Alternative names: Bulging Cervical Disc, Slipped Cervical Disc, Cervical Disc Protrusion.
A bulging disc is one of the most common spinal injuries and occurs when a weakened or deteriorating intervertebral disc bulges out of its normal position. Most commonly (90% of the time) this occurs in the lumbar (lower) spine, but when it occurs in the upper spine (neck region), it is known as a Bulging Cervical Disc.
A bulging disc is not the same as a herniated disc. A bulging disc simply bulges outside of its normal space between two vertebrae; in a herniated disc, the tough outer layer (annulus) ruptures and the inside (nucleus) leaks out.
Bulging discs are considered a natural part of the aging process and disc degeneration. However, they can also be caused by excessive stress on the spine, overuse, misuse, or spinal injury. Smoking is also a risk factor for disc deterioration.
When considering the upper spine (neck bones), we need to remember that these 7 most delicate bones in the spine – and the discs that separate them – need to support your head (weighing 9 to 12 pounds, or 4 to 5.5kg) while at the same time allowing a wide range of movement. Even without any additional trauma, this means a lot of wear and tear over our lifetimes.
Bulging cervical discs often do not cause symptoms unless they bulge significantly into the spinal canal. (A bulging disc can become a herniated disc, which generally causes more significant symptoms.)
When a bulging cervical disc does cause symptoms by putting pressure on the spinal cord or a nerve root, these may include:
Pain, numbness or tingling is usually only on one side (left or right) because a disc will usually bulge towards one side of the spinal canal.
Once a bulging disc is suspected, diagnosis needs to be confirmed through imaging. Although an X-ray can show changes in the spaces between the vertebrae, it cannot show a bulging disc. This requires an MRI, and if more information is required then a Myelogram with CT Scan can be used.
Treatment depends on the symptoms that are present. Watching and waiting, rest, pain medications, and physical therapy are the first things to try. Symptoms often resolve within several weeks to months, but if instead they become progressively worse then surgery may be desirable.
Laminotomy is a surgical procedure in which an opening is made in the lamina, and a discectomy (becoming less popular now due to inherent problems) involves removal of a disc. Other more radical types of surgery are also used.
A bulging disc is not a serious condition and does not require treatment until it starts causing symptoms. The pain may clear up on its own or become worse over time.