What are bulging disk treatment options?

You might find the answer I provided to a similar question helpful: How to treat my back pain and numbness in leg?
 
Best wishes, Peter

Treatment for disc injuries ranges from exercise and yoga to surgical intervention. The difficulty is determining which will work best for you. This is where your GP and physio will be able to guide you to the best available approach.

As your GP and Physio will be aware of, there are specific guidelines that can be utilised to best treat your condition. Currently it is recommended that initial intervention is aimed at reducing the pain and undergoing conservative management. If the practitioner notes that there is deterioration in your condition or there is no change over a 6-8 week period, they may refer you for specialists opinion.

Most often, conservative managment for lumbar spine disorders is all that is needed to get you back to your normal activity. This includes chiropractic, physiotherapy, osteopathy, acupuncture, exercise and yoga/pilates as well as medications that your GP may give you to manage your pain levels during this period.

Currently, the Americal College of Physicians and the American Pain Society recommend the treatment approaches chiropractors use alongside exercise therapy and acupunture in the treatment of chronic and subacute low back pain.

The key issue to sort out is the extent of the disc bulge, the location (i.e.  the level it is at - low back, neck?) and exactly what direction the disc is bulging in. 
Many disc bulges are not identified, as they don't always cause symptoms. 

One theory out there is that traction (or stretching) of the disc can help to improve the mobility of the whole vertebral segment, leading to decreased pain and numbness. 

Our clinic uses a specialised table, called a Motorised-Flexion-Distraction Table, which can help to cause traction on the local disc level. Check out our website for a video of the table in action (www.sydneyspine.com.au). The key issue to sort out is the extent of the disc bulge, the location (i.e.  the level it is at - low back, neck?) and exactly what direction the disc is bulging in. 
Many disc bulges are not identified, as they don't always cause symptoms. 

One theory out there is that traction (or stretching) of the disc can help to improve the mobility of the whole vertebral segment, leading to decreased pain and numbness. 

Our clinic uses a specialised table, called a Motorised-Flexion-Distraction Table, which can help to cause traction on the local disc level. Check out our website for a video of the table in action (www.sydneyspine.com.au). 

A McKenzie Physiotherapist has post-graduate training in spine probelms.  They will get you to perform numerous movements with the aim to find one key exercies to rapidly reduce the pain.  If the pain centralises - ie less in your leg and more in your back, then that's a good sign.
Watch this video clip to find out more http://www.youtube.com/watch?v=8BXDe5fcp7I

As there is a vast array of severity in radiculopathies (pain in the limb due to nerve compression) this question will best be dealt with your primary health care provider. In our practice we are often called upon by GPs and neurosurgeons to trial a conservative approach to this issue before the neurosurgeon will recommend surgery. 

Ask your neurosurgeon if he/she feels that conservative management may be right for you. Unfortunately, not everyone can avoid surgery for resolution, but there are specialists there to assist when things have gone too far. 

Hi Anneabell,

Sounds like you are having appropriate management directed by your GP… An MRI to assess the integrity of the discs in the lumbar spine and possible nerve compression helps with the diagnosis.

As Sandra mentioned earlier, a credentialled or diploamed McKenzie physiotherapist is very well skilled to direct your treatment. My suggestion to you… please go to www.mckenziemdt.org.au to find a McKenzie physiotherapist near you. 

A key feature of the Mckenzie Method is to educate YOU ON HOW YOUR BACK MOVES. This education is vital with or without surgery! A neurosurgeon I work with has suggested that education is the first part of treatment! Having a read of TREAT YOUR OWN BACK is a great place to start. I have used this with a couple of patients in the last week with good effect!

If you have tried treatment to date, and had limited benefit, the cortisone injection may well help. Approximately 40% of people who have a cortisone injection for back pain, then benefit from the McKenzie Method.

All the best with your recovery!

Neil

For starters your clinicial needs to determine if your pain is coming from the disc area or possibly related to other lumbar/pelvic regions.  Alot of people have bulging disc on scans but are non-symptomatic as disc degeneration is a normal occurance of life.  The therapist firstly needs to assess if there is neural impingment?  Referred pain you are experiencing can come from poor muscular support, poor posture or any thing that can cause irritation/compression to the nerve.

You mentioned you ahve bilateral leg pain?  If it was your knee you would have only pain in that knee and possiblity below.  This is easily rulled out by a good assessment of the knee.

There is solid eviedence that if your symptoms are disc related stability and postural exercises will help if you do not have significant nerve impingment.  Most other therapies like traction/manipulation massage have great short term effects but you really have to correct the underlying issue (strength, posture, work environment) which your therapist can help you with.

Good luck with your rehabilitation.