Acupuncture for the treatment of disc bulge & herniation is helpful, as with many other conditions, in increasing blood flow prompting the body to release endorphins. Disc problems have a high prevalence among those that are 30-50 year old, and are two times more likely to occur in men than in women. The problem is that many times disc bulge goes untreated and then turns into the bigger problem of herniated discs. Acupuncture is a holistic way to create long-term healing for disc bulge and herniation.
Western Medicine Disc Bulge & Herniation
It is important that we understand how disc bulge and herniation happens as well as how the spine is structured. There are 24 vertebrae of the spine in addition to 23 spinal discs. The discs sit between each pain of vertebrae, and disc bulge happens when the discs are damaged & bulges outward beyond the vertebrae. Most often it occurs in the lower back, but can also occur in the neck and signs & symptoms depend on where the disc is situated, and will usually affect one side of the body. The discs provide the spine with the elasticity that it needs to move and act as a shock absorber that our movements create during daily life and activities. If the discs are bulged, left untreated, and the pressure becomes too great, they turn into herniated discs which occurs when a spinal disc ruptures. The symptoms for disc bulge and herniation are many times the same, and there are some people that may have it with no symptoms.
Symptoms of Bulging Disc:
- Local pain at the site of the bulging disc
- Neurological symptoms such as tingling, numbness, or searing pain
- Pain when standing upright with good posture
- Muscular weakness, cramping, or spasms
- Radiating pain extending into the arms or legs
- More intense pain during strenuous activity
The specific symptoms of disc bulge will also depend on the region of the spine that’s affected.
Examples of specific symptoms associated with disc bulge:
- If the bulging disc pinches the nerves in the thoracic spine, then the patient may experience pain encircling the chest.
- If the bulging disc compresses the nerve tissue of the cervical spine, then the patient may experience arm weakness.
- If the bulging disc affects the nerves extending from the lumbar spine, then the patient may experience tingling in the feet and legs.
The trouble, or difficulty with bulging disc is that its symptoms can mimic other conditions of the spine. Therefore, it is vital to have your patient in as soon as possible for a thorough consultation to get a proper diagnosis. There are also similar symptoms when it comes to herniated discs, which is why many times it is difficult to distinguish the two. Those who have herniated discs sometimes have no symptoms at all.
Symptoms of Herniated Discs:
- Weakness – the muscles used by the affected nerves tend to weaken with herniated discs. This can cause the patient to have difficulty lifting or holding items or even cause them to stumble.
- Leg or arm pain – the pain from a herniated disc is often described as sharp or burning. If the herniated disc is in the neck, the most pain will be felt in the arm or shoulders or potentially shoot up the arm or leg when coughing, sneezing or moving in certain ways. If the herniated disc is in the lower back, the pain will typically be felt in the thigh, buttocks, and calf or potentially have pain in the foot.
- Tingling or numbness – patients with a herniated disc often have radiating tingling or numbness in the body part that is served by the affected nerves.
What causes disc bulge and herniation? Well, as we said above, one normally will lead to the other. There are times where it can be the result of a traumatic event or injury, but more often than not, it is the result of aging and natural degradation of the discs.
Conditions that can cause disc bulge:
- Degenerative Disc Disease – this condition occurs over many years as the discs in the spine begin to dehydrate from aging. The exterior of the disc can crack and harden due to less liquid in the disc. The micro-tears are what can lead to bulging or even collapsed discs.
- Spinal Injury – these can include falls, car accidents, sports injuries, and occupational injuries. These types of injuries can cause normal wear and tear over many years to occur in an instant with these accidents.
- Bone Spurs – these happen along the edges of the joints, and can grow into the disc space causing bulging discs.
As we said before, most often bulging discs and herniation are often just age-related degeneration. As we age, our discs deteriorate and bulge downward. It can affect multiple discs, and if left untreated can not only lead to herniated discs, but also to other degeneration-related issues like spinal stenosis which is one of the most common conditions that derive from bulging discs. However, bulging discs can also resolve on their own. If the bulged disc progresses to disc herniation, most patients are unable to pinpoint the cause. Additionally, there are several associated risks with developing bulging or herniated discs. Some of which are indeed potentially within patient control depending on their circumstances.
Risk factors for bulging & herniated discs:
- Occupation – when a patient has a physically demanding job it will pose a greater risk. Things like repetitive lifting, pushing, pulling, twisting, and bending sideways for a job can all increase risk.
- Smoking – smoking lessens the oxygen supply to the disc causing it to break down more quickly than with someone who is a non-smoker with normal wear & tear on their spinal discs.
- Genetics – some patients actually are more susceptible to bulging and herniated discs when it is common within the family.
- Weight – a patient with extra body weight puts extra stress on the discs in the lower back.
Equipping a patient with the knowledge to prevent bulging & herniated discs or prevent it from worsening is a key protocol to treatment.
Preventing bulging & herniated discs:
- Quit smoking
- Maintain good posture
- Maintain a healthy weight for the height of the patient
Knowing all of this information will allow you to use your best judgement when it comes to a treatment plan for your patient. Although there are many differences with treatment in eastern and western medicine, it is often important to know these types of conditions inside and out to best help our patients.
Bulging Discs vs. Herniated Discs
What’s the Difference?
That being said, it can also be confusing differentiating bulging & herniated discs because on the surface (and underneath in many cases) they appear to be very similar in symptoms & causes. A spinal disc has a tough, rubbery exterior (annulus) which encases a soft jellylike center (nucleus), and both affect each part of the disc in different ways.
- Does not always affect the perimeter of a disc. It usually affects a quarter or half of the discs circumference, and only the outer layer of tough cartilage is involved.
- Not as likely to cause pain as it doesn’t bulge as far out as a herniated disc and irritate nerves.
- Occurs from everyday wear and tear.
- Minuscule tears in the spinal disc causing the liquid interior to rush toward the exterior wall creating a protrusion on the disc.
- Also known as disc prolapse or protrusion
- Usually there is pain on one side of the body, but larger disc bulges can cause pain on both sides of the body.
- Happens when a crack in the outer layer of the cartilage allows some of the softer inner cartilage to protrude out of the disc.
- Also called ruptured discs, slipped discs, or disc extrusion.
- The whole disc is not usually affected but a small area of the crack.
- More likely to cause pain as it bulges out farther therefore irritating the nerve roots. Irritation of the nerves can be a compression of the nerve or just painful inflammation of the nerve root which is more common.
- Many have herniated disc with no symptoms, and if there are tests that indicate the patient has a herniated disc, the back pain may be from something else.
- Can occur in any part of the spine.
- Most commonly on the L4-L5 vertebrae, and the L5-S1 vertebrae in the lumbar spine.
Essentially, a bulging disc is a tear in the outer layer causing the disc to bulge, and a herniated disc is when the jellylike interior bursts through that tear reaching the spinal canal while still remaining connected to the disc causing even larger, and potentially more painful bulge. As we stated above, more often than not, patients who experience a herniated disc initially start with a disc bulge that progressively becomes worse if they don’t seek treatment or make the necessary lifestyle changes to address the issue.
Acupuncture for Bulging & Herniated Discs
On a surface level, we know that acupuncture, for most conditions, stimulate healing by increasing blood flow, and prompting the body to release endorphins decreasing the perception of pain leaving needles in place anywhere from 20-40 minutes. When specifically speaking of disc bulge & herniation, acupuncture alleviates discomfort that is associated with these conditions as well as slowing down the degeneration process, and heal it more rapidly.
Oriental medicine disc bulge & herniation diagnoses:
- Liver and Kidney deficiency resulting in lack of nourishment in the channels
- Injury to the area
- Invasion of wind, cold, or damp
Most often though, it is linked to Kidney deficiency. The goal of treatment of bulging & herniated discs is to repair the torn fibers of the disc, and the breakdown & absorption of the herniated nucleus material. Also, acupuncture treatment has a goal of returning the bulging or herniated disc back to its proper place, and slowing down the degenerative changes such as the buildup of fluid in the spinal nerve roots.
Acupuncture works for bulging & herniated disks by:
- Addressing the pain in the lower back or neck (depending on where the disc bulge or herniation is) as well as the degeneration of the discs themselves as we mentioned above. Acupuncture stimulates the flow of qi to the Kidneys.
- Moxibustion – increasing qi and blood circulation to stimulate healing by heating mugwort and placing it over the bluging or herniated disc.
- Herbal medicine taken orally or topically to reduce pain & increase blood circulation.
Essentially, your treatment goal as an acupuncturist should be the get the patient out of pain from their bulging or herniated disc, reducing the inflammation (excessive heat), and then begin healing & strengthening the affected area until the disc is healthy again. It should also be in the treatment protocol to correct, as much as possible, any contributing factors that may predispose the patient to a recurrence of bulging or herniated disc.
Kidney deficiency is caused by the poor circulation and inflammation of qi due to poor body mechanics. Due to this, the inflammation causes excessive heat bringing forth symptoms of swelling, pain, and loss of function which, in turn, causes Bi pain syndrome with Blood & Qi stagnation with dampness. Acupuncture points for disc bulge & herniation are mostly in the local area of the bulge or herniation or points that are involved in rectifying Kidney qi.
Acupuncture points for disc bulge & herniation:
- UB23 – Shen Shu – Kidney Shu – located 1.5 cun lateral to GV4 level with L2. Inserted perpendicularly .8-1 in or oblique, and moxa is applicable. This is the back shu point of the Kidney, and regulates the qi of the Kidney (yin & yang). It also resolves dampness, nourishes Kidney essence, benefits the bones, strengthens the back, and nourishes the blood.
- GV4 – Ming Men – Life Gate – located on L2 of the spine. Inserted perpendicularly .5-1 in, and moxa is applicable. This tonifies Kindey qi and Kidney yang. It strengthens the lower back, expels cold, and dries damp-cold. Works well with ginger moxa.
- UB25 – Da Chang Shu – Large Intestine Shu – located 1.5 cun lateral to GV3 level with L4. Inserted perpendicularly .8-1.5 in or oblique, and moxa is applicable. This is the back shu point of the Large Intestine, and eliminates stagnant qi & blood causing the pain, muscular atrophy, numbness, and motor impairment of the back. Benefits the lower back and relieves fullness & swelling.
- GV3 – Yao Yang Guan – Lumbar Yang Pass – located on L4 of the spine. Inserted perpendicularly .5-1 in, and moxa is applicable. It is a warming point for cold or cold damp in the lower warmer used for low back pain. GV3 is a local point whereas GV4 is for back pain from yang deficiency. It tonifies Kidney yang & qi, and especially good for back pain that radiates to the legs.
- UB40 – Wei Zhong – Bend Middle – located midpoint of the transverse crease of the popliteal fossa between the tendons of biceps femoris and semitendinosus. Inserted perpendicularly .5-1.5 in, and moxa is applicable. It is useful for all lumbar related issues, and is the He-sea point of the bladder channel. It clears dampness from the bladder channel, eliminates blood stasis, and opens the channel to benefit the low back, knees, hips & legs.
All in all, the goal of acupuncture and oriental medicine is to heal the disc and restore function.
Acupuncture, Disc Bulge, & Herniation
There are other treatment options available in western medicine such as anti-inflammatory medications during flare ups or steroid injections if there is significant nerve pain. However, the long-term treatment that acupuncture offers along with an exercise program/plan for the patient is second to none. There is no concrete evidence that shows these western treatment options to be overly effective or more effective than acupuncture especially in the long-term. In fact, in a systematic review and meta-analysis of Acupuncture for Lumbar Disc Herniation in 2018, it proved acupuncture to have a more “favorable effect” in the treatment of lumbar disc herniation than multiple methods of western treatment such as ibuprofen or lumbar traction. Although, larger scale studies are needed, acupuncture is a favorable treatment for disc bulge and herniation with real results long after the session is over.
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