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According to statistics, around 56% of adults have one or more bulging discs. MRI scans have shown that 2-35% of working-age adults have an asymptomatic disc bulge.

Most bulging discs occur as a result of normal aging. Some discs begin to bulge due to the degeneration process of the disc, where water content inside the disc reduces and vertebrae misalign occurs. A bulging disc becomes serious when it causes the spinal canal to narrow.

Many patients have bone spurs on the facet joints of the spine, which are behind the discs. The combination of the spurs and the bulging disc will cause narrowing of the canal, which is often referred to as spinal stenosis. Injury to a disc from misuse or overuse can cause a disc to bulge. This is often experienced with physical activity, such as athletics and certain occupations.

A bulging disc that presses on a nerve of the lower back can result in pain, numbness, tingling, and/or weakness of the back, buttocks, and/or leg. Cervical spine bulging disc can lead to pain in the neck, deep pain near the shoulder blade, and pain radiating down the arm into the fingers.

Bulging discs occur most often in men and women in their 30s and 40s. The risk factors are:

Injury or trauma

Participating in contact sports

Physically demanding occupation

Alcohol and/or tobacco use

The diagnosis of a bulging disc begins with a complete medical history of the problem and a physical examination. In addition, certain diagnostic tests are ordered, such as:

X-rays - While an x-ray does not show a bulging disc, it will give the doctor of how much spinal wear and tear is present.

MRI - The magnetic resonance imaging scan is used to diagnose the bulging disc.

The treatment of a bulging disc depends on the severity of the bulge, the presence of spinal narrowing and nerve compression, and the patient’s symptoms. Treatment options include:

Medications - The pain specialist can prescribe NSAIDS, opioid agents, muscle relaxants, and antidepressants.

Spinal decompression therapy - This involves gentle decompression of the disc and elongation of the spine using a special table and machine. The table applies distraction force to compress the disc and allow it to move back into normal position. In one clinical study, the success rate of this therapy was reported at 86%.

Acupuncture - With this ancient Chinese therapy, a skilled practitioner inserts small needles into acupoints of the back. This allows for release of endorphins and blocking of pain signals. In a review of randomized controlled trials, acupuncture was found to be superior to control measures for chronic pain.

Facet joint block - To improve spinal mobility and relieve pain, the doctor can inject an anesthetic, with or without a steroid, into the facet joint space near the bulging disc. This way, the medication is directly placed onto the nerves. In a recent clinical study, facet joint injections had an 85% success rate.

Intradiscal injection - In one recent study, researchers found that injecting the disc with a sterile solution decreased back pain and the degree and incidence of ossification.

Epidural Steroid Injection - A bulging disc may cause irritation and inflammation of adjacent spinal nerve roots. If the bulge is large enough, it may actually pinch on a nerve root too. An epidural may provide significant pain reduction.

Radiofrequency ablation (RFA) - With this procedure, radiofrequency waves are delivered to the painful spinal region via a special injection device. RFA destroys a portion of the nerve tissue. In a recent review, the majority of patients reported 40% or more pain reduction following the procedure.