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.
Repeated microtrauma over an extended period can lead to disc injury. The best example of accumulated micro trauma 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 displacement places your spinal joints and nerves under pain-causing pressure.
Your aim to continually maintain a good position includes regular postural change.
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.
You should regularly alter any sustained posture to allow your spine to move and remain healthy.
Sudden Unexpected Load
Sudden unexpected load to the intervertebral discs can also occur in traumatic situations, e.g. a motor vehicle accident. This excessive load may occur due to the nature of the sudden forces exerted through your body at the time of impact, and your body attempts 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 weight 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.
Spinal disc injury does have a genetic predisposition. The deficiencies discovered include a lesser tissue density and increased elastin component of the fibrocartilaginous fibres. These make up the annulus of the intervertebral disc. Other factors that may play a role could be environmental – such as excess abdominal fat, poor core stability, reduced lower limb strength, nature of occupation (e.g., heavy physical load versus light or no physical pressure).
Overall, genetic factors are mild to a moderate contributing factor in disc injuries, and if one does sustain a disc injury, it is rarely ‘genetic’. And you can’t change your genetics. All you can do is be more diligent in your back injury prevention
Bulging Disc Symptoms
A bulging disc injury is suspected when your back pain is aggravated by:
- forward bending
- coughing or sneezing
Altered bladder and bowel function can indicate a severe disc pathology, which should prompt immediate medical assessment.
How is a Bulging Disc Diagnosed?
Your physiotherapist or doctor will suspect a spinal disc injury based on the history of your injury and your symptom behavior. 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.
MRI scans often identify a disc bulge. 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.
Bulging Disc Treatment
Most minor and moderately bulging disc injuries are treated conservatively without the need for surgery. Torn fibres of the annulus will heal and the disc bulge to usually resolve fully. While this occurs, your bulging disc treatment centres on encouraging the fluid to return and remain in the centre of the disc. This rehabilitation keeps the torn fibres closer to one another and the structure of the annulus as healthy as possible.
Your physiotherapist will advise you on the best positions to stay in and prescribe a back brace your. They’ll also explain to you the postures to avoid, which can be detrimental to your recovery.
By maintain the disc fluid in the central position that you intend it to stay, you are helping Mother Nature to lay down its scar tissue optimally for an excellent long-term solution. Please remember that scar tissue formation will take at least six weeks, so the longer that you avoid aggravating postures, the better!
PHASE I – Pain Relief & Protection
Managing your pain is usually the main reason that you seek treatment for a bulging disc. In truth, it was the final symptom that you developed and should be the first symptom to improve.
You are managing your inflammation. Inflammation is the primary short-term reason for why you have suddenly developed bulging disc symptoms. It best reduced via ice therapy and techniques or exercises that unload the inflamed structures.
Your physiotherapist will use an array of treatment tools. They aim to reduce your pain and inflammation. These treatment modalities may include ice such as the DMEforLess Hot or Cold Pack for Back Supports –..., electrotherapy, acupuncture, unloading taping techniques, soft tissue massage, gentle exercise and temporary use of a back brace. Linked is a brace that can help with a bulging disk Back in Shape Brace for Lower, Mid and... Your doctor may also recommend a course of non-steroidal anti-inflammatory drugs such as ibuprofen.
PHASE II – Bulging Disc Exercises
As your pain and inflammation settle, your physiotherapist will turn their attention to restoring your normal joint alignment and range of motion, muscle length and resting tension, muscle strength and endurance.
Your physiotherapist will commence you on a lower abdominal and core stability program to facilitate your important muscles that dynamically control and stabilize your spine.
Researchers have discovered the importance of your back and abdominal core muscle recruitment patterns. Standard recruitment order of your deeper muscles, then intermediate and finally, superficial muscle firing patterns are typically required to prevent back pain. Your physiotherapist will assess your muscle recruitment pattern and prescribe the best exercises for you, specific to your needs.
Your physiotherapist may recommend a stretching program or a remedial massage to address your tight or shortened muscles. Please ask your physio for their advice.
PHASE III – Restoring Full Function
As your back’s dynamic control improves, your physiotherapist will turn their attention to restoring your normal pelvic and spine alignment and its range of motion during more stressful body positions and postures. They’ll also work on your outer core and leg muscle power.
Depending on your chosen work, sport or activities of daily living, your physiotherapist will aim to restore your function to allow you to return to your desired activities safely. Everyone has different demands for their body that will determine what specific treatment goals you need to achieve. For some, it is merely to walk around the block. Others may wish to run a marathon.
Your physiotherapist will tailor your back rehabilitation to help you achieve your own functional goals.
PHASE IV – Preventing a Recurrence
Back pain does tend to return. The main reason back pain recurs is due to insufficient rehabilitation. In particular, poor compliance with deep abdominal and core muscle exercises. You should continue a version of these exercises routinely a few times per week. Your physiotherapist will assist you in identifying the best activities for you to continue indefinitely.
In addition to your muscle control, your physiotherapist will assess your spine and pelvis biomechanics and correct any defects. It may be as simple as providing you with adjacent muscle exercises or some foot orthotics to address any biomechanical faults in the legs or feet.
General exercise is a vital component to successfully preventing a recurrence. Your physiotherapist may recommend pilates, yoga, swimming, walking, hydrotherapy or a gym program. These modalities all appear to help back pain. Exercise will assist your back pain relief in the long-term.
Bulging Disc Exercises
Your physiotherapist will prescribe the best bulging disc exercises. They will consider your disc bulge location, size, neurological symptoms and the acuteness of your symptoms. Please follow their recommendations as they guide you from back pain and back towards your healthy life.
Fine-tuning and maintenance of your back stability and function are best achieved by addressing any deficits and learning self-management techniques. Your physiotherapist will guide you.
DMEforLess offers the same medical-grade products that doctors use and prescribe, and because we sell directly to you, the savings are significant. Learn more, and get the best solution for your pain or injury by calling 888-681-7456, emailing us at info@DMEforLess, or find us on Facebook HERE.
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