Bulging Disc

Pain Associated with Bulging Disc

FAQs on Bulging Disc

It is estimated that 90% of Americans will experience some form of back problems at some time in our lives.

These types of conditions usually affect us between the ages of thirty and fifty by natural age related wear and degeneration, but trauma can cause them at any age. A bulging disc is a condition affecting an intervertebral disc that causes it to extend beyond its normal range, often causing the impingement (compression) of a nearby nerve and resulting in, often very severe, back and leg pain. Bulging discs are generally a part of getting older unfortunately for many of us, but sometimes an injury, especially a spinal compression injury or whiplash injury, can affect an intervertebral disc and bring about the condition we call “bulging disc”.

What symptoms are associated with a bulging disc?

The location of the bulging disc will determine where our symptoms occur, cervical (the neck) discs can impinge nerves that can cause you to feel pain, numbness and tingling in the hands, arms, neck, shoulders, and chest while lumbar (lower back) will affect the buttocks, legs, feet. If the bulging disc does not press on an adjacent nerve root, it may simply cause back or neck pain due to the bulging irritating the tiny nerve endings in the outer portion of the disc.

Although in different locations throughout the body, many of these symptoms are similar:

• Back or Neck Pain, which may radiate outwards
• Numbness
• Tingling
• Burning sensations
• Radiating pain
• Restricted movement without experiencing pain

Often these symptoms are exacerbated with certain physical activities such as bending, walking, lifting, turning the head from side to side, twisting the body, and even lying flat on the back or side.

How are bulging discs diagnosed?

Diagnosis usually begins with a Q&A with the Chicago pain management doctor. This will include questions about previous trauma, smoking, occupation and family history. Sometimes a spinal injury won’t show symptoms for months or even years. In an automobile accident for example, you may feel ok after the accident and then a day or two later feel sore, especially in the neck, but then recover only to experience problems in your neck years later as the injury has hastened the degeneration of a particular disc. Imaging is also used to determine if a bulging disc is the source of your symptoms of if another is the culprit.  Although x-rays cannot image the disc specifically, it can image the vertebrae to determine if another cause, like arthritis, DDD (degenerative disc disease may cause a loss of height), or even if a fracture is the problem. The Gold Standard for diagnosing a bulging disc is the MRI, as it is the most reliable and the only true way to see a disc bulge.

What are the patient’s treatment options for a bulging disc?

Doctors usually opt for conservative treatment for a bulging disc and go with OTC (over the counter) medications like ibuprofen (an anti-inflammatory medication) for inflammation or acetaminophen and naproxen sodium (non-narcotic analgesics) for pain.

Along with the over the counter medications, additional treatments may include the following:

• Physical Therapy
• Chiropractic
• TENS Units
• Acupuncture
• Short term bracing
• Spinal Decompression Therapy

If a patient is experiencing pain too severe for the OTC medications, then short term opiates may be helpful. Long term opiates for a bulging disc are typically not the best treatment option.

What can the patient expect if they undergo a nerve block?

The medications used in a nerve block injection are designed to numb the nerve and stop them from sending pain signals to the brain. Because of this they are generally very effective and so the patient can expect a significant reduction in felt pain. With bulging discs there can be a combination of issues causing pain, such as from a disc tear or inflammation of nerve endings.Therefore, for the arm or leg pain an epidural injection may help. For persistent back pain, an intradiscal injection may be extremely helpful.

How is a nerve block injection performed?

These injections are an outpatient procedure and generally only take about thirty minutes to perform. The patient is placed on an exam table and the area(s) to be injected are first cleaned with antiseptic solution and then the skin is numbed with topical anesthetic. The Chicago pain doctor usually uses a fluoroscope, (a type of x-ray machine that allows the doctor to see the needle in real time to aid in accurate placement of the needle), to insert a thin needle. A contrast dye is often injected first to ensure the medications will contact the nerve correctly; when this has been confirmed the doctor injects a mixture of local anesthetic and a corticosteroid. After the procedure is complete, the patient is placed in another room for observation for adverse reactions to the medications for another thirty minutes or so.

How long do the benefit of the injections last?

Usually the injections will be given in a series over several weeks. Most often the first treatment will provide relief from several days to a few weeks; subsequent treatments typically result in longer duration of relief. Intradiscal injections have been shown to provide approximately three months of back pain relief, on average. The epidural injections, overall, have a 75-90% effectiveness for arm or leg pain relief.

What risk or side effects are possible?

Usually these injections are very safe, the risks and side effects are minimal. The patient may experience swelling, bruising, or bleeding at the injection site. Allergic reaction to the medications is possible but rare. Infection occurs in well under 1% of procedures.

How successful is treatment for the relief of a bulging disc?

In most cases, pain can be managed with a conservative treatment program from our clinic. For moderate to severe pain, most patients (more than three quarters) that receive the injections report a moderate to significant reduction in felt pain levels. Surgical intervention is an absolute last resort.

Premier Pain & Spine offers comprehensive nonoperative treatment for those individuals with back or neck pain due to bulging discs. Most insurance is accepted, and there are seven metro Chicago pain management clinics for treatment.

Call (847) 519 4701 for more information and scheduling with pain management Chicago trusts or request an appointment!

References:

[Case-control study on suspine rotation manipulation for the treatment of lumbar disc herniation].
Evaluation of degenerative diseases of the lumbar spine with reformatted and 3-dimensional computed tomography images.
Herniation of the cervical disk in plastic surgeons.
Intervertebral disc health preservation after six months of spinal growth modulation.

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