Traditional bulging disc treatments are often discussed with a patient after a doctor confirms a bulging disc diagnosis. Traditional bulging disc treatments can be either surgical or nonsurgical and aim to accomplish one of two things: to remove pressure on the pinched nerve in the spine or to block the pain signals that come from the pinched nerve to the brain.
A bulging disc, if only mild or moderate, could heal on its own. The elastic outer layer meant to hold the disc in the proper shape and height could regain its elasticity over time if the pressure on the disc is removed. Therefore, a combination of muscle-strengthening exercises and other pain management methods may help subdue the symptoms of a bulging disc while the disc heals itself.
Traditional conservative bulging disc treatments
The first step for traditional bulging disc treatment is often a series of conservative, nonsurgical therapy. These procedures help reduce the pressure on the bulging disc so it can heal while also blocking pain signals that travel from the pinched nerve to the brain or other areas of the body.
The most common conservative treatments for a bulging disc include:
- Physical therapy — Physical therapy helps strengthen the core muscles surrounding the spine. Because many bulging discs are caused by constant pressure on the discs over the years, strengthening the muscles near the spine will help remove that pressure, allowing the bulging disc to begin the healing process.
- Pain medication — Many types of pain medication for a bulging disc work by blocking pain signals from reaching the brain. When a bulging disc pinches a nerve root or the spinal cord itself, signals of pain and discomfort are experienced. The pinching can also interfere with nerve function in parts of the body along the affected nerve, causing radiating pain. Pain medication serves to block these signals, thereby reducing the pain and discomfort caused by a bulging disc.
- Stretches and yoga — Stretching and yoga, like physical therapy, strengthens the muscles around the spine to help reduce pressure on the bulging disc and the pinched nerve. The stretching will help to relieve pressure on the bulging disc by creating more space within the spinal canal and relieving compression on the nerve root.
- Lifestyle changes — Lifestyle changes like quitting smoking and limiting the consumption of alcohol and tobacco can help improve the health of the discs in the spine, thereby helping the bulging disc to begin the healing process. Changes like weight loss and exercise can also help reduce pressure on the spine and help relieve pain caused by a bulging disc.
- Corticosteroid injections — Similar to pain medication, a corticosteroid injection numbs the area around the bulging disc. This helps reduce the pain signals sent from the pinched nerve and other areas of the body to the brain.
Traditional surgical bulging disc treatments
Typically, traditional bulging disc surgery is only considered if several months of conservative treatment has not yielded any substantial pain relief.
Traditional bulging disc treatments like surgery often have potential risks. Like any surgery, it is important to understand the potential risks and benefits before agreeing to any procedure. The type of surgery performed can be described in two categories: decompression and fusion.
A traditional open back decompression surgery to treat a bulging disc is often performed in a hospital and requires a few nights of hospitalization after the procedure. The traditional decompression surgery is performed in the following steps:
- An initial incision is made in the neck or back, usually at a length of 5 – 10 inches. The incision often cuts through the muscles surrounding the spine in order to provide more room for the surgeon to access the bulging disc. While this does create more room for the operation, a potential risk is that the large incision could lead to excessive scar tissue, which could cause chronic pain after the surgery.
- A piece of the bulging disc is removed to reduce pressure on the pinched nerve.
- The incision is closed and the recovery period begins. The recovery after traditional bulging disc surgery could last between three – six months, though some patients experience stiffness and pain for more than a year. The surgical team will provide a guideline for what to expect during the recovery period and exercises that can help facilitate healing.
A traditional bulging disc fusion is a similar procedure. However, instead of removing a small portion of the bulging disc, the surgeon may insert a small metal cage around the disc to hold the two surrounding vertebrae in place and to move the bulging disc off of the pinched nerve. The metal cage is held in pace with a series of small implants, which often includes screws and rods to fuse the two surrounding vertebrae together.
Because a fusion is much more involved than a decompression, there is an increased risk of failed back surgery. Failed back surgery syndrome is a condition that describes the continuation of previous symptoms or the onset of new symptoms after the back surgery has been completed. The rate of failed back surgery among adults who undergo traditional open back surgery is roughly 40 percent.
To reduce this risk of complication and shorten the amount of recovery time involved, some patients are choosing minimally invasive spine surgery to treat a bulging disc.
The next step to take before starting any traditional bulging disc treatment is to consult a doctor or spine care specialist about the available treatments that fit your condition and medical history.