitely not limited to, suggestions for stress relief, nutrition and other lifestyle choices that may be negative contributors.
Sometimes, patients think a bulging disc is the same as a herniated disc, but that is incorrect. A herniated disk is when the outer layer has a crack, known as an annulus. In a herniated disc, a small part of the disc is affected, allowing the soft nucleus to protrude. In a bulging disc, there is no crack. The disc bulges out of place but does not crack. Unfortunately, a bulging disc can affect more areas than a herniated disc.
Once it is determined that you have a bulging disc, there are a variety of treatment procedures available. Sometimes, I will stretching your spine may help alleviate pain. Stretching increases the space between vertebrae, thus relieving pressure on affected nerves. Sometimes, this is easily accomplished by having the patient lie down on specially arranged cushions that puts their spine in the correct position to allow gravity to balance out their pelvis and spinal column. It’s a misconception that chiropractors “pop a disc back into place” using forceful adjustments. That popping sound comes from release of gas under pressure within a joint. It’s similar to the sound heard when opening a can of soda. Through the use of low force, I manipulate the spine to relieve pressure. There are also other complimentary treatments for back pain; my clinic provides both acupuncture, physical therapy and massage therapy, three additional proven treatments for the successful treatment of patients with back pain caused by bulging discs.
It bears repeating that treatments for back pain are highly individualized. Depending on your chosen work, sports or activities during your daily life, I will need to modify treatments to allow you to safely resume your day to day activities. Everyone has different demands for their body; part of my job is to provide treatment to meet these goals.
We need to both be active partners in your health care and treatment.
As a chiropractor, I believe in prevention as well as treatment. Researchers have identified a link between your body’s core strength and a natural protection for one’s back. People who do not exercise face an elevated risk of back pain. A lack of exercise can leave one with a weak and/or stiff back which increases the stress on the spine increasing the likelihood of disc problems. Exercise, for as little as 30 minutes a day, for a minimum of three times a week, can help support your spine as well as the muscles in your back, stomach and neck. I show my patients the exercises that target your back, stomach and legs to increase the strength and flexibility of these muscles. Exercises such as partial sit-ups, crunches, pelvic tilts, bird dog and bridging exercises as well as side plank exercises are all beneficial.
Adding moderate aerobic activity increases the blood flow to the spine, providing nutrients that support healing. Aerobic exercise also increases balance, strength and flexibility that can help prevent future injuries. It should be added that excessive or improper exercise can raise the risk for a bulging disc. Improper or overly intense exercise may lead to back troubles. A jerky golf swing or the incorrect use of a rowing machine can put extra stress on your spine and, over time, may cause additional injuries. Sometimes, it is a simple adjustment in your form that may help. Research shows that 30% to 70% of cyclists experience lower back pain; a simple adjustment to the seat height and angle may lessen the stress on the lower back.
Excess body weight puts additional strain on the spine and can also contribute to the recurring injuries. Exercise has to be supported by a healthy lifestyle, including diet. Eating the right foods for you, in the correct portions is a personal responsibility as are other lifestyle choices. We know so much more now about inflammatory foods and how to use proper nutrition as preventative medicine. Science has shown us that smoking tobacco decreases the oxygen flow to the inter-vertebral discs. This prevents the discs from absorbing the nutrients they need to function and can cause the discs to degenerate more rapidly because they become brittle. Simply quitting smoking will have an immediate remedial effect on the health of your back – as well as your entire body.
It’s also important that patients understand the importance of wearing proper shoes for the variety of activities they perform. Proper footwear provides your back with additional support and very well may prevent additional types of injuries from occurring. Wearing high heels, however much in style, can throw off your alignment and increase the risk of a bulging disc, putting particular stress on the lower back. While we seem to live in a world highlighted with high-priced sneakers, many people do not wear the correct size to give the heel and ankles the necessary support.
In summary, the fine tuning and maintenance of one’s back stability is best achieved by looking at your day to day activities and immediately addressing any deficits and learning self-management techniques. Unfortunately, bulging disc injuries are usually not a quick fix. Most bulging disc injuries take several weeks to settle and can remain weak and vulnerable for up to six weeks, sometimes longer. However, most bulging disc injuries will not remain painful during this time period – giving you even more of an incentive to become serious about the care and protection of your spine.
If you have been diagnosed with a bulging disc or believe you may have one due to your symptoms, please give me a call. I am confident that I can help get you back in action!
Yours in health!