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Progression of a Disc Issue in the Spine

bulging discs

By: Mike Bills, MS PT

There are many things that can go wrong with a disc in your spine.  You may have heard the terms degenerated, bulging, herniated, ruptured, slipped and many more.  These are basically all describing the same thing just a slightly different progression in each case.

A disc that is irritated or has some abnormal pressure on it may be termed a “slipped disc”. What this means is that the surrounding muscles have not done a good job supporting the spine and maintaining proper alignment of your spine and as a result, the increased pressure on the disc or discs from the surrounding muscles has allowed the disc to start to lose its shape and/or potentially move slightly to one side.

This loss of shape or slight movement to the side then starts the process of pinching on something, which starts the pain cycle. This may also include a loss of movement or difficulty performing activities during the day if the bones start to rub against each other.

If this problem persists and the pressure remains on the disc, the problem can progress to a bulging disc. This means that the pressure on the disc has stayed for too long or has continued to increase. Now, the disc is actually sticking out to the side. Think about the analogy of a jelly donut. If you push on it long enough or hard enough, the donut will start to loose its shape and some of the donut will begin to have a protrusion out to the side.  The walls of the disc are beginning to weaken. This is a sign that your problem is getting much more serious. Pain will increase and you may start to develop symptoms down into other body parts like into your arm or your leg.

The next progression would be a herniated or a ruptured disc. The pressure on the disc continues and due to the pain, surrounding muscles get very tight. The rings in the wall of the disc cannot hold up to the pressure anymore and now a hole forms in the outside of the disc and the jelly starts to leak out. It can seep out gradually, which is indicative of a herniated disc, or, it can just blast though the wall, which is what happens with a ruptured disc. Either way, your symptoms will get worse and will spread into new places as well.

A degenerative disc is the most common condition that occurs in the spine. This is simply where the wall of the disc is breaking down slowly over time as the result of minor injuries, poor posture, lack of muscle strength around the spine, tight muscles, stress, etc.  This is all increasing the pressure on the disc and the rings in the disc are breaking down. The disc loses its shape slowly, starts to put pressure on other structures and the problem slowly progresses.  

Generally, a disc problem of any of these levels will initially present itself as a stiffness or soreness in the spine and maybe some pain in the surrounding areas. In the case of a lower back problem, it may be pain in the center of the spine of the lower back accompanied by pain off to the sides of the spine or even into your buttocks. For the neck, you would experience pain in the spine as well as some pain into the shoulder or shoulder blades. If the pressure on the disc continues, increases, or isn’t relieved, the disc can start to bulge or slip further and thus the symptoms will progress. Not only will the pain intensify and become more constant, but it will also spread into new areas such as down your leg or down your arm. By now you will most likely be modifying how you are doing things due to the pain as well. While this may help to decrease your pain temporarily, it’s important to understand that it is not helping to relieve the pressure on the disc. The problem will get worse. As the problem continues to progress, the pressure on the disc will continue to increase, the disc will get weaker and this will allow the disc to either bulge even more, or eventually rupture. The disc will lose its shape and not only push on the nerve but also the vertebra. As a result, your symptoms of pain will get more intense and more constant. You will also begin to experience numbness or tingling as well as possible weakness or loss of function in areas.

The good news is that physical therapy can address these disc issues regardless of how far along this issue has progressed. Through specific exercises and manual, hands-on treatment, the physical therapists at Loudoun Sports Therapy Center can address your disc issue and prevent those symptoms from impacting your life. Call our office TODAY at 703-450-4300 and schedule your full evaluation.  

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