Bulging Disc Diagnosis & Treatments
What Are The Diagnostic & Treatment Options For A Bulging Disc?
Often patients who suffer from a bulging disc (also known as a protruded disc), do well with conservative therapy and never need to pursue interventional or surgical procedures. In fact, some patients with bulging disc often have their symptoms diminish within 4- 6 months. When symptoms are severe and last more than 3 months with no relief of conservative treatment, patients may benefit from further diagnostic injections and least invasive or surgical procedures for bulging disc treatment.
How is a Protruded Disc Diagnosed?
A comprehensive diagnostic workup is essential to properly diagnose a protruded disc. The following workup provides an accurate and thorough diagnosis, as well as a disc protrusion treatment option.
• Medical History – Inventory of symptoms, previous treatments and medical care.
• Physical Examination – A careful examination by a spine specialist for limitations of movement, problems with balance, and pain. The examination should also cover loss of reflexes in your extremities, muscle weakness, loss of sensation or signs of spinal cord damage that are associated with bulging discs.
• Diagnostic Tests – Generally, when searching for signs of disc protrusion, plain x-ray films are taken which allows the physician to rule out other problems such as infections. CT scans and MRIs are often used to give them a three-dimensional view of the lumbar spine and can help detect bulging discs.
• Pain Mapping Injections – These injections can be used for therapeutic relief but more important, can pinpoint the pain generator.
Non-Operative Protruded Disc Treatment
- Medications-Ant-inflammatories: muscle relaxers and on rare occasions narcotic medications
- Alternating Heat/Cold Therapy: during the first 24-48 hours
- Physical Therapy Exercises: including stretching, massage, and strengthening
- Chiropractic Care. Many patients find relief in seeing a chiropractor for re-aligning and improving motion in “locked” joints.
Interventional Spine Procedures for Bulging Disc Treatment
- Epidural Steroid Injections: are used two-fold, first, to relieve inflammation of the affected spinal nerve and secondly, diagnostically to confirm the correct affected spinal level at which the pain originates from.
Least Invasive Procedures for Bulging Disc Treatment
If pain still persists after conservative treatment and interventional spine injections, and there is evidence by CT Scan, MRI or X-ray or neurological deficit, then surgical intervention is usually recommended.
The following least invasive procedures can be used for bulging disc treatment with 90% success:
- Stem Cell Therapy: Regenerative stem cell therapy offers patients suffering from discogenic low back pain a less invasive healing option. Stem cell therapy performed by our surgeon is an innovative way to use your body’s own stem cells to treat degenerative and discogenic pain. After conservative efforts have failed and the patient is still in pain, this is an excellent alternative to invasive surgery.
- Endoscopic Discectomy: With an incision less than a 1/2 inch, the surgeon can avoid all lamina bone resection and enter the spinal canal without disturbing or cutting muscle. The surgeon directly observes the herniated disc in a water (arthroscopy) environment with a surgical working channel endoscope coupled with a HD camera. Recovery after endoscopic surgery for bulging discs is superior to microdiscectomy, with most patients returning to work within a 1-2 weeks. Conscious sedation is used with the patient awake, comfortable and aware during the procedure.
Bulging Disc Surgery Recovery
Most patients can begin getting out of bed one hour after undergoing endoscopic surgery to treat their bulging disc and return home shortly afterward. Activity is gradually increased and patients are typically able to return to work within 1-2 weeks. There will probably be some pain after the endoscopic procedure and is usually localized to the incision site. However, just because there is less or no pain, always consult your physician or orthopedic surgeon before beginning any physical work.
At home, you will need to continue to rest. You will be instructed on how to gradually increase your activity. You may still need to take the pain medications for a while. However, pain and discomfort should begin to reduce within a week after surgery. The doctor will discuss with you other techniques for reducing pain and increasing flexibility before you leave for home. The doctor will also discuss with you a time frame for when you can resume basic activities such as walking, driving and light lifting, and when you can return to more advanced activities such as physical labor, sports and yard work.