Disc Bulge

We’ve all experienced a moment when our back suddenly “gives way”… it can be sharp, stabbing, and take your breathe away pain… it’s really scary.

Sometimes if the pain doesn’t resolve we will see a doctor or physio and go on to get a scan or image like a CT scan or MRI scan. When we read the report we might see things like disc bulge, disc protrusion, nerve impingement.

The image below shows the discs, which are like the cushions of our spine, occasionally we can hurt the outer wall of the disc causing a disc bulge that may or may not press on the adjacent nerve.

This is why back pain can travel down our thigh or leg, and even down to the inside or outside of our feet.

Experiencing this type of pain can be scary, especially in the first few days when you are struggling to move… the good news is that most disc bulges return to normal after 2-4 weeks and on imaging completely resolve after 8-12 weeks.

Recent evidence has actually found that disc bulges should not be feared as a life sentence but instead a normal part of aging “like wrinkles on your skin”.

The below study was people who had NEVER HAD BACK PAIN…. They found that 50-75% of people in their 40’s had either a disc bulge or disc degeneration on their scan… but they had never complained of pain..

This is a giant leap indicating that it could be a normal and pain-free part of aging much like wrinkles on your skin… this is great news as it wasn’t that long ago that people were getting injections and surgeries for disc bulges and now we know that is the wrong course of action.

Getting a proper assessment is the first thing you should do. We would determine the severity and advise you on some movement options.

Some strategies that can help are finding your direction preference and sticking to that. For example you may be able to stand up tall and arch backward a little bit… if this feels good… keep doing it… keeping in mind a 2-4/10 on the pain scale is okay

For others, laying down and pulling knees to your chest or swaying your knees side to side… the key here is to find movements that you can do… and keep moving… your back and discs are a system that relies on movement so it’s important not to do nothing.

Another option can be deep breathing… this can help relax some of the muscles around your spine, reduce some pain, and introduce gentle movement.

At physio we will perform soft tissue massage, gentle movements to help you move better and reduce pain in that first 3-5 day period.

Lastly, taking paracetamol and going for a walk as tolerated can be the absolute best thing. Even if you do 2-3 short walks a day. Often the back gets sorer when still or sitting.

In Summary;

• Get assessed, understand your back pain, and if you have a disc bulge. 
• Try a movement that you can do… knees to chest or arching back.
• Deep breathing to reduce pain and help movement.
• Paracetamol and short walks.
• Get some manual therapy and advise from a health pro to help with that first 3-5 days.

This area has changed considerably in the last 5-10 years. Professionals used to prescribe bed rest for 3-5 days if a patient had back pain or a disc bulge, and now we know its the exact opposite… movement is key.

The best evidence we have is that back pain is multifactorial and can be triggered by inflammatory processes, psychosocial stressors, AND physical load.

Therefore a huge part of helping back pain is strengthening and this is what physio’s excel at. If we can make your back more robust and strengthen it… it is less likely that physical load will irritate it.

Discs actually respond to load and were stronger, fatter and healthier in people who ran or lifted weights… they respond to load like muscles… getting stronger.

For those who have been through guided and graded strengthening for 8-12 weeks and still get consistent back pain it is important to address other inflammatory and psycho-social factors that we can help and advise on.

Please get in touch or book online if you would like to see someone who has a modern and evidenced-based approach to disc bulge and back pain.

We are located in Rozelle, Panania, Clovelly, Coogee and Miranda.