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Experts say 60% of people will experience lower back pain at some point. In many cases, a herniated or bulging disc is to blame.
“It’s a common disorder that we deal with daily and affects the majority of Americans at some point in their lives,” said Moises Googe, DOa neurosurgeon with Corewell Health.
What causes the bulge
Herniated discs have complicated causes, including both modifiable and beyond our control factors.
Smoking is a major modifiable behavior that causes bulging discs, Dr. Googe said.
“Nicotine is a vasoconstrictor, so it closes off the tiny vessels in our nerves, tendons, and joints, which leads to decreased blood flow,” he said.
This decrease in blood flow causes the discs to dry up, sag and swell.
“Think of it like stepping on a tin can. Just like the can, a disc expands as it flattens,” he said.
Other modifiable or somewhat modifiable factors include excessive weight, diabetes, osteoporosis, and extreme physical conditioning.
Dr. Googe said age and genetics are the main non-modifiable factors.
Prevention
“Some people are just prone to herniated discs as they age,” he said. “People who struggle with multi-faceted medical issues, conditions such as liver disease or cardiovascular disease, may also be predisposed to spinal conditions.”
Manual labor or high-impact sports can also increase your chances of suffering a herniated disc, he said.
Athletes participating in certain contact sports, such as football and hockey, as well as professional and amateur golfers may develop bulging discs.
Dr. Googe noted that playing golf is one of the highest risk factors for developing spinal problems due to the rotational components of a golf swing.
As a general rule, all athletes involved in high impact sports should wear proper protection and padding.
Prevention often involves changing your lifestyle, he said.
“Quit smoking – get advice if you need it – maintain a healthy weight and exercise for good core muscle strength. Also, it’s wise to get a routine medical checkup to get your blood pressure under control blood pressure and, if you have diabetes, make sure it’s under control,” he said.
For most people, prevention is simple.
“The best way to prevent the development of a herniated disc is through healthy diet, exercise and a healthy lifestyle. It’s as simple as that,” Dr. Googe said.
Treatment
Early treatments for herniated disc include physical therapy, injections, anti-inflammatories, ice, heat, rest, chiropractic care, muscle relaxants, steroids, massage, and/or acupuncture.
Dr. Googe said most herniated discs, around 85%, tend to resolve on their own using these conservative methods.
However, pain and weakness in about 15% of cases may require surgery.
Indications for surgery usually include excruciating pain or weakness in the legs or nerve compression causing bowel and bladder dysfunction.
Generally, herniated discs are irreversible, although ongoing studies are evaluating whether stem cell injections can successfully rehydrate a disc.
Patients usually acclimatize.
Dr. Googe said exercise focused primarily on core strength can help manage a bulging disc.
“When you unload weight and compression on the spine, you also unload pressure on the disc,” he said. “Crunches are great, as are planks, plyometrics, and stretch exercises.”
Stretching, yoga and Pilates are also helpful for people managing the condition, he said.
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