BULGING DISC, DISC PROTRUSION, HERNIATED DISC & SLIPPED DISC

Between each vertebrae lies a gel-filled disc that absorbs load and helps the spine move. The outer part of a disk is made up of fibrous cartilage that keeps the gel contained. When the spine is compromised it can lead to the outer part of the disc to tear/split and ‘gel’ to seep out, consequently protruding outwards against the spinal cord. This is known as a disc bulge.


As the disc presses against the spinal cord often severe pain and disruption to that area which the cord inhibits is caused. It usually protrudes to one side, hence symptoms are usually one sided, affecting the neck, shoulders, arms and even back.

BULGING DISC SYMPTOMS

Contrary to common belief, a bulging disc may not always be painful.

Symptoms from a cervical herniated disc may be short-lived and only last for a few days, or it could be more chronic and last for months or even longer. It can be common for the pain to be intermittent, being easily agitated and flaring up with certain activities. It is important to note that findings on imaging do not always correlate to symptoms, as often even though symptoms completely subside the disc may not technically heal.

Common symptoms:

- Pain in the neck (LITERALLY)

- Pain in the shoulder and down the arm

- Pain in the back- Numbness, pins/needles in the shoulder, arm, finger

- Degreased range of motion of the neck and shoulder commonly

- Pain with coughing and sneezing

 

 

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CLEARING UP MISCONCEPTION

Some people incorrectly use the terms bulging disc and herniated disc interchangeably. Typically a herniated disc known to be a completely ruptured disc. This however doesn’t mean that bulging discs cannot eventually become herniated discs.

For advice specific to treating your ‘Disc Bulge’ please get in touch with one of our expert practitioners at one of our Sydney physiotherapy clinics or check out our online services.

WHAT IS A SPINAL DISC & ITS FUNCTION?

The spine is made up of many vertebrae which house and protect the spinal cord. Separating each spinal joint are our discs which are made up of strong fibres tissue. Their gel-filled nature renders them ideal for load and shock absorption. They also assist with moving our body efficiently, as when the spine moves the disc allows for smooth movement by preventing friction between the bones.

WHAT CAUSES A DISC BULGE

A disc bulge occurs when the spine is damaged, which can happen over time or as a result of a particular incident.

Causes of a disc bulge can be summarised into 3 categories:

1. Accumulated and Repeated micro-trauma
General body positioning and activities can place unwanted excess stress on our neck joints and over time this excessive load can begin to weaken and damage structures of our neck and spine, causing a disc to bulge. One of the most common examples of this is having poor posture, with our neck being poked forward. This position places excess load and stress on neck joints, compromising the discs.

 

2. Acute trauma
Sudden unexpected trauma to your neck can damage structures around your spine, causing an immediate disc protrusion and/or injure your disc, leaving it damaged, weakened, and at risk of protruding. Common examples of this are, poor lifting techniques, sporting injuries and motor vehicle accidents.

 

3. Uncontrolled factors
Genetics - Those who have a family history of decreased bone density and obesity can be at risk.
Sedentary lifestyle - Those who lead a sedentary lifestyle tend to have poor strength and stability of joints and muscles. This can render their spine and disc at risk of becoming damaged.
Age - As we age, general degeneration of the disc and spine can occur.

 

 

HOW IS IT DIAGNOSED?

Disc bulges can be diagnosed by a comprehensive subjective and physical examination by a highly trained physiotherapist. Your physio may recommend imaging such as MRI, x-rays, to determine the extent of damage. If you're suffering from a ‘Disc Bulge’, don't put up with it any longer. Get started on your path to recovery by visiting one of our Sydney physiotherapists or begin rehab online with one of our programs!

DISC BULGE TREATMENT BY YOUR PHYSIO

A disc bulge should first be conservatively managed by your physiotherapist. They will assess your lifestyle, posture, neck structures and identify the main causes of your disc bulge. They will then implement the most effective treatment methods for you.


The main aims of treating a disc bulge should be to:
- Reduce aggravating factors such as improving posture, adjusting activities and sleeping patterns.
- Decrease pain, and improve range of motion of the neck
- Promote healing of damage structures
- Improve muscular strength, control and postural awareness
- Prevent the injury recurring

Modalities of treatment can consist of:
- Soft tissue massage
- Posture control and correction exercises
- Neck stabilisation exercises
- Taping techniques for support and control
- Ergonomic education
- Acupuncture and dry needling
- Hot and cold therapies
- Neck strengthening and support exercises
- Neck stretches
- Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen

MEDICAL INTERVENTION

Please seek a consultation with a doctor if you:

- Are stumbling or feeling clumsy, especially whilst walking
- Have problems using your hands and arms for fine motor skills
- Have loss of balance and coordination


Cortisone injections (known as epidural steroid injections) into the spine can provide longer-term relief and allow you to undergo your rehabilitation process in more comfort. Various surgical procedures treat cervical herniation. However, evidence suggests only a small percentage (~10%) of people with bulging discs ultimately require surgery.

 

Ultimately physiotherapists can provide YOU with long standing relief, the knowledge to prevent this from recurring and the skills to manage/treat your condition. Evidence suggests treatment should follow conservative management, focussing on neck strength and support. Our on 4 week program will outline in detail your road to recovery! It involves day-day routines of stretches, mobilisation exercises, postural control and correction based exercises, strength and stabilisation exercises, which are best designed to resolve your bulging disc!

 

If you are looking to alleviate your pain and treat your bulging disc then please enquire about one of our sydney physios or sign up for one of our online services for expert help and treatment.