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Treatment For Bulging Disk

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Bulging disk also known as Contained Spinal Disorder is a condition characterized by bulging of intervertebral disc towards spinal canal. Loss of water content in nucleus pulposus is the main cause responsible for occurrence of bulging disk…

Bulging Disk
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Bulging disk, also known as a Contained Spinal Disorder, is a condition that occurs usually in spinal or lumbar region, lower back and in few cases witnessing with neck region. It commonly occurs as the human body ages and with the increase in age degeneration of inter vertebral disk occurs. Disks are soft material that engulfs the vertebrae of spinal chord and provides a cushioning support. When the disc moves out of its normal location or radius bulging disk occurs.

To understand the phenomenon of bulging disk, we have to understand the anatomy and physiology of intervertebral disc.

Intervertebral Disc
Spinal chord is encased by spine made up of intervertebral discs whose primary function is supporting the body weight. The repeated daily stress over time results in degeneration of the disc. Each vertebra of a spine contains intervertebral disc. The stress of every day movements is transferred to these discs. They act as shock absorbers to absorb any kind of impact and provide a cushioning support.

A healthy intervertebral disc contains a great amount of water in its center known as nucleus pulposus. This water content provides a spongy behavior to disc.

An excessive pressure or injury can be harmful for the structure of outer ring of ligament covering nucleus pulposus. This ligament is better known as annulus.

Pathology and Mechanism
Because of aging factor the scars received by annulus over time lead to small cracks to this ligament and make it weaker. Eventually this leads harm to nucleus pulposus and it starts loosing its water content. Due to the loss of water content, intervertebral disc starts loosing its spongy nature and degeneration occurs. This leads to further development of cracks due to increased impact and more loss of water. So the cushion effect diminishes and spine can’t absorb stress any more.

The space between two intervertebral discs decreases, even collapses which results in the movement of two adjoining disc to come closer. Because of this movement, there is a considerable shift in location of facet joints at the back of spine. Bone spurs by activities of osteophytes which began to accumulate around the disc spaces and facet joints. This spurring process is a natural response by spine to reduce the excessive motion of that typical segment of spine.

Pathologically, this condition is known as Bulging Disc. When this bones spurs start growing towards spinal canal, exerting and protruding pressure on spinal nerve, the condition become much more painful. This condition is also known as spinal stenosis.

Symptoms
In case of bulging disc, the nature of the symptoms usually depends upon the precise location of the affected intervertebral disc in the spine. Person may suffer pain and discomfort in their legs and hips if disc at lower back is affected while others may suffer such pain in arms if the intervertebral disc is located near shoulder region in upper back. The symptoms from this degenerating disc include discogenic pain.

Diagnosis
Magnetic resonance imaging (MRI), CT scans and X-rays can confirm the presence of bulging disk. The diagnosis is made only after getting or identifying the complete case history by the physicians. Here X-rays can be used to confirm that the intervertebral disc space has been decrease. MRI tests are carried out to decide a loss of water content in the intervertebral disc.

Treatment
The treatment of bulging disc can be of two types.

a) Conservative Treatment- According to the assessment of seriousness and severity of the pain treatment is decided. Some problems need an immediate medical attention while others do require a plenty of rest with a supplement of anti inflammatory, analgesic pain killers like cortisones. In some cases, if the protrusion of disc is much more in the spinal canal then the surgery is required. The treatment is aimed at making the patient comfortable as quickly as possible, getting him/her back to normal state in a time bound carefully designed rehabitation program to reduce further wear and tear of the disc.

b) Rest - Rest plays the most important role in the treatment of bulging disc. In most of the cases, a complete, sound rest is what your body is craving for. It is used to reduce the stress and pressure off your spine. Sometimes a placement of pillow under knees can help a lot. Although, rest is most important parameter you should not get stucked with a complete bed rest and should try to return to normal activities gradually. Rest combined with a small amount of recommended exercises can do wonder.

c) Physical Therapy – In most of the cases a physical therapy proves of immense help in rehabitation program. Workout with an expert physical therapist helps in reducing inflammation and pain, improving and rebuilding your strength, and returning back to normal activities with a greater ease. A well rounded physical therapy is aimed at controlling symptoms, practicing mobility and safe exercises. In case of patient suffering from back pain gradual physical exercises is the best way to combat the pain. It also teaches you to maintain a correct posture to offer maximum rest and less stress to spine.

d) Epidural Steroid Injection (ESI) – They are used as pain killers. They are of great help to control inflammation.

A bulging disc though common in old age, it is not necessary that everyone will experience the pain associated with it. Only when intervertebral disc extents towards spinal canal, pain arises.

Published by Stenosis Advisor

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By Jayashree Pakhare
Published: 2/26/2007

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