In order to first understand how Physical Therapy can treat a bulging disc or herniated disc, it is vitally important to understand - “What is a disc?”
As always, let's keep it simple, because both the anatomy and the depths of information on Physical Therapy topics can become quite dense, muddy, and boring.
So simply put, vertebral discs (discs between the bones/”vertebrae” of the spine) are shock absorbers and aid in flexibility and motion while supporting both the spine and spinal cord. Additionally, they are a nice cushion between each vertebra to prevent the painful “bone on bone” rubbing together during movements.
And since the spine extends from the skull to the sacrum, we have vertebral discs between each segment along the way. This is why we have cervical (neck) discs, thoracic (mid-back) discs, and lumbar (lower back) discs.
I like to describe the disc as a jelly donut. In that there is a more dense fibrous outer ring of the disc, and a gelatinous center core. Together, this unique structure of the disc provides both stability and cushion.
I’ve noticed many people use the terms bulging disc and herniated disc interchangeably, but in fact these are two very different injuries to the same structure.
Staying with the jelly donut analogy, a bulging disc is when the jelly has been pushed up against the donut wall, but has not squeezed out of the donut. These injuries are generally considered mild and many people have bulging discs without experiencing symptoms.
A herniated disc, on the other hand, is when the jelly is squeezed out of the donut. As with all injuries, there are grades of severity of a herniated disc; however, that isn’t the intent of this blog.
How does this injury occur?
This injury can occur in many ways, including age - considering both injuries can be classified as a degenerative condition. It is important to note that being told you have “degenerative disc disease” may indeed be technically accurate and can cause bulging discs; however, in my opinion, this is a terribly phrased diagnosis. You are not diseased. This diagnosis is very much treatable and you are not destined to have pain for the rest of your life.
Additional causes of bulging discs range from postural concerns with prolonged computer work (usually neck), lifting with poor mechanics (usually lower back), car accidents (even simple fender benders), and repetitive strain associated with work.
Can bulging discs be treated successfully?
Yes, absolutely. There are, of course, caveats and prognostic indicators that can predict both good and poor outcomes with conservative treatment. It is important to remember, though, that even patients with poor prognostic indicators can still have successful outcomes, these are simply predictors to guide decision making.
Indicators that you can successfully conservatively treat a bulging disc (or any mechanical neck pain) include:
Younger Age
Better psychological health
Greater social support
Greater optimism regarding diagnosis
Coping that includes self assurance
Less need for socializing
Indicators that you may have poorer outcomes with conservative treatment of a neck bulging disc include:
Poorer health
Passive Coping Strategies
Poor Psychological health (Depression)
Worrying about the pain/symptoms
Becoming angry or frustrated regarding your pain/circumstance
How are bulging discs treated?
Well, this is where differing opinions can present based on bias, experience, or profession.
The traditional healthcare model would suggest making an appointment to be seen by your PCP, where - in all likelihood - will take weeks to get seen, an X-ray will be performed, and medication will be administered.
During this time, symptoms may have progressed due to lack of guidance and without an active treatment approach. Additionally, imaging studies may not tell the whole story and lead to pain catastrophizing/increased worry which we know leads to a poorer prognosis.
Additionally, treating symptoms passively with rest and medication is not a modern approach, nor is it an updated evidence-based approach.
The modern approach? Utilizing direct access Osteopractic Physical Therapy services at the first onset of symptoms.
An Osteopractic Physical Therapy treatment plan will first and foremost begin with a comprehensive assessment, consisting of thorough differential diagnosis of the structures involved to rule in or rule out the source of the symptoms. These diagnostic measures are more valuable than a static x-ray and will paint a more comprehensive picture of your diagnosis.
Following an explanation of the findings, which both reduces anxiety and improves optimism, highly skilled manual therapy can begin immediately.
Manual therapy, when performed by a fellowship-trained Osteopractor, includes dry needling, spinal manipulation / adjustments, joint mobilizations, cupping, scraping, and more.
But there’s more…
Manual therapy is great, but when combined with the right resistance exercises, the real magic happens.
This is because when a disc injury to the neck/lower back occurs, muscular changes can occur at the segments involved. Again, I won’t get too deep into the dense research associated with this - I’ll stick to the simple explanation method.
Muscles in the neck/lower back rapidly weaken and become dysfunctional following a disc injury - and resistance training targeting these muscles both stop and reverse these changes.
This means, if you are only doing gentle stretches or gentle chin tuck exercises, then you likely aren’t loading your muscles enough to cause a real positive change.
Where can I find this treatment?
If you are in the Lafayette, Louisiana region, including Youngsville, Broussard, Scott, Rayne, and all of Acadiana, then you have Osteopractic, Direct Access, Physical Therapy in your backyard.
At Flow Physical Therapy and Wellness in Lafayette, LA, our Physical Therapist is both Fellowship-trained and earned his Diploma in Osteopractic Physical Therapy as awarded by the American Academy of Manipulative Therapy.
If you are struggling with neck pain, lower back pain, or were diagnosed with a disc bulge from an X-ray and you weren’t given much direction…
Click the button below to be seen and treated by an Osteopractor…today!
Dr. Patrick Thompson, PT, DPT, OCS, Dip. Osteopractic, FAAOMPT
Owner of Flow Physical Therapy and Wellness
337.366.1703
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