The lumbar disc connects two vertebrae while allowing them some motion. It also serves as a cushion or shock absorber. The lumbar disc consists of several outer layers made of tough fibrous material called the annulus. Its center, the nucleus, has a gel-like consistency. With normal aging, the disc may lose fluid and become dehydrated, causing compression and deterioration of the annulus. When this outer layer is worn out, the nucleus bulges out, forming a bulging lumbar disc.
When this happens, the bulging lumbar disc loses its ability to smoothly hold together the two vertebrae that it connects, causing instability as well as irritation of nerves, that both lead to intense pain.
A severe case of bulging lumbar disc results to inflammation of the involved nerve root that directly causes the pain the sufferer feels down one leg, a condition known as sciatica. With direct pressure on the nerve, the leg or foot becomes weak.
In a bulging lumbar disc, there is a definite displacement of a disc’s nucleus where a fragment of it pushes out of a tear in the annulus. Usually, a bulging lumbar disc occurs with the start of disc degeneration.
Initially, conservative treatment is used to treat a bulging lumbar disc. Such treatment usually starts with a few days to weeks of rest and maintenance of moderate (painless) level of activities. The doctor may also prescribe NSAIDs or non-steroidal anti-inflammatory drugs such as Advil, Motrin, Celebrex and others. Sometimes, the doctor will also prescribe epidural steroid injections in order to provide medication to the specific level of the bulging lumbar disc.
Another form of conservative treatment is physical therapy, which is performed under the supervision of a qualified physical therapist who will conduct an in-depth assessment and, along with the doctor’s diagnosis, will perform different types of modalities that have been proven to be effective in treating bulging lumbar discs.
If the abovementioned non-invasive treatments are not effective in treating the bulging lumbar disc and the patient continues to suffer severe pain and greater muscle weakness, the surgery becomes necessary. Surgical treatment may be in the form of microlaminotomy, which is used for large herniations, or a percutaneous discectomy, if the disc bulge is small and the disc fragment is not extruded completely.
The majority (about 90 percent) of bulging lumbar disc patients does not require surgical treatment and gets well with only conservative forms of treatment, although, about 5 percent of patients with degenerated lumbar discs will continue to experience severe lumbar spine pain, which may affect normal functioning. This incidence is often not directly caused by surgery but the exact causes are unclear.
If the surgery is successful, about 85 percent of patients will be able to go back to their normal functions after six weeks. There may be permanent feeling of numbness in small areas of the affected leg but this is not debilitating.