A bulging disc in your lumbar spine may cause low back pain and/or pain radiating into your buttock and posterior thigh. But, you can also have discs that bulge that do not cause pain or any other symptoms.
Understanding the difference may help you avoid surgery or other unnecessary treatments.
The intervertebral discs are like little shock absorbers or spacers between the vertebra of your spine.
The outer part of the disc is call the annulus. It is a strong and durable ligament that runs in a circle and connects each vertebra to the next vertebra.
Forms a Little Shock Absorber
Inside of the annulus is the nucleus fibrosis. This inner part of the disc is a soft and spongy kind of material that makes the disc like a little shock absorber.
With the annulus around the outside and the nucleus fibrosis on the inside, it is the intervertebral disc that allows motions like bending and twisting.
Bulging can develop when the annulus become weak or stretched. This can occur with repetitive bending and lifting activities, but it may also happen without any identifiable cause.
A bulging of your disc can cause back pain when the annulus is stretched or damaged, and if the bulge is pressing on nerve it may cause pain radiating into your lower extremities or other symptoms of sciatica.
First we should ask: Do I need to treat my disc?
Many times a bulging of the disc is found on an MRI when you are being evaluated for back or lower extremity pain. If that bulging is the only abnormality, then certainly it needs to be treated and there are some things that can be done.
But Not Surgery
Discs do not need to be treated surgically just because they bulge.
There are more conservative treatments with much less risk that can effectively treat an injured disc. If your only symptom is severe back pain then it may not be coming from your disc at all. Discs that bulge do not generally cause severe back pain.
If you are having radiating pain into your buttock and thigh, and if your MRI shows a disc that is pushing on nerve you may need to consider treatments such as aggressive physical therapy and if that is not helpful, possibly epidural steroid injections.
These are options that you can discuss with your doctor.
It is uncommon for a disc that is only bulging to cause severe symptoms.
However, when the MRI shows other more serious problems and the disc that bulges, the disc most likely will not require treatment.
Spinal Stenosis or Severe Arthritis
For example, if your MRI shows spinal stenosis or severe arthritis along with a disc that bulges, it is the stenosis or the arthritis that needs to be treated.
This is because stenosis and the arthritis commonly cause much more severe pain than a bulging disc, and that is what is likely causing the majority of your pain. Also, many of the treatments for stenosis and arthritis will likely improve your disc injury.