A cervical bulging disc is the most common atypical spinal event in the neck and is found in a huge number of people with and without pain. Bulging discs are one of the most misunderstood of all spinal abnormalities and are in no way inherently pathological by nature.
It is crucial to learn all about intervertebral disc bulging before seeking treatment for any diagnosed abnormality found on an MRI or CT study. Far too many patients seek unnecessary care for innocent bulging discs, while others make poor treatment choices for pathological disc irregularities.
This article will assist patients in better understanding the nature of disc bulges in the cervical spine and how these may become problematic, potentially causing neck pain and other expressions throughout the body.
Bulging is a word used to describe a wide range of possible changes in normal intervertebral body anatomy. Doctors have a tendency of using the word to describe both minor and insignificant transient disc shape changes, as well as more permanent and potentially serious alterations, which are also called herniations.
Of all spinal conditions, disc pathologies suffer from the greatest diversity of diagnostic terms, creating a confusing landscape for any patient to navigate. In the truest sense, bulges generally describe asymmetric shape patterns which occur in intervertebral discs, extending the edge of the annulus outwards past its typical position in the anatomy. That’s it. They are not harmful or painful by nature, although they can become so, in some scenarios, when they exert influence on a neurological structure.
There is indisputable evidence that spinal discs bulge constantly and may or may not return to their original shape after each geometric alteration. It is therefore not uncommon for patients to receive results which change greatly from one imaging study to the next, including bulges which come and go, change sides, change size or other possible variations.
Basically, if a disc swells in any area, it may be called a bulge. There is often little, if any, diagnostic distinction made between discs which might bulge innocently and discs which may exert force on a nerve or the actual spinal cord itself.
Bulging discs in the neck are virtually normal. They are virtually universal. Most of us will have one or more of them in our necks or in our lower backs. Some of us have many of them.
The normal process of aging will cause discs to dry out through the process known as desiccation. As we get older and our discs suffer wear and tear, they lose their ability to retain moisture and therefore shrink in size and diminish in elasticity. This causes the disc to bulge in many people. However, since the disc is shrinking and losing mass, these degenerative bulges rarely present any significant health issue, since they rarely influence the crucial nerve structures of the spine.
Traumatic injury to the neck can also cause a cervical disc bulge to occur. These events may be painful, but they may also be asymptomatic. However, trauma-induced bulges have a greater chance of causing pain, at least short-term, compared to bulges formed from typical degeneration.
Many bulges are ruled idiopathic. This means that there is no definitive formative or contributory process to be seen in the spinal region. This is common in younger patients who do not yet have significant deterioration and have not experienced a known injury. Many of these idiopathic disc issues may be caused by genetic, congenital or developed contributors.
It is vital that all bulging discs be evaluated by a spinal neurologist for best results. Discs have no internal nerves, so the simple fact that a bulge, herniation, rupture or extrusion exists will never generate pain. It is only when a neurological tissue is compressed, or chemically affected, that pain might occur. However, even this is not a given. In fact, many patients suffer terrible nerve symptoms including numbness, weakness, incontinence and the inability to stand, without having any significant or lasting pain whatsoever.
So, in summary, here are some pointers to keep in mind. Please discuss these points with your doctors when evaluating the relevance of any disc bulge found in the cervical spine:
Does the disc compress a nerve?
If this is suspected, has nerve conduction testing been performed to confirm nerve involvement?
If so, do the symptoms match the clinical expectation exactly, or are there discrepancies, such as a lack of correlation to the affected areas or over diversity of the expression?
Does the bulge affect the spinal cord?
If so, is the cord being compressed, or merely effaced?
Once again, do the symptoms match the clinical expectation?
If no nerve tissue is affected, is there another theory of pain being linked to the disc bulge?
Is mechanical pain possible, or have other structural changes resulted from the disc abnormality, such as escalated arthritic activity?
If so, can these changes definitively explain the symptoms?
Seeking care for any unsure diagnosis is generally ill-advised. When it comes to neck pain, seeking care for even the most definitive diagnoses often yields poor results.
Remember: statistically, disc bulges respond the least favorably of all spinal abnormalities, since they rarely turn out to be the actual causation of chronic and defiant pain.