How to Treat a Bulging Disc in Your Lower Back

Disc bulges are a common cause of lower back pain. They can sometimes be reduced by doing simple exercises and stretches, and making some lifestyle modifications.

Have you been told by your doctor that you have a bulging disc in your spine?  If so, here are some things you should know.

1.  Bulging discs can only be definitively diagnosed from an MRI (magnetic resonance imaging) study, not an x-ray study.  If a doctor told you that you have a bulging disc just by looking at your x-ray, find another doctor fast.

2.  A certain amount of disc bulging is normal, or typical in the population.  The primary function of a spinal disc is to assist the spinal column in supporting the weight of the body.  Since it is viscoelastic (can change shape, due to its fluid behavior), a disc will naturally bulge outwards when standing, like pressing down on a donut.  If you had your MRI in the late afternoon, gravity will have acted on your discs for many hours already (unless you were lying down the whole day, which is obviously unlikely), and will show discs with slight bulging, even when you are recumbent (most MRI machines are recumbent; i.e. the patient lies down during the study).

3.  What really matters is if there is injury to the disc, and whether or not it is obstructing nerve tissue in any way.

The architecture of a disk can be imagined as a slice of an onion, but with a jelly center, encased tightly by a vertebra above and below.  If an injury event causes that jelly center to punch through successive rings in a focalized (as opposed to broad) spot, but the last couple of rings remain intact, you have a disc protrusion.   If the jelly punches all the way through the outer ring and is still connected to the disc, it is called a disc prolapse. If the jelly center punches through the outer ring and breaks off  and settles in the spinal canal, it is called a sequestered disc.

These can be painful, as there is internal injury to the disc and the protrusion can potentially press against an exiting nerve root or spinal cord, depending where it is located.  Pressure to an exiting nerve root in the lower spine most often causes same side leg pain, numbness and/or weakness.  Disc prolapses and sequestered discs are usually addressed via spinal decompression surgery or discectomy (total or partial removal of disc); disc bulges are usually first handled conservatively via manual therapy (physical therapy, chiropractic) and exercises.

A disc injury can also not involve bulging.  An annular tear or fissure is when the rings of the disc separate circumferentially (along the perimeter), instead of split radially (outwards from center).  These can be equally painful, as they are deep and difficult to heal.

If you have a disc bulge, there is still hope for recovery without surgery.  It all depends on your body's ability to heal itself.  In this sense, those who have a greater chance of recovering from a bothersome disc bulge have an otherwise healthy spine:  no to minimal arthritic changes, good bone density, healthy ligaments and tendons (basically, younger patients) good spinal flexibility, well-conditioned spinal musculature, and not overweight.

Here are some stretches/ maneuvers you can do that may help reduce the size of a disc bulge before it progresses to a surgical case. Warning, do not attempt to do these exercises if they cause a significant, sharp increase in pain.  Do them slowly and pay attention to the changes in pain characteristics during the exercise.  If you notice reduced pain with a certain movement, then continue.

1.  Place yourself on movement restrictions for at least a few months:  no heavy lifting, no jumping, no prolonged sitting, no frequent bending at the waist.

2.  Eat a healthy diet consisting of plants and animals only; i.e. minimize processed food including grain foods.  Flood your body with the necessary vitamins, minerals, and anti-oxidants to give it a boost as it attempts to repair your bulging disc.

3.  Lose the weight, if you you are overweight.  This alone will take significant pressure off of your injured disc.  Eating a protein and good fat based diet along with lots of plants is a natural, healthy way to drop the pounds without having to rely on exercise too much.

4.  Stretch your back frequently.  Lie on your back, knees bent with feet on the floor.  Take a deep breath in and gently and slowly arch your lower back as your stomach rises; exhale and flatten your back against the floor; repeat 10 times 4x/day.

Another exercise you can do is lie on your back and hold both knees tightly to your  chest.  Try to shape your spine in an egg-shaped curve, especially the lower spine.  Hold for 20 seconds; repeat five times.  Alternatively, you can get a large exercise ball (Swedish exercise ball) and lie on top of it, with your lower back at the very top.  The curvature of the ball will slightly traction apart the disc.

5.  Ask your doctor if you are a candidate for using an inversion therapy table.    While this can stretch the spinal discs using gravity, it is not for everyone.

As your pain decreases, it usually means that the bulge is decreasing in size.  At this point, you can do light back extensions:  stand with feet 6" apart.  Place both palms behind your hips, and gently arch your back.  Hold for ten seconds; repeat five times, several times a day.

Alternatively, lie on your stomach.  Make a triangle with your hands (hands open, touch index and thumb fingertips together) and place under your chest.  Push up (extend your elbows) and arch your lower back, while arching your neck back as well (this is called the cobra position in yoga).  When you do lower back extensions, the backs of the vertebra pinch together and force the bulge towards the center of the disc.

Here is a video of stretches/ maneuvers you can do that may help reduce the size of a disc bulge before it progresses to a surgical case:  http://www.youtube.com/watch?v=1b1sz3QXeVQ.  Once again, do not attempt to do these exercises if they cause a significant, sharp increase in pain. 

Remember to do these exercises slowly with good form and control; remember to breathe. 

Dan Perez, DC

san ramon chiropractor

This post is contributed by a community member. The views expressed in this blog are those of the author and do not necessarily reflect those of Patch Media Corporation. Everyone is welcome to submit a post to Patch. If you'd like to post a blog, go here to get started.

Bertha Smith April 25, 2013 at 12:52 AM
What if you tried phyiscal Therapy and it did"nt help and is Bugles Dic The same as Degenerative disc disease the same reply please
Roger Davis May 31, 2013 at 03:04 AM
Dan Perez's Blog is about to help those people who is suffering Back Disc Surgery, I also would like to give some information by giving this link - http://www.samedayspinesurgery.com/
Madeeha Nasir June 13, 2013 at 02:41 AM
my mother is suffering from the same problem.she 62 years old and is over weight as well.she is on rest from last 1 month. please suggest.....is surgery beneficial for her or she should take more rest only.
Dan Perez June 24, 2013 at 04:12 AM
Apologies for the late reply. Bulging disc is a general term for a disc that is bulging outwards to some degree. It can even be normal, technically, as discs bulge out somewhat when standing. You don't have to have degenerative disc disease to have a bulging disc, but often the two are related. DDD is deterioration of the disc from wear and tear, poor health, and other factors. It is when the disc loses its fluid content gradually. It does not have a good prognosis; there will usually be some degree of chronic pain and loss of mobility with stage 4 DDD. Some doctors will recommend surgery (fusion), some will suggest you learn to live with it. It depends on your situation. There is risk of worsening the problem with surgery. If you are overweight, losing some weight may reduce the severity of the disc pain. I can provide assistance with this if you are interested. I can be reached at 925-788-6253.
Susan August 17, 2013 at 02:12 PM
You seem like such a nice doctor! I love how you keep just the slight hint of a smile while you are talking...like you have reason to be happy inside! I love the fact that you want to bring back the old fashioned one-on-one doctor/patient relationship because i get tired of feeling like i am going through a drive through restaurant when i go to the doctor (Nurse: "NEXT! May I take your order please." Me: "ah yes, I would like the doctor to give me a prescription for cortisone because of this allergic reaction i am having". Nurse: "Sure, pull around to the front window...that will be $80.00 please."). I chose my children's pediatrician and dentist for their one-on-one, personal attitude, and i have been with them for 16 years now! I wish more doctor's...especially general practitioners (I need one for me & hubby) would have the winning personality and caring attitude that you do! Do doctors EVER go into practice to help people and not for the money anymore?
Bobbie Jo Badillo September 06, 2013 at 05:24 PM
I have been suffering for so long with back, neck and everything else in between hurting! Just got a diagnosis back from my MRI that I have degenerative bone disease and a bulging disc, moderate to severe! So that makes me feel even more worthless because I can't do anything even with the pain meds!
LeighAnn Williams October 05, 2013 at 05:39 PM
Hi, I am 38 years old. I had a spinal from L4 down 13 years ago, recently I have been in severe pain. My doctor just gave me my CT Scan results. I have been diagnosed with osteoarthritis, I have bulging disks, bone spurs and narrowing of the nerve passageways. I am patiently waiting for the Spine Group to schedule an epideral, praying the injection will help with the pain.
Dani Mitchell-Gebhart October 10, 2013 at 03:18 AM
Just turned 40. Broke several vertebrae in my lower back 3 yrs ago. Have had no effects from those breaks until the last 6 months. Weighed close to 300 lbs and have lost 105lbs in the last 18-20 months. Thought i was having a problem with my sciatica but turns out i have a bulging disc and degenerative disc disease (my mom also has this). Been is CONSTANT pain for the past 6 months, just had the MRI at the beginning of September. See the spine Dr. on the 15th of Oct. I have not rested. I don't have time to baby this. Can it get worse? I was getting relief from the inversion table but now that makes it agonizing. Please advise if damage continues is it irreversible?
Dave Wright October 24, 2013 at 08:55 PM
I was just diagnosed with a bulging disc by a spine specialist. I told him my symptoms and he "knew" right away what the problem was. He gave me some stretching exercises, bending backwards, stretching my glutes. I have a follow up tomorrow. Should I insist on an MRI or x-ray?
Jen Rader November 05, 2013 at 01:04 PM
I am a recent runner (past 2.5 years or so). Through running I have lost almost 75 lbs. Got about 20 or so left to go. Please tell me I can continue running! I do not bounce a lot, I run very smoothly and gently, lightfooted. The running helps me control depression, manage my weight, and has made a new person of me! With a neurologist and an MRI, I have been told I have 3 bulging disks in the lower lumbar region, and that is the source of my leg pain... which has been dull and chronic, and only recently sharper and debillitating. Any advice?
Mags Thomson November 09, 2013 at 12:53 PM
I had an mri in 2001 after years of bsck paim. This showed a bulging disc between l4 l5. I was offered fusion infact the consultant almost took it as red he was doing it on me. I refused. I did regular stretching to control the pain and about two yrs ago I took up taekwondo I now find even thpugh ive got restricted movent im also suffering less pain. All the exercise and ttwisting has giving me more mobility I recommend moving as much as possible.
Sherry Furoy Anderson November 11, 2013 at 06:40 PM
I was hurt at work and seen a WCB Dr. He sent me to a physiotherapist I was then told I had a protruding(Bulging)Disk. I did not receive any test or exray and have began treatment. What I am wondering about is the form he filled out said C-34 and it is in my lower back. Everything I am reading says they are L- 5 or L-6 not C-34. I don't know what to believe.
Dave Wright December 04, 2013 at 10:24 AM
Had an MRI, confirmed bulged disc. Have an appointment with a spinal surgeon on Thursday to go over remedies.
Janet Lord January 04, 2014 at 05:09 PM
Very helpful exercises, thank you so much.
Glenn Walden February 04, 2014 at 05:33 AM
If you have a back problem like Dave Wright, From an ex spine fusion patient like me,email me I'll tell you how to get that disc back into place with a massage process,that no doctor or spine specialist on the planet knows. I'm not involved in any medical or massage field,in fact I'm a mechanic who due to my horrific back problems have taught myself a method that works 100%,for any back suffers who would like to know I will tell you!no gimmick!no money!my info for free!because I would like to help people that have affected like I was???I if you want to know email me at.. glennwalden@hotmail.com and yes that is my real name also Thank you and I wish you all the best


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