The bulging disc tends to be the most common cause of back pain. There are several different stages of breakdown within the discs of the spine and the bulging disc is normally the first phase of break down. There are several reasons and multiple causes for a bulging disc. Like any type of pain the better you understand what is causing your pain the easier to treat, or at least easier to pick what makes the most sense for your condition.
My goal is to help you understand your spine so you can make better decisions about what to do and what not to do!
The spine is made of bones, nerves, discs and muscles. There are 24 vertebrae (bones) between your head and hips and a disc separates each vertebra. The disc is part cushion that allows for 360 degrees of motion, and part shock absorber.
The discs separate the vertebrae and allow for nerves to exit out of the spine. The nerves that exit the spine pass adjacent to the disc. This is important because if you have subtle changes within the disc you will very often have a pinched nerve, this can result in severe pain. See my blog on sciatica.
Your discs are very much like jelly donuts. The outer portion of the disc is thick cartilaginous material, we call this the annulus. The inner portion of the disc is a jelly like material. The key to a healthy disc is to make sure you have healthy jelly. The jelly can change over time as a result of wear and tear; this can lead to a low level degenerative process.
So what causes a bulging disc?
There are 2 reasons you can have a bulging disc. The first reason tends to be less common of the 2 reasons but still tend to happen frequently.
- The annulus is the other potion of the disc, this portion holds in the nucleus. When the annulus is under an abnormal amount of pressure you will get small tears. The normal pressures on the disc will cause the nucleus to migrate in the direct of the tear (weakness). This will cause the annulus then to start to push out between the vertebrae. This is a bulging disc. (It’s bulging out between the two vertebrae.) When the disc pushes out, the outer fiber of the annulus will become irritated, and this will cause back pain. It can also cause a pinched nerve. This will result in pain in the arm or the leg depending on where the bulge is. The pinched nerve in the legs is known as Sciatica.
- The second cause of a bulging disc is the most common reason.
The disc is like a jelly donut, but truthfully it more like the tire on your car. The outer portion of your disc is much like the outer portion of your tire. The tire holds the air in and the air gives stability to your tire. When the tire has the proper amount of air it is very stable. When the tire runs out of air the tire becomes unstable.
Would you drive your car on the highway at 75 miles an hour if your car had the proper amount of air…? Well the answer is of course is yes. But would you drive your car at 75 if you had a flat tire. Probably not because it’s not stable. So what does this have to do with a disc? The disc of your spine relies on the jelly for stability.
When the jelly is well hydrated and healthy the disc is more stable.
Unfortunately, what can happen is that the jelly can start to dry out, this is the same as a tire running out of air. The jelly gives stability to the disc; the same way air gives stability to a tire. When the jelly gets dry the result is a flat tire. When you have a flat tire the outer portion of the tire starts to bulge out. The same happens in the spine when the disc starts to dry out the outer portion of the disc will start to bulge out. This is a bulging disc.
So to recap; there are 2 main reason for bulging discs.
- The annulus (tire wall) starts to break down because of micro tears. The jelly (air) starts to push out the fibers where the weakness is present, resulting in a bulging disc. The nucleus (jelly) is healthy but the annulus is weak.
- The nucleus (jelly) dries out. (The tire runs out of air, a flat tire). The annulus bulges out…. The annulus is healthy and jelly is dried out!
A little secret is if you have a bulging disc you might just need more hydration of the nucleus. (Air in your tiers). We call this FUNCTIONAL DISC REHYDRRATION!