Bulging Disc in the Lower Back: Causes and Treatment.

A bulging disc in your lower back is most often caused by naturally occurring changes as you age. Most bulging discs don’t cause symptoms, but they may progress to become herniated discs.

Lower back pain is very common. Researchers estimate that 619 million people worldwide had lower back pain in 2020, with 843 million people estimated to experience lower back pain by 2050.

Problems with the discs in your lower back are a potential cause of lower back pain. This includes bulging discs.

Let’s explore what causes a bulging disc in your lower back. We’ll also cover symptoms to look out for and how a bulging disc is diagnosed and treated.

Bulging disc vs. herniated disc

Your intervertebral discs have two layers. The nucleus pulposus is the softer, jelly-like inner layer. It acts as a shock absorber, dispersing forces when you move. The annulus fibrosis is the tough outer layer that’s made of cartilage. It helps to support and protect the nucleus pulposus.

A bulging disc still has an intact annulus fibrosis. However, the disc itself has extended beyond the surrounding vertebrae and into the spinal canal. It can sometimes impinge on nerve roots or the spinal cord. A bulging disc may eventually progress to a herniated disc.

In a herniated disc, the annulus fibrosis is not intact and has ruptured. This allows the soft nucleus pulposus to leak into surrounding tissues.

What can cause a bulging disc in your lower back?

There are a couple of potential causes of a bulging disc in your lower back. We explore these below.

Degenerative disc disease

Degenerative disc disease (DDD) is a common cause of bulging discs in your lower back. It occurs due to natural age-related wear and tear to your discs.

Generally speaking, discs undergo a variety of structural changes as we age. One of these is that they tend to dry out and contain less water, causing them to lose height and bulge outward.

The discs in your lower back, called the lumbar spine, are commonly affected by DDD. Researchers have estimated that 266 million people worldwide experience lumbar DDD each year.

Increasing age is one of the main risk factors for lumbar DDD. Genetics also play a significant role, with about 50–70% of DDD being caused by genetic inheritance. Other things that may accelerate the development of DDD include:

• previous injuries
• obesity
• repetitive strain on your lower back, such as frequent heavy lifting, pulling, or bending
• poor posture
• sedentary lifestyle
• smoking
• socioeconomic factors

Injury

While bulging discs in your lower back most often happen due to DDD, it’s possible that an injury may cause them as well. This may occur due to things like a fall or a car collision.

Sports injuries can also often impact your lower back. The lumbar spine is a commonly injured site in many sports, such as American football, baseball, and dance.

Bulging disc in lower back symptoms

Many people with a bulging disc in their lower back have no symptoms.

For example, an older 2015 study found that the prevalence of disc bulging was 30% in participants at age 20, increasing to 84% by age 80. None of these people had any symptoms.

However, it’s possible for a bulging disc to begin to press on nearby tissues, such as the nerve roots in your lumbar spine. This could lead to lower back pain that may:

• range in severity from mild to severe
• come and go
• spread into your buttocks and thighs
• become worse when you do certain motions, such as lifting or bending
• cause weakness, numbness, or tingling in the legs, which can affect walking

Bulging disc in lower back emergency symptoms

Generally speaking, it’s important to see a doctor to discuss any lower back pain that’s persistent, recurring, or affects your daily activities.

However, there are some signs and symptoms that signal a medical emergency. Go to the nearest emergency room for any lower back pain that:

• comes on suddenly
• is severe
• develops after a known injury
• happens with a loss of sensation anywhere in your lower body or loss of strength in your legs
• affects your ability to walk or stand on your own
• occurs along with issues affecting bowel or bladder control

How is a bulging disc in the lower back diagnosed?

If you see a doctor for lower back pain, they’ll start by getting a medical history. They’ll ask about things like:

• when your pain started and if anything may have triggered it
• where specifically you feel pain
• if you feel pain when you do specific movements

Your doctor will also perform a physical exam. They may also observe how you walk and test your reflexes and ability to feel sensations.

A straight leg raise test can help to determine if more severe bulging or a herniated disc is present. During this test, you lie on your back while your doctor lifts your leg. Feeling pain down your leg as this occurs can signal a disc issue.

Imaging allows your doctor to view your lumbar spine and is a vital part of detecting a bulging disc. X-rays, MRI scans, or CT scans may be used to help determine the location and severity of a bulging disc.

How do you treat a bulging disc in the lower back?

A bulging disc in your lower back may be treated with home remedies and over-the-counter (OTC) treatments or with medical treatment.

Home remedies and OTC treatment

Some of the potential home remedies for pain caused by a bulging disc in your lower back include:

• using hot and cold therapy with a heating pad or a cold compress
• staying active, but avoiding activities or motions that cause your pain to flare
• trying to improve your posture
• performing core strengthening exercises
• taking steps to manage your weight if you have overweight or obesity
• getting adequate, quality sleep at night
• finding effective ways to ease stress, as stress may make pain sensations worse

You can also use OTC medications to alleviate lower back pain. Some options include acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs) like:

• ibuprofen (Motrin)
• naproxen (Aleve)
• aspirin

Medical treatment

If home remedies and OTC treatments don’t help with lower back pain due to your bulging disc, medical treatment may be recommended. This can include:

• working with a physical therapist
• receiving steroid injections
• having a surgical procedure if other treatments aren’t effective

Frequently asked questions about bulging discs

Below, we’ll answer some more frequently asked questions about bulging discs.

How bad is a bulging disc in your lower back?

A bulging disc in your lower back typically occurs due to natural changes that occur with aging and it often doesn’t cause symptoms. However, it’s possible for a bulging disc to progress to a herniated disc. This is a more serious condition that requires medical treatment.

Can a bulging disc go away on its own?

Because discs often bulge due to degenerative changes, they may not go away on their own. While many bulging discs are asymptomatic, several treatments are available to manage a bulging disc that’s causing pain.

Is walking good for a bulging disc?

Sedentary behavior can contribute to degenerative disc disease (DDD), so walking can be a gentle way to stay active if you have a bulging disc. The key is to keep exercise low impact so that you don’t aggravate your condition.

What are the signs a bulging disc is getting worse?

New or worsening symptoms can signal that a bulging disc is getting worse. Keep a lookout for pain that gets worse or radiates to your buttocks or thighs and feelings of weakness in your legs.

What is the best pain reliever for a bulging disc?

OTC pain relievers like acetaminophen and NSAIDs are often used to manage lower back pain due to a bulging disc. Steroid injections may be used to help with pain if OTC pain relievers aren’t effective. Always check with a doctor before starting OTC medications for a bulging disc.

Takeaway

A bulging disc in your lower back happens when a disc extends past the surrounding vertebrae. Unlike in a herniated disc, the strong outer layer of a bulging disc remains intact.

Most of the time, a bulging disc happens due to DDD, which occurs naturally as we age and may be greatly influenced by genetic factors. Repetitive motions, poor posture, and obesity also contribute to DDD.

Many bulging discs don’t cause symptoms. When symptoms occur, they can be treated with a combination of home remedies, OTC treatments, and medical treatments. It’s possible for a bulging disc to progress to a herniated disc.