Editor: Dr. Amy Spencer, PT, DPT, OCS, MTC, CSCS, CKTP - A Board Certified Clinical Specialist in Orthopedic Physical Therapy and Certified Manual Therapist. Owner and Physical Therapist, Specialized Physical Therapy in North Reading, MA.
Intervertebral discs are thin sections of cartilage located between each vertebrae of your spine. They are made of two distinct parts: a tough outer ring of fibrous tissue known as the annulus fibrosus; and a soft, more gelatinous section known as the nucleus pulposus, which is located inside of the annulus fibrosus.
- The annulus fibrosus is made of tough fibrocartilage that binds the vertebrae together but is flexible enough to allow your body to move freely.
- The inner nucleus pulposus acts as a shock absorber to support the body’s weight and prevent the vertebrae from painfully crashing into each other.
As you get older, the intervertebral disc can start to lose water and become weak and dried out. This can lead to disc compresses and the deterioration of the tough outer ring, which will cause the inner ring (nucleus) to bulge out. This is normally referred to as a bulging disc. The bulge typically affects a large portion of the disc, so it looks somewhat like a hamburger that’s too big for its bun.
Continued stress on the spine will cause continuous degeneration in the disc. The inner nucleus pulposus may even rupture out from the annulus. This is sometimes referred to as a ruptured, slipped, or herniated disc. The fragments of disc material may press on the nerve roots that are located just behind the disc space. This can cause pain, weakness, numbness, or changes in sensation. Most herniated discs occur at the lower lumbar spine, especially at the L4-5 and L5-S1 levels. Bulging is considered part of the normal aging process of the disc and is common to see bulges on MRIs of patients of all ages.
Symptoms of Disc Bulge:
Many people have bulging discs without knowing it. There would not be any noticeable symptoms, as long as the bulging area does not press on the surrounding neural tissue. If the bulging disc impinges on the nerves of your spine, you may experience the following symptoms:
- Arm or leg pain: If your herniated disc is in your lower back, you’ll typically feel the most intense pain in your buttocks, thigh, and leg below the knee. It could also affect part of your foot. If your herniated disc is in your neck, the pain will normally be experienced in the shoulder, arm, or hand. This pain can also shoot down your arm or leg when you cough, sneeze, or move your spine in certain directions.
- Numbness or tingling: Patients who have a herniated disc often experience numbness or tingling in the body part that is served by the affected nerves.
- Weakness: Muscles served by the affected nerves tend to weaken. This may cause you to stumble, or impair your ability to lift or hold objects.
Please seek medical attention immediately if you have weakness or numbness in both legs, along with loss of bladder or bowel control. This could be a sign of a rare but serious medical problem known as Cauda Equina Syndrome.
Causes of Disc Bulge:
Normal wear-and-tear of your disc will happen as you age. Your discs will dry out and they will not be as flexible. This makes them prone to tearing or rupturing if they are strained or twisted. Most patients cannot pinpoint the exact cause of their herniated disc, although sometimes it is caused by lifting something using your back muscles. Make sure to always use your leg and thigh muscles if you need to lift a heavy object. Twisting and turning while you are lifting something can also result in a herniated disc. Some herniated discs are the result of traumatic car accidents or hard blows to the back.
Treatment of Disc Bulge:
Physical therapy is highly recommended to patients with disc bulges. It will help you regain and maintain pain-free mobility. Physical therapy is designed to strengthen your spinal muscles, stretch muscles that may increase nerve compression in your spine, and teach you techniques to reduce or alleviate the pain in your spine. Manual therapy is an important component that will release chronic muscle tension or spasms that may be contributing to the pain.
Electrical stimulation may also be used to stimulate your muscles using a safe electrical impulse current. This has been proven to reduce muscle spasms, alleviate inflammation, and increase your body’s production of endorphins (natural pain killer). The entire process is focused on relaxing and re-educating the muscles needed to support your spine. It will often be accompanies with customized stretching and strengthening exercises concentrated on restoring muscle performance, motor function, and spinal range of motion. After you have completed physical therapy, you will be able regain normal function and enjoy your recreational activities again.
As mentioned earlier, bulging discs occur because of the weakening of the outer fibrous containment ring of the disc. This weakening is often age related, and unfortunately unavoidable. However, some activities may speed up the development of disc bulges and therefore should be avoided. Make sure to protect your back when lifting, practice good posture, maintain a healthy weight, and exercise regularly to strengthen the core muscles that are supporting your body weight. If physical therapy is unsuccessful, your physician may recommend surgery.
SPT is just minutes from Andover, Reading, North Andover, and Wilmington MA
Specialized Physical Therapy is conveniently located in North Reading and also proudly serves residents in Andover, Reading, North Andover, Wilmington, Boxford, Burlington, Woburn, Stoneham, and Methuen. We offer free and spacious parking located within a few steps away from our clinic’s door.
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Specialized Physical Therapy practices a comprehensive approach to total muscle, joint, and spine health. We are the preferred physical therapy clinic in Greater Boston, because we offer an extensive range of physical therapy services designed to restore your physical strength and mobility while reducing your pain. Our physical therapy clinic sets itself apart by:
- Providing proven techniques for alleviating minor, major, acute, and chronic pain.
- Specializing in sports medicine, manual therapy, post-surgical care, auto accidents, prenatal and postpartum conditions, orthopedic injuries and overuse injuries.
- Maintaining a clean, comfortable, private and quiet clinic, making it ideal for private consulting, educating and performing the latest physical therapy techniques.
- Focusing on your individual needs, not the bottom line, because we are a small, physical therapist-owned and family-oriented clinic.
- Treating one patient at a time in our private treatment room to make sure that you get the personalized care and attention you need.
- Completing your treatment from start to finish with only exceptional doctorate trained and fully licensed Massachusetts physical therapists that have excellent skills, breadth of knowledge, and invaluable experience to help you reach your goals and succeed.