Bulging Disc

Bulging Disc Treatment in AlaskaIf you imagine a disc as a jelly donut — as a pain physician once described — a bulging disc has jelly being pushed out on either side. It isn’t a fun image, but it is accurate. Bulging discs are under sincere pressure, and that “jelly” is actually a soft, gelatinous inner layer called nucleus pulposus. Intervertebral discs are composed of a tough, fibrous outer layer called the annulus fibrosus. When the disc is compressed, nearby nerve pain may be caused.

Healthy vertebrae and discs are crucial to movement, among other functions. Discs provide a cushion between each of the 33 vertebrae in the spine. The vertebrae, stacked on top of each other with discs in between, create the spine and provide nerve protection. Discs have three roles: to connect and form the spine, to absorb weight placed on the spine and to allow for movement. When discs are compressed, they become misshapen.
It is in the lower back where most bulging discs occur. At times, they can also be seen in the neck and upper back too. The good news is, some 52% of those who have a bulging disc experience no symptoms or pain. For the other 48%, a physician can determine which disc or discs are bulging as a result with an MRI or CT scan. Diagnostic imaging is suggested for those who have had 4-6 weeks of severe pain and haven’t had results with conservative therapies. The cause of the bulge, which could be disc herniation or degenerative disc disease, may also be determined.
Most bulged discs will not require treatment, but for those that do, there are many options. Physicians will likely start with conservative care; most bulging discs heal with these treatment options within a month:

  • Over-the-counter anti-inflammatory/pain relief medications
  • Short-term prescription pain relief from opiate medications
  • Steroid injections for inflammation
  • Physical therapy to help strengthen and improve stability
  • Acupuncture
  • Chiropractic traction
  • Rest

Surgical treatment is generally not necessary. Once a physician can identify the underlying cause for the bulging disc, it can be treated with an open discectomy if conservative care fails. This procedure is the most common and gold standard for treating herniations, alleviating pain and pressure.


  1. Hsu, P.; et al. Lumbosacral radiculopathy: Pathophysiology, clinical features and diagnosis. In: UpToDate, Basow, DS (Ed), UpToDate, Waltham, MA, 2011.
  2. Fardon, D.; Milette, P. Nomenclature and Classification of Lumbar Disc Pathology: Recommendations of the Combined Task Forces of the North American Spine Society, American Society of Spine Radiology, and American Society of Neuroradiology. Spine. Vol 26, E93-E113. 2001.
  3. Milette, P. The Proper Terminology for Reporting Lumbar Intervertebral Disc Disorders. American Journal of Neuroradiology. Vol 18, 1859-1866. 1997.
  4. van Rijn, J.; et al. Observer Variation in MRI Evaluation of Patients Suspected of Lumbar Disk Herniation. American Journal of Roentgenology. Vol 184, 299-303. 2004.
  5. Wheeler, S.; et al. Approach to the diagnosis and evaluation of low back pain in adults. In: UpToDate, Basow, DS (Ed), UpToDate, Waltham, MA, 2010.
  6. Steiger, T.; et al. Diagnostic testing for low back pain. In: UpToDate, Basow, DS (Ed), UpToDate, Waltham, MA, 2011.
  7. Robinson, J.; Kothari, M. Clinical features and diagnosis of cervical radiculopathy. In: UpToDate, Basow, DS (Ed), UpToDate, Waltham, MA, 2010.
  8. Robinson, J.; Kothari, M. Treatment of cervical radiculopathy. In: UpToDate, Basow, DS (Ed), UpToDate, Waltham, MA, 2010.
  9. Chou, R. Subacute and chronic low back pain: pharmacologic and noninterventional treatment. In: UpToDate, Basow, DS (Ed), UpToDate, Waltham, MA, 2010.
  10. North American Spine Society 2009: Lumbar (open) Microscopic Discectomy. Patient Handouts page. Available at http://www.knowyourback.org/Pages/Treatments/SurgicalOptions/LumbarDiscectomy.aspx. Accessed April 15, 2011.
  11. Buckwalter, J. A.. Aging and Degeneration of the Human Intervertebral Disc. Spine. Vol 20, 1307-1314. 1995.