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Neck Disc Bulge by Barbara Trent

Help, I have a disc bulge in my neck!

If you HAVE, or EVER EXPERIENCED ongoing, severe neck pain, I’m sure you’d agree that – without using expletives – it’s an absolute thorn in the side, and often, more so than pain in other areas of the body.

With simple things like opening bottles or glancing around while driving, causing pain to shoot up into your head and down your arm, and things like washing your hair meaning guaranteed agony!

After treating many, many clients with neck disc bulges over the years and trialling, testing and tweaking many different techniques (and continuing to do so)… I’d like to share with you my advice on how you can successfully move BEYOND your disc bulge, even if you have had surgery!

 Keep an Open Mind

Whether or NOT you have been diagnosed with a disc bulge, the reality is disc bulges are incredibly common. In fact, population studies show that many people with ZERO pain have disc bulges. Yes, you can have disc bulges without actually having pain!

But if you have been diagnosed with a disc bulge on an MRI and you ARE actually experiencing pain, well here are some very helpful facts to know;

  Yes, Size Matters, but there’s more.. 

Only 5% of MRI findings can be directly attributed to pain, and these include larger disc bulges that visibly are compressing directly on a nerve root. So keep in mind that even an obvious disc bulge on MRI may not be directly the source of the pain you are experiencing.

 So what if you have a disc bulge and you still have pain, where does that leave you? 

Well, on the plus side, 80% of disc bulges typically resolve within 12 weeks, with a small percentage having to go down the surgical route if there is very high levels of pain, radiculopathy (pain referral from nerve compression) and high levels of disability.

I’ve already tried acupuncture, pilates, chiro and even physio…So WHAT NOW??

Obviously getting rid of PAIN is your first priority. So for sure medication can play a major role in helping to deal with flare ups AND is also a really helpful aid to allow you to progress through your recovery by:

a) allowing you to tolerate therapy better if you have extreme pain sensitivity and
b) helping you get stronger – as muscles don’t fire well when in the presence of pain or inflammation!

For sure there is actually a whole host of hands on techniques out there that can be useful in reducing muscle tension and pain...but prolonged pain requires using MORE treatment tools!

It’s SUPER IMPORTANT to realise that if you have long standing pain, there is also QUITE likely to be a some NON physical factors (e.g. like sleep hygiene, pain behaviours and emotional stressors) that may be playing a BIG ROLE in keeping you sore...And I can’t emphasise enough how addressing this can make ALL the difference!

But getting your pain to resolve “Effectively” goes BEYOND what I’ve mentioned so far. 

So if you tick the following boxes for:

a) HAVING a disc bulge,
b) NOT being candidate for surgery (or you’ve HAD surgery), and you’re
c) STILL having considerable pain

Then DO NOT DESPAIR! The KEY to resolving even longstanding disc bulges, is in understanding the mechanics of HOW they likely occured in the first place.

There is a lot of progress that you can make by addressing the following MAJOR FACTORS that deal with the ACTUAL underlying issues keeping you stuck.

Remember this guy, ALF?

Think of Alignment, Load & Function!

Let’s deal with LOAD first – why does it matter?

You may well have felt your initial pain come at you out of nowhere, while doing virtually nothing, ‘like the straw that broke the camel’s back!’

But the REALITY is that disc bulges don’t typically happen over-night and that most are slow burners – having more to do with ‘LOAD related changes over TIME‘, less to do with trauma, and little or NOTHING to do with age!

So the key factor here for you to consider is – How well can your discs handle Load?

I often use the ‘front wheel of a tricycle analogy’ to describe how discs are actually designed to take LOAD. Where the spine is like multiple stacked tricycles with each wheel representing a joint;

  • The Front Wheel is Intervertebral Disc, which is designed to carry load
  • The Back Wheels are the two Facet Joints – designed to steer or direct movement


Each spinal segment (and ‘tricycle’) should be able to handle bends, twists, turns and any extra load added to the body externally, as long as the driver (YOU), and your MUSCLES are able to handle the forces, and do so in a safe & sensible way!

As I mentioned being able to handle load requires TWO other factors:

You also need to have good neck ALIGNMENT to distribute the weight on the discs; and be able to FUNCTION properly (i.e. to control the type of forces on your neck that match up with the activities you want to do, even if it’s simply to wash your hair!

So before you make any further decisions on what you’ll do next about your disc bulge (or bulges) and neck pain, why not ask yourself the following crucial questions:

a) Alignment

Am I able to align my neck optimally when handling heavier objects? This requires being able to move your neck freely through its natural range – Yes or No?

b) Load

Have I got good strength in my neck muscles locally and in the rest of my body (global strength) to handle loads; And is my core and scapular muscles showing up to do their job so my neck isn’t getting overloaded – Yes or No?

c) Function 

Has my neck been safely and progressively trained back to handle the type of activities that I want to do – Yes or No?

The good news is that if you answered ‘No’ to most of these questions, there is STILL a lot more scope for you to progress much further in your recovery! 
 
If you have a neck disc bulge and are experiencing ongoing pain or disability why not contact our NeckcarePro service here in Galway Bay Physiotherapy 091 569 706 or visit us at www.galwaybayphysio.ie to book an appointment, so we can help you accelerate your recovery process.

Barbara Trant
(MISCP, MSc Clinical Physiotherapy)

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