What Complications Can a Bulging Disc Cause?

Jan 18, 2023

If you’ve ever suffered from a bulging disc, you know that this injury can be excruciating and have likely sought relief. While some herniated or bulging disc pain may resolve on its own or with mild intervention, without proper treatment, the injury can lead to permanent issues that cause more pain than the original problem. In some cases, an untreated bulging disc can even lead to permanent nerve damage. To understand why it is so important to treat a herniated disc quickly and properly, keep reading.

What Is a Bulging Disc?

What Is a Bulging DiscRather than a single bone, the spine is made up of small bones stacked on top of each other, called vertebrae. To prevent the vertebrae from rubbing against one another, there are rubbery cushions between each bone. These spinal discs are made up of a tough outer covering (the annulus) and a soft, jelly-like center (the nucleus).

These discs are vulnerable to injury during a traumatic event like a car accident but more commonly degrade over time as a result of wear and tear. Damage to the discs typically happens in four stages:

  • Stage 1 – Bulging: Flattening of the disc causes some or all of the disc’s outer shell to bulge out further than normal.
  • Stage 2 – Protrusion: The nucleus begins to bulge from the center of the disc but does not break through the annulus.
  • Stage 3 – Extrusion: The nucleus of the disc breaks through the annulus.
  • Stage 4 – Sequestration: A fragment of the disc breaks off and migrates into the spinal canal.

The first two stages are considered incomplete herniations of the disc, while 3 and 4 are complete herniations. Not all discs will move through every stage.

Herniated discs are extremely painful because of pressure on the nerves surrounding the spine. Any small piece of a disc that moves outside of the vertebrae’s space will enter the spinal canal, causing pressure on nerves in that area. This pressure can lead to pain, as well as numbness and tingling in the areas of the body controlled by that nerve.

Common Signs of a Bulging Disc 

As a disc herniation worsens, you may have more obvious signs of the injury. But the sooner you are able to identify a problem and seek treatment, the more likely you are to resolve the issue and avoid serious issues down the line. While it can be difficult to identify the exact cause of back pain, there are three main signs to look for that indicate a potential disc injury.

Pain when sitting 

Any activity that places pressure on the lower spinal discs can exacerbate issues related to a bulging disc, and sitting exerts a huge amount of pressure in this area. When a disc is herniated, the increased pressure can amplify the issue, aggravating the lower back.

Sciatic, or radiating pain into the leg 

When discs in the lower back are herniated or bulging, the nerves that are most often impacted are those in the spinal nerve roots. Any compression or irritation of these spinal nerve roots can cause their function to be altered. This leads to numbness, weakness, and/or tingling along the front and/or back of the leg, thigh, and even foot, usually on only one side. Because of the affected sciatic nerve, this issue is sometimes referred to as sciatica.

Pain caused by specific activities 

Certain activities may irritate disc injuries more than others. These include bending down or forward, lifting a heavy object, pushing and pulling heavy objects, coughing, and sneezing. The pain usually comes on quickly, though it may last for a time after the activity.

What Causes a Bulging Disc?

What Causes a Bulging DiscA herniated disc or bulging disc is usually not brought on by a single incident but instead is a cause of degeneration over time. However, someone who is already prone to the injury could see it brought on suddenly by a force or trauma, and some injuries are enough to cause a healthy disc to become herniated.

Risk factors for a bulging disc include:

  • Having a sedentary lifestyle with little physical activity.
  • Smoking cigarettes.
  • Heavy lifting and other continued strain on the lower back over a long period of time.
  • Back muscles that have been weakened due to other injuries.
  • Poor posture during sleep, sitting, standing, or exercising.
  • Being overweight or obese.
  • Participating in high-contact sports or activities.
  • Not using proper shoes during activities like running.
  • Having a physically demanding job that includes lifting, pushing, pulling, bending, or twisting.
  • Being genetically predisposed to developing a herniated disc.
  • Frequent driving, due to prolonged sitting and the vibration of the motor vehicle.
  • Not drinking enough water to keep the discs properly lubricated.

However, the biggest determinant of risk is often age. As we age, the discs lose their flexibility, which makes them more likely to tear or rupture when even slightly strained. Most people will not be able to pinpoint a single cause of their herniated disc unless there is a traumatic event like a car accident that causes the issue.

Complications of an Untreated Bulging Discs 

A bulging disc is the mildest grade of disc herniation and means no damage has occurred to the disc itself yet. Without proper treatment, this injury is more likely to progress to a higher grade and cause more symptoms or even permanent issues.

The most common outcome is that the bulging disc continues to be irritated and protrudes into the spinal canal, herniates, or even migrates into the spinal canal entirely. When this happens, symptoms worsen, and treatment is more invasive. It is even possible to require surgery to remove a damaged disc, either replacing it with an artificial disc or fusing the surrounding vertebrae together to prevent movement.

If the protrusion occurs for a long period of time, it can also permanently damage the nerves that it impacts.

In very rare cases, disc herniation can also compress the entire spinal canal, along with all the nerves of the cauda equina. The cauda equina is a group of long nerve roots, resembling a horse’s rail, that continues after the spinal cord ends into the spinal canal.

Worsening symptoms, especially when you are getting treatment, can be the first sign of this progression, especially if they begin to hamper your daily activities. Any issues with bladder or bowel control and dysfunction can indicate that there is an issue with the cauda equina and should be treated as an emergency. Additionally, the progressive loss of sensation in the areas a saddle would touch, called “saddle anesthesia,” is also something that calls for emergency medical attention.

Treating a Bulging Disc

Treating a Bulging DiscThe good news is that there are many treatment options available for a bulging disc to prevent it from becoming a more serious issue. Addressing the problem before it becomes a higher grade of herniation or a new concern can make recovery easier and faster, but wherever you are in an injury, it is important to seek care.

Most bulging and herniated discs can be treated without surgical intervention, with various treatments working best for different patients. The correct treatment for you can depend on the length of time that the issue has been present, the severity of the pain, your age, and the nature of the symptoms. The goal of treatment is typically to relieve pain enough that the patient can return to everyday activity and restore proper anatomy, which helps prevent further issues.

Common treatments for a bulging disc will include:

  • Medication: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are commonly used to relieve pain and inflammation related to a bulging disc. These are available over-the-counter in medications like Tylenol. For more severe pain, a prescription muscle relaxer or pain reliever can also be issued and used with caution.
  • Physical therapy: Through a personalized routine of exercises and movements, a physical therapist can help relieve nerve pressure and minimize the pain of a bulging disc. Physical therapy can also help with preventing future herniations and improving posture for better support in the future.
  • Chiropractic care: Spinal manipulation can be used to address long-term back pain and ensure that the spine is properly aligned to prevent any protrusions. Adjustments are often focused on the lower back, where herniations are most common.
  • Ultrasound therapy: Using sound waves, which are small vibrations, body tissue in the back can be relaxed to relieve nerve pressure.
  • Massage therapy: Targeted massages can often provide short-term relief for back pain as a way of managing symptoms during the course of treatment.
  • Heat and cold: During initial symptoms, applying ice can relieve pain and swelling. Later on, gentle heat can relieve sore muscles and pain.
  • Limiting bed rest: While rest is important, and you should avoid heavy lifting and strain, too much bed rest can cause stiff joints and weak muscles that worsen the issue. Resting for 30 minutes and then going for a short walk is a good way to balance movement and rest.
  • Braces and other support devices: The compression and stability provided by a brace can help reduce pain.
  • Steroids: Cortisone injections and epidural steroid injections are known to provide long-term relief when injected into the area around the spinal nerves. Oral steroids may also reduce swelling and inflammation.
  • Anti-convulsant medication: While these drugs were designed to control seizures, they can be effectively used to address radiating nerve pain caused by a bulging disc.
  • Spinal decompression therapy: Non-surgical, intermittent spinal traction can reduce the symptoms of bulging discs for months at a time.
  • Electrotherapy: Common treatments involve a transcutaneous electrical nerve stimulator (TENS) machine, and more advanced options include PENS and rTMS.

Alternative medicine like acupuncture, yoga, reiki, and moxibustion can also be supplemental options to relieve symptoms.

While most people with a disc injury won’t need surgery, it will be considered in patients who do not experience relief with other treatments or who begin to struggle with walking, standing, bowel control, and bladder control.

If surgery is needed, there are four common types that may be performed:

  • Diskectomy: The damaged disc is removed in order to relieve pressure on the nerves. This can be done via a cut to the back or the neck, or through a much smaller incision in a microdiscectomy. In the latter, a tube with a camera on one end is inserted to see and remove the disc.
  • Lumbar laminotomy: In some cases, the surgeon will also need to remove a small piece of bone called the lamina from the vertebra. This lamina forms a protective cover over the spinal cord, and removing it can help to access the herniated disc for removal. This may occur during a discectomy or in a separate surgery.
  • Spinal fusion: After a diskectomy or laminotomy, the surgeon may fuse together the two vertebrae on each side of the disc to stabilize your spine and prevent the bones from moving or causing pain.
  • Artificial disc surgery: In rare cases where particular discs in the lower back are affected, the damaged disc can be replaced with an artificial one. These discs are made of either plastic or metal and can stabilize the spine and help you move more easily.

Whatever treatment is best for your situation, it is important to both see the plan through and continue any preventative treatments you are given. Having a bulging disc once makes you more likely to experience the same thing in the future, so working to actively manage your health and stability is critical.

At AICA Marietta, our team of specialists is dedicated to not only treating disc injuries but creating plans to keep our patients healthy in the future. With a mix of orthopedists, neurologists, physical therapists, chiropractors, and other specialists, AICA Marietta is able to provide a holistic treatment plan that is custom-built for each patient’s needs and symptoms. We can also help to develop a program that prevents future pain and injury, ensuring you are your best self in the future. Visit us in Marietta today to begin feeling relief.


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