My Bulging Disc Isn’t Touching A Nerve So Why Is There Still Pain?

“I had an MRI for my back pain and they said I had bulging discs but they’re not causing my back pain because they’re not pressing on a nerve”… This kind of comment and variations like it are the bane of many people with lower back pain. And the dismissal of such issues as not being the cause, only to be sent to pain management is a real failure of the systems of support that are supposed to help you with your back health. Why does this happen and what can we do about it? That is what we’ll be discussing today and hopefully you find it gives you hope if you’ve been told this by your GP, medical doctor or specialist.

To watch the full video click here.

The bulging disc is not touching the nerve

The fact that the disc is not touching the nerve in the moment that you did the MRI means just that. For many the MRI is in a lying down position, a position with a fraction of the compression on the discs compared to the loaded position. When we look at things like loaded imaging or video imaging, we can see that tissues that are injured can sometimes move in ways unexpected. Therefore just because your disc happens to not be pressing on the nerve, and that you don’t have the same excruciating pain in the MRI tube as usual, does not mean that when you’re at home and feeding the dog, or moving around the house, the disc cannot be further strained or pushed to create more pressure on the nerve.?

In addition to this, the disc itself does not HAVE to press directly on the nerve to be a problem, or be painful and this is something that needs to be understood.

If the disc is bulging, it is not as healthy as it should be

The simple truth as is often visibly evident on the MRI is that one or two of those discs, usually L4,L5 and L5,S1, the last two discs in our spine, are more degenerative than the others. When looking at the MRI you can literally see the difference between these and the discs higher up in the lumbar spine. Often the discs in question will be bulging and dark grey, as opposed to others being nice and light in colour, almost white. This whiteness denotes fluid content.?

Therefore if the discs in question are in fact bulging we know that the health in that region is substandard, and not just the disc, but likely the other structures that make up that segment of the lumbar spine. The ligaments etc around the inter-vertebral junction. And therefore their integrity and resilience in question. Especially when coupled with an examination showing pain and provocation under load and other movements that are designed to test and strain segments of the lumbar spine.?

Imaging infrequently tells us something we didn’t already know

It’s important to note that when it comes to back pain and sciatica, if you’ve done a good consultation and examination, you already know that the tests for spinal integrity are indicating that you’re back is not in the best condition, its capacity to bear load impaired, especially when focussed to the low lumbar spine. The good clinician will already know that the back is the problem, you the patient, know the back is the problem! So the imaging that reveals the bulging disc only adds a little more context and description.

Why do you have pain if the bulge isn’t touching the nerve?

The pain can be there for a number of reasons related to a movement that you might do to directly strain the injured tissue, i.e. if you have a sprained wrist, and then bend the wrist in that same direction it will hurt, not because you “pressed a nerve” but because you’re ripping the same ligaments that have just been torn! The secondary reason for pain that’s a little more unique to the low back is that congestion fills the spaces around the spine and this can really create a lot of “pressure” because of the bony holes and their inability to “stretch” to accommodate the increased pressure. This has the result of irritating the nerves in the region giving rise to the back, buttock or sciatic pain.

The solution to these bulging discs in your low back

You cannot fix a problem if you’re in denial, and unfortunately it is the lack of thought about the issue that results in patients being sent to “pain management” instead of for proper rehabilitation work. It is the denial of the medical practitioner in this case that is the issue. By diverting away from the clear lack of health in the area and presenting information, sending you on for a pain management appointment in 6 weeks or 6 months, you’re left alone to make the problem worse.?

Instead, treat the back as an injury, use proper rehabilitative exercise and protocols, like those in the Back In Shape Program, to start to rehabilitate and restore strength, resilience and health back into the area. This will help the region compensate for the damage and stabilise the region again. Granted, depending on the scale of disc bulge, it likely will not look nice and white like the others again, but the body has a remarkable capacity for shoring up these areas and stabilising them if you only give it the support and guidance required. If you do things right there is every chance you’ll get back to being able to do all the things you want to again without this terrible back pain or sciatica.