Spinal discs consist of a thick ring of cartilage called the annulus that contains a gel-like center called the nucleus. The discs in the spine are located between the vertebrae to absorb shock and allow the spine to flex.
Over time, discs can lose water content, causing them to stiffen or bulge out, causing a condition called a bulging disc. The annulus can also rupture, causing the nucleus material to be pushed outward. This is often referred to as a herniated disc. Bulging and herniated discs may also be referred to as “slipped” or “ruptured” discs.
When a disc is bulging or herniated, it can put pressure on the spinal nerves, which can cause pain or numbness in different areas of the body. Initially, bulging discs may be treated with nonsurgical methods. If symptoms persist, surgery may be recommended.
Dr. Alex Ching offers both surgical and nonsurgical care for bulging and herniated discs. Dr. Ching has been in practice for more than a decade, and is fellowship trained and board certified in spine surgery. He has led presentations on state-of-the-art treatments for bulging discs on the national level and previously served on an American Academy of Orthopaedic Surgeons panel on bulging discs.
Causes of Bulging Discs
Bulging discs can occur in the neck and lower back. They typically develop because the disc has weakened over time. Discs can lose water content with age, causing them to shrink and narrow the space between the vertebrae.
Though it can be difficult to pinpoint the exact cause of a bulging or herniated disc, there are several risk factors that can contribute to weakening of the discs, including:
- Lifting heavy objects using incorrect lifting techniques
- Being overweight
- Repetitive activities that put stress on the back
To prevent the development of a bulging disc, or to prevent a bulging disc from getting worse, Dr. Ching recommends exercise and staying in shape, with a particular focus on core strength to support the back and cardiovascular conditioning. It is also important to maintain a healthy weight, which can reduce stress on the spine.
Symptoms of Bulging Discs
Bulging discs can cause different symptoms depending on their location. In the lower back, a bulging disc might cause:
- Sciatica – sharp pain that shoots from the buttocks down the back of the leg
- Back pain
- Weakness, tingling, and numbness in one of the legs and/or feet
- In rare severe cases, loss of bladder or bowel control
In the neck, bulging discs may cause the following symptoms:
- Shooting pain down one of the arms
- Pain in the trapezius muscles (the muscles located between the neck and shoulder)
- Weakness, tingling, or numbness in one of the arms
- Burning pain in the shoulders, neck, or one of the arms
With that said, other spine conditions can produce similar symptoms, so it is important to see a qualified professional like Dr. Ching to obtain an accurate diagnosis and treatment plan.
Treatment Options for Bulging Discs
Dr. Ching offers both surgical and nonsurgical treatment options for bulging discs. Nonsurgical treatment is always recommended initially; Dr. Ching only recommends surgery if symptoms persist with nonsurgical treatment.
80-90% of patients have sufficient relief with nonsurgical treatment. Nonsurgical treatments may include:
- Anti-inflammatory medications
- Activity modification
- Cortisone injections
If symptoms have not improved or have worsened after 6 weeks of nonsurgical treatment, Dr. Ching may recommend surgery.
For herniated discs in the lower back, Dr. Ching typically recommends a lumbar discectomy. During a lumbar discectomy, Dr. Ching makes an incision in the back (approximately 1 inch long) and removes the protruding portion of the disc that is compressing the nerve. By eliminating the source of nerve compression, symptoms are typically relieved.
For bulging discs in the neck, Dr. Ching may recommend cervical disc replacement. During a cervical disc replacement, the bulging disc is removed through an incision at the front of the neck, and a disc replacement device is placed in the disc space. This allows the spine to maintain motion at that level.
If a patient is not a candidate for cervical disc replacement, an anterior cervical discectomy and fusion may be recommended. During this procedure, the bulging disc is removed, and the two vertebrae are fused together using plates and screws. This eliminates motion at the affected level of the spine, with the goal of eliminating pain.
Recovering from Surgery
The recovery process can vary depending on the procedure and the patient’s individual needs. Dr. Ching and his team will discuss the recovery process with you so that you know what to expect after surgery.
In the majority of cases, patients are able to return home either the day of surgery or after a one-night hospital stay. Patients typically feel relief from nerve-related pain almost immediately, though there may be some surgical pain in the initial recovery period. Dr. Ching and his team will have a pain management plan in place while you recover.
For the first two weeks after surgery, patients are advised to rest and take it easy, though walking around the home and preparing light meals is permitted. After the first two weeks, patients are able to gradually return to activity, starting with light activity and walking in the neighborhood. Patients are typically cleared to resume driving when they are no longer taking narcotic pain medication. Full recovery and return to activity takes, on average, 3 to 4 months.
Physical therapy recommendations are tailored to patients’ needs. The majority of patients do not need physical therapy after surgery. However, Dr. Ching may provide physical therapy recommendations for patients who wish to progress in recovery more quickly, or for patients who are progressing more slowly than average.
Bulging Disc Treatment in Tualatin, OR
Dr. Alex Ching is a board certified and fellowship trained spine surgeon with over a decade of experience. He offers both surgical and nonsurgical care for bulging and herniated discs, and has been involved in research on advanced treatments for these conditions. If you would like to make an appointment with Dr. Ching, please call his office at (503) 828-1150, or request an appointment online.