1. See your family physician and/or physical therapist

 

There are several reasons that a person may experience pain in the low back region, while pain due to a lumbar disc bulge (characterized by increased pain with movement, leg pain and possibly numbness, tingling and weakness) can be a serious problem, in some cases necessitating surgery. So step 1, if you suspect you have a lumbar disc bulge, don't wait for the pain to go away on its own because it probably will not resolve without some form of treatment! Instead, make an appointment to see your physician or a physical therapist so they can correctly evaluate your complaints and prescribe an appropriate management plan. 

 

2. Take appropriate medication

 

NSAIDs (Nonsteroidal anti-inflammatory drugs) such as Ibuprofen, Naproxen, and Aspirin can help relieve pain and inflammation in the area surrounding the disc. Only take these as recommended by your physician.

 

3. Avoid the activities that are causing pain

 

Often, pain from a bulging disc increases with certain movements especially heavy lifting, bending forward or twisting your back, as well as prolonged sitting.  Avoid these movements to allow the disc to begin to heal! It can be compared to having a cut on your knuckle. The more you bend your finger and pull on the cut, the longer it will take to heal. 

 

4. Sit with support

 

Sitting is often a position that increases pain from a disc bulge, however, sitting with a towel rolled up and placed at your belt line can be helpful in tolerating those times when you need to sit (especially at work or when riding in a car). This helps you sit up straight and keeps the natural curve in your low back which adds support to the injured disc. 

 

5. Avoid low chairs 

 

Sitting in a low chair or a soft piece of furniture will likely lead to "slouched" sitting. This places excessive stress on the bulging disc, will cause pain, and lengthen the recovery time.

 

6. Exercise

 

It is helpful to perform gentle stretches when healing from a bulging disc. Often it is helpful to lie on your stomach while propping your upper body up on your elbows. Rest here 5-10 seconds and return to lying flat. Repeat 10 times and if this is comfortable repeat every 2-3 hours. Working up to walking 20-30 minutes for cardiovascular exercise will be important when you can tolerate this. Your physical therapist can be very helpful in teaching you other effective exercises.

 

7. Wear a lumbar support brace

 

If you have a physically demanding job or cannot completely avoid more strenuous activity, a lumbar support brace may be helpful in unloading the injured disc while you continue what you need to do. These are relatively inexpensive and your physical therapist or physician may be able to assist in selecting the best one for you to wear.

 

8. Have patience

 

After beginning treatment, it's important to realize that a bulging disc will heal over several weeks or months before pain is no longer present. It will take time to heal, but most people will heal without requiring surgery and knowing this may provide peace of mind during the healing process.

 

9. Stop Smoking

 

If you're a smoker, another reason to quit is that you're placing yourself at a higher risk for developing back pain including from a bulging disc. Smoking has been shown to weaken the lumbar discs over time by reducing the body's ability to deliver nutrients to the discs. Smoking may also lead to a higher sensitivity to pain.

 

10. Try heat or ice

 

Either heat or ice may be helpful in managing pain. They will not cure the problem, but applying them for 15-20 minutes several times per day may help to at least reduce symptoms as part of your overall treatment plan.

 

Aaron Treiber, DPT

Orthopedic Spine Physical Therapist

Mid-Michigan PT Clinical Team

 

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