Bulging discs are not always noticeable in the neck or back. In fact, many people are unaware of a developing bulging disc in the spine because, unless the disc presses against a nerve root or the spinal cord itself, there are no symptoms present.
For many people, bulging discs develop slowly over time as a result of the weakening and aging of the spine. The elasticity in the annulus fibrosus (outer layer of the disc) begins to stretch, allowing the disc to reshape and bulge over years of constant pressure on the spine. Because the majority of bulging discs develop over time, there are warning signs that can be felt as a disc begins to bulge. By recognizing the bulging disc warning signs, you may be able to be proactive about your treatments instead of suffering through several months or years of pain.
Bulging disc warning signs — symptoms
Typically, bulging disc warning signs begin as mild symptoms of pain or discomfort. One of the most common signs of a developing bulging disc is sudden pain when bending or twisting in a certain position. This is because, as a disc begins to bulge, it may not yet be pressing against a nerve root or the spinal cord. However, a shift in the spine during movement could cause the bulging disc to pinch a nerve, which results in sudden pain. However, when the spine shifts back to a resting position, the pressure will be relieved from the pinched nerve and the pain will disappear.
Other bulging disc warning signs and symptoms include:
- Muscle weakness
- Burning sensation
- Chronic headaches (if bulging disc is in the cervical spine)
Because a bulging disc only shows symptoms when a nerve is compressed, the pain and symptoms could radiate down the pathway of the pinched nerve, causing them to be felt in different, seemingly unrelated, areas of the body.
For example, a bulging disc in the neck may cause pain and symptoms to spread to the shoulders, arms, hands and head, while a bulging disc in the lower back can reach all the way to the buttocks, legs and feet. In the less common occurrence of a bulging disc in the thoracic spine (middle of the back), pain and symptoms may wrap around the rib cage and the chest.
How to recognize bulging disc warning signs
Throughout life, most adults experience some form of neck or back pain. This can be brought on by something as minor as sleeping with your neck in the wrong position or lifting a heavy box incorrectly to something more serious like the onset of a bulging disc. So how do you differentiate between bulging disc warning signs and indications of a minor injury?
The first way to tell the difference between a bulging disc and a minor injury or muscle strain is the length of pain. For example, a pulled muscle or a slight “tweak” in the neck may be painful for a day or two, but you should start feeling some relief after the second or third day. Even if the pain has not completely gone away at that point, you should still feel a decrease in the level of pain after a couple days. In contrast, bulging disc pain will generally not decrease over time without treatment. If you notice that your pain continues or even worsens after a week or more, you may be experiencing the first signs of a bulging disc.
What to do if you feel bulging disc warning signs
If you are experiencing bulging disc warning signs, you should schedule an appointment with your doctor for a professional diagnosis and recommendation for treatment. Your doctor may perform the following diagnostic tests to find the cause of your pain and symptoms:
- Questions about your pain and symptoms
- Review of your medical history
- Questions about your current lifestyle
- Physical exam
- Imaging tests such as an MRI or CT scan
Once your doctor determines what is causing your condition, you can begin to discuss the treatment options available to you. Most spine conditions respond to conservative treatments, allowing patients to avoid spine surgery. If your doctor diagnoses you with a degenerative bulging disc, you may be given a treatment plan consisting of some of the following common conservative treatments:
- Physical therapy
- Pain medication
- Chiropractic care
- Massage therapy
- Rest (limited)
- Low-impact exercises
- Lifestyle changes, such as weight loss and exercise
- Stretching and yoga
- Corticosteroid injections
These conservative treatments are designed to lengthen and strengthen the spine, reducing pressure on the bulging disc and pinched nerve. Typically, conservative treatments can be measured for effectiveness after a few months. If the pain and symptoms have not reduced at this time, your doctor may recommend spine surgery for a bulging disc. This type of surgery is often a procedure called a discectomy, sometimes coupled with a stabilizing spinal fusion if necessary.
Ask your doctor about the advantages and potential risks of traditional open neck or back surgery and minimally invasive spine surgery. While there are doctors who prefer both types of procedures, new studies have indicated certain advantages of minimally invasive spine surgery over traditional spine surgery, such as a shorter recovery time and lower risk of complication. Your doctor can help you research both surgery options, if necessary, so you can make a confident decision about your treatment options.