What Causes a Bulging Disc?

What is a Bulging Disc? A bulging disc injury is a common spine injury sustained to your spine's intervertebral disc. It can occur in your lumbar spine (lower back), thoracic spine (upper and mid-back) or your cervical spine (neck). Spinal discs are the shock-absorbing rings of fibrocartilage and glycoprotein that separate your bony vertebral bodies, while allowing movement at each spinal level, and enough room for the major spinal nerves to exit from the spinal canal and travel to your limbs. The annulus is the outer section of the spinal disc, consisting of several layers of multi-directional fibrocartilaginous fibres all densely packed to create a wall around the glycoprotein filled jelly-like disc nucleus.  The degree of spinal disc injury varies considerably from mild disc strains or internal derangments, mild-moderate-severe disc bulges through to complete disc rupture and herniation of the nucleus through the annular wall. The fluid component, or disc nucleus, in the disc centre is like the caramel inside a chocolate. It normally moves within the annulus adjusting to the pressures placed on your spine. However, if you injure the annulus, the wall weakens and the nucleus can press outwards on the weakened disc wall, causing your disc to bulge outwards. A disc bulge (commonly referred to as slipped disc, can potentially press against or irritate the nerve where it exits from the spine. This nerve pinch can cause back pain, spasms, cramping, numbness, pins and needles, or pain into your legs. What Causes a Bulging Disc? When a bulging disc, disc herniation or disc rupture occurs, it is typically due to either: a pre-existing weakness in the annulus, or a sudden increase in pressure through the disc causing fibres of the annulus to tear.  The causes of disc injury can be summarised under three headings: 1. Accumulated Microtrauma Repeated microtrauma over an extended period can lead to disc injury. The best example of accumulated microtrauma is poor posture. Poor posture when sitting, standing and working stresses your spine. Sustaining a slouching or forward bending of your spine leads to overstretching and weakness of the posterior fibrocartilage (or annulus) of the spinal discs. Over time, this leads to poor disc integrity and displacement of the disc nucleus fluid posteriorly. This places your spinal joints and nerves under pain-causing pressure. To decrease the effect of poor posture on your spine it is important to continually attempt to a maintain a good posture or even better, regularly change your posture.  During your initial efforts to retrain a good posture, poor muscle endurance and posture awareness predisposes you to sag back into your old habits. In these instances, it is useful to note that supportive posture devices such as a lumbar roll, Basset spine support, kinesio taping or a back brace are available to help you maintain a lordotic curve to your lumbar spine during this transition phase. Any sustained posture should be regularly altered to allow your spine to move and remain healthy. 2. Sudden Unexpected Load Sudden unexpected load to the intervertebral discs can also occur in traumatic situations, ie: a motor vehicle accident. This may happen due to the nature of the sudden forces exerted through your body at the time of impact and your bodies attempt to repel those forces.  Unexpected load or torsion of a disc can result in tearing of the annulus fibres and hence a disc injury. You should always lift any amount of load using the correct postural lifting principles. Using poor lifting techniques, such as bending forward and pulling with your back may result in sudden and unexpected loading of the disc.  Ask your physiotherapist about these principles. 3. Genetic Factors As with many conditions spinal disc injury is considered to have a genetic predisposition.  Those suggested to be susceptible are people who are known to have a lesser density of and increased elastin component of the fibrocartiliginous fibres, which make up the annulus of the intervertebral disc. Other factors that play a role are more environmental in nature – such as excessive abdominal fat, poor core stability, poor lower limb strength, nature of occupation (ie: heavy physical load versus light or no physical load).  Overall, genetic factors are a very minor contributing factor in disc injuries and if one does sustain a disc injury it can almost never be put down to ‘genetic factors’. And, let’s be honest, you can’t change your genetics. All you can do, is be more diligent in your back injury prevention. Contact PhysioWorks or Book Online What are the Symptoms of a Bulging Disc? A bulging disc injury is suspected when your back pain is aggravated by: sitting forward bending coughing or sneezing lifting Sciatica, leg pain, pins and needles, numbness or weakness are commonly associated with more severe disc pathologies. Altered bladder and bowel function can indicate a severe disc pathology, which should prompt immediate medical assessment. How is a Disc Injury Diagnosed? Your physiotherapist or doctor will suspect a spinal disc injury based on the history of your injury and your symptom behaviour. Your physiotherapist will perform clinical tests to confirm a spinal disc injury and detect if you have any signs of nerve compression. The most accurate diagnostic tests to confirm the extent of your spinal disc injury are MRI and CT scans.  In the MRI show, a disc bulge can be identified. X-rays do not show acute disc bulging. However, X-rays can show signs of chronic disc injury such as degenerative disc disease and disc narrowing. Treatment for Bulging Disc  Read full article: Bulging Disc Contact PhysioWorks or Book Online Helpful Products for Bulging Disc Related Injuries Ankylosing Spondylitis Back Muscle Pain Bulging Disc Core Stability Deficiency Degenerative Disc Disease Facet Joint Pain Fibromyalgia Muscle Pain: Strains or Tears Pinched Nerve Piriformis Syndrome Pregnancy Back Pain Sacroiliac Joint - SIJ Pain Scheuermann's Disease Sciatica Side Strain (Abdominal) Spinal Stenosis Spondylolisthesis Spondylolysis (Back Stress Fracture) Spondylosis (Spine Arthritis) Stress Fracture Trochanteric Bursitis (Hip Bursitis)

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