Your spinal discs are the cushioning tissues between your spinal vertebra and are made up of a gel like substance on the inside, somewhat like the consistency of peanut butter. Spinal discs can be found between every level of the spine; from the 2nd cervical vertebra to the base of the low back. The exterior portion of the disc is more like a wall of tissue that holds the gel in place.
A bulging disc is the result of the wall being overstressed and protruding under pressure. Pain can be provoked with stress to the wall and can sometimes be felt halfway down the arm in the case of the cervical spine or into the leg if the lumbar discs are involved. If the bulge presses a spinal nerve, sciatica symptoms can be provoked and will be felt thru the glute and down the leg. Improvement/reduction in the disc bulge can result in alleviation of pain and other symptoms such as numbness or tingling. In this stage, pain is usually intermittent and has definite aggravating and relieving factors. Physical therapy can greatly help with these symptoms. One evidenced based treatment is based on gentle repeated movements and educating the patient in self-treatment.
A herniated disc occurs when the cushion that sits between the spinal vertebra is pushed outside its normal position; the gel protrudes or bursts through the wall of the disc. This results in not only strain/ rupture to the disc but the gel that passes through the wall may press on spinal nerves causing additional pain and discomfort/sciatica. In this case, the gel will not go back in place and the body must absorb at least parts of it and scar over the injured wall. In many cases, the body can heal from herniated discs without invasive techniques such as surgery. Surgery may be indicated especially if there is pressure on the spinal cord causing loss of bowel or bladder control or in the case of significant muscle weakness of the extremities.
Symptoms of bulging or herniated discs may be similar. Both can cause local spinal pain as well as radiating pain into the arms/ legs. There can also be numbness/tingling and weakness. Recent studies show that outcomes for herniated disc are the same at one year post injury whether a person undergoes surgery or chooses a conservative route such as physical therapy. MRI’s have actually shown that many people are functioning normally with bulging and herniated discs with no symptoms at all.
Physical therapy can help with both of these disc issues but is recommended within a few days of injury or certainly within a few weeks. Scar tissue and other dysfunctions can begin by 8-10 weeks and recovery will take more time and effort at this point.
The most effective precautions include avoiding activities that bring on or increase spinal pains and especially if the pain travels into the arms or legs. In general, practicing good posture and use of your body in bending and lifting activities can be instrumental in preventing and treating disc problems.
For more information on disc pathology and treatment go visit us at mountainphysicaltherapy.com. We’re here to help you. After all, we keep bodies moving!