Bulging Disc Pain Management in Knoxville, TNTo fully understand what a bulging disc is, it is important to know a few key components of the spine. The spine is made up of individual vertebrae and between each vertebra, there is a cushion called a disc. A bulging disc is when part or all that cushion is pushed out into the spinal column. In this article we will take a look at the symptoms, causes, prevention, and treatment options for a bulging disc in Knoxville, TN. A bulging disc affects the lumbar and cervical spine. Rarely does it affect the thoracic, or mid, spine. When a bulging disc does occur in the mid spine it is considered a medical emergency. Bulging slipped, and ruptured discs are other names for a bulging disc and can be caused by simple wear and tear from age or an injury to the spine. Lifting, twisting, bending, or stooping are enough to cause a bulging disc. Traumatic injury such as a car accident or fall, are unlikely to cause a bulging disc. At least 2% of people will experience a bulging disc, men more than women. The age to get a bulging disc is between the age of 30 and 50. According to the Cleveland Clinic, 9%-25% of people describe having back pain per year and it is the fifth most common reason for people to seek medical care in the United States.
Common SymptomsSymptoms of a bulging disc in the cervical spine include numbness or tingling down the arms, localized pain, and radiating pain down one arm or the other and into the hands. Often, patients will feel pain between their shoulder blades. Symptoms in the lumbar spine are like that of the neck. They include localized pain, sciatica, radiating pain into the legs and feet, and numbness and tingling in the legs and down to the feet. Often, the pain is worse on one side or the other.
DiagnosisBulging discs are diagnosed with a clinical exam. At that visit, reflexes, strength, and sensation are checked to rule out nerve damage. An x-ray is usually ordered next to rule out any fracture or a mass. An MRI or CT scan is often performed. These are specialized images that look at the internal structures of the spine. The CT uses x-rays while the MRI uses magnets and radio waves. EMGs or nerve studies are sometimes done to rule out any nerve damage done by the slipped disc. A myelogram is done when there are multiple slipped discs. This test injects dye into the spinal column before a CT scan. It shows the pressure on the spinal cord due to the discs.
How to treat a bulging disc?Treatment can include anything from doing nothing to surgery. Treatment for a bulging disc often starts conservatively with a trial of anti-inflammatories (NSAIDs), physical therapy, ice, and rest. Neuropathic medications such as Gabapentin or Lyrica may be used as well as muscle relaxers. This depends on the patient’s symptoms. If conservative treatment does not work, then a corticosteroid injection may be needed. This involves directly injecting an anti-inflammatory steroid into the epidural space around the spinal nerves. It is placed directly where the pain and inflammation are to help calm down that inflammation and reduce symptoms. Corticosteroid injections are usually performed in the hospital or outpatient center under x-ray guidance. Patients are typically monitored for 20-30 minutes after the procedure. These injections are most performed on the lumbar spine but can be done on the cervical spine as well. There are 3 different approaches to injecting into the lumbar spine. The first approach is called Interlaminar and that is when the needle is placed between the two laminae in the spine to reach the epidural space. It is typically used for patients with or without radicular pain and localized back pain. The second approach is called Transforaminal. This is when the needle passes through the foramina. It is typically used for radicular pain or when a patient has a specific injury to a nerve root. The last approach is called the Caudal approach. This is when the needle is placed through the sacral hiatus. It is the approach that has the least number of risks. The risks to the corticosteroid injections include reaction to the medication, headache, infection, bleeding, injury to surrounding structures, temporary paralysis, and exposure to minimal amounts of radiation. The benefits include pain relief (temporary or prolonged), improvement in daily activities, and a reduction in the need for further invasive procedures. Typically, each injection lasts up to 6 months, although 70% of patients felt at least 50% improvement in 1-2 months and 40% found improvement in 1 year according to the Cleveland Clinic. Patients are only allowed 3 injections per year.
Does a bulging disc require surgery?The final and most extreme treatment for a bulging disc is surgery. Knoxville doctors for a bulging disc will only recommend surgery if none of the other options work or the symptoms affecting the patient reduce their quality of life. Surgery is also recommended if the patient is having bladder or bowel dysfunction, difficulty controlling their legs, or is unable to control the pain. Surgery is meant to help the symptoms of a bulging disc. It is meant to improve numbness, radicular pain, bladder or bowel dysfunction, or weakness. The types of surgeries one might have include diskectomy, laminectomy, artificial disc surgery, or a spinal fusion. A diskectomy involves removing the damaged disc in the spine. This surgery is used to help relieve radicular pain and usually does not help pain localized to the back or neck. If the entire disc is removed, then a spinal fusion is needed to support the spine. This involves placing hardware into the spine and fusing the vertebrae. Laminectomy involves removing bone spurs and making space around the vertebrae. It is usually done due to arthritis of the spine. Artificial disc surgery involves replacing the damaged disc with a mechanical disc. Some surgeries can be done on an outpatient basis, but most require a few nights of hospitalization. Physical therapy is done after the healing process to help gain strength and stability.
Risk factors and preventionThere are certain criteria, besides age, that put a person more at risk for a bulging disc. A person’s weight, occupation, and lifestyle could increase a person’s risk for a bulging disc. A more sedentary job or one that requires a lot of driving are some examples. Genetics also plays a part in increasing risk factors for bulging discs. If one family member has a bulging disc, it is likely others will as well. Prevention of a bulging disc is as easy as maintaining a good diet and exercise program, not smoking, maintaining good posture, and a healthy weight.
Bulging Disc Treatment in Knoxville, TNIf you don’t get your bulging disc pain under control you are not giving your body the ability to heal properly! Omega Pain Management is one of the Knoxville pain management clinics that is highly reputable for diagnosis and addressing pain issues. Igor Smelyansky, MD leads the team of pain management specialists that help people gain control of their pain with a strategic pain management plan. Whether you are suffering pain from a bulging disc in Knoxville, herniated disk, or any other type of back pain these pain experts will offer you pain management solutions that will reduce or eliminate your pain. Call 865-338-5137 TODAY to get started!
AANS. Herniated Disc. www.aans/en/Patients/neurological-conditions-and-treatments/herniated-disc. (2022)
Cleveland Clinic. Herniated Disk (Slipped, Ruptured, or Bulging Disk). my.clevelandclinic.org/health/disease/12768-herniated-disk. (2022)
Epidural Injections. www.radiologyinfo.org/en/info/epidural. (2021)