Intervertebral discs are in a sense cushions between the bones in your spine (vertebrae) made of a hard rubbery outer wall (annulus fibrosis), and a softer inner core (nucleus pulposis). The purpose of the disc is to cushion the joints of the spine thus allowing the wide range of motion possible in the spine.
A bulging disc is an intervertebral disc that through injury or age deterioration has weakened; and so through mere gravity, the weight of your body pushes down on the disc flattening it to a degree so that the sides extend beyond their normal range. This can cause problems as when the disc bulges out it may come into contact with the nerve trunk that extends between the vertebrae, which may cause immense amounts of pain. Bulging or herniated discs usually affects individuals between the ages of 20’s-50’s.
What are the symptoms of a bulging disc?
Symptoms of a bulging disc will vary with the location of the injured disc. If it is a cervical (neck) disc that is bulging this can cause pain, tingling, and numbness in the neck that may radiate out through the chest, shoulders, arms hands and fingers. For a bulging disc in the lumbar (lower back) pain may begin at the site of injury and spread throughout the lower body including the buttocks, hips, legs, and feet.
How is a bulging disc diagnosed?
Your symptoms can be a good indicator that a bulging disc is likely, but the only way to be certain is to have an MRI (Magnetic Resonance Imaging) performed so that the Northern Colorado pain management doctor can get a good image of the tissues in and around your spine.
How do you treat bulging discs?
Treatment for a bulging disc in the early stages can be as simple as hot and cold compresses, bed rest, and strengthening exercise including NSAIDS, Tylenol, etc. Treatments for chronic pain may include PT, chiropractic therapy, spinal decompression therapy and opiate medications.
Interventional treatments for a symptomatic bulging disc may include intradiscal injections, facet blocks or epidural injections. Depending on the patient’s symptoms, the Boulder pain management doctor will cater specific treatments for optimal pain relief.
What are expectations when a patient gets treatment for a bulging disc?
Dependent upon the severity of the condition and how well the patient responds to treatment there is no way to anticipate the level of success a patient may experience from treatment. Most patients however do experience relief from pain through one or more forms of treatment, and studies show that over 75% of patients with spinal disc issues achieve nonoperative pain relief.
How are the treatments performed?
For patients requiring nerve block injections the procedure is performed as follows; the patient will lie on an exam table, the area to be injected is exposed and a topical anesthetic is used to numb the skin and underlying tissue. A needle is then inserted with the guidance of a fluoroscope (a type of x-ray machine) to ensure proper needle placement.
A contrast dye is then injected to ensure the proper nerve is being treated, after which a mixture of local anesthetic and corticosteroid is injected. The patient usually experiences immediate temporary relief from the local anesthetic, but this wears off after several hours. It may then take up to a few days before the steroid medications take effect, it also may take several treatments to reach maximum benefit. Patients who receive nerve block injections may experience relief from pain for several months at a time.
What risk or side effects are there?
- Light bruising or swelling at the injection site
- Very minimal bleeding (a few drops typically) at the injection site
- Tissue damage from the steroid if the same area is injected often
- Nerve damage if a nerve is struck, this risk is minimal when a fluoroscope is used
How successful are they the relief of pain for the condition?
Most patients receiving the injections will experience relief from pain that will be long lasting. Usually after two or three treatments the pain relief will last for several months. If you have been diagnosed with bulging discs discuss with your Colorado Clinic doctor what your alternatives are for treatment.