Dr. David Kulla, DC provides individualized conservative care for bulging and herniated discs at Synergy Wellness Chiropractic & Physical Therapy in New York City. With more than 26 years of clinical experience, Dr. Kulla evaluates disc-related back pain, neck pain, sciatica, numbness, tingling, weakness, and other symptoms to determine which treatment options may be appropriate.
Our Manhattan office at 237 First Avenue near East 14th Street offers chiropractic care, rehabilitation, Cox Flexion-Distraction, spinal decompression, physical therapy, and other conservative treatment approaches for appropriate patients with spinal disc conditions.
What Are Spinal Discs?
Intervertebral discs sit between the vertebrae of the spine and help absorb forces while allowing movement. Each disc has a tougher outer layer, called the annulus fibrosus, surrounding a softer inner portion called the nucleus pulposus.
Spinal discs naturally change with age. They may gradually lose water content, become less flexible, or develop small changes in the outer fibers. These changes do not always cause pain, and many disc abnormalities seen on MRI are present in people without symptoms.
What Is the Difference Between a Disc Bulge and a Herniated Disc?
A disc bulge generally describes a broader outward extension of the disc beyond its usual boundary while the outer layers remain largely contained.
A disc herniation occurs when disc material extends through a weakened or disrupted portion of the outer disc. Herniations can vary considerably in size and location and may be described on imaging as protrusions, extrusions, or sequestrations.
Whether an MRI report uses the term bulge or herniation is only part of the clinical picture. The location of the disc change, the nearby nerves, the patient’s symptoms, and the physical examination all help determine whether the finding is clinically significant.
Symptoms of a Bulging or Herniated Disc
Disc-related symptoms depend on the location and severity of the problem. Some people have no symptoms at all, while others may experience:
- Lower back or neck pain
- Pain traveling into an arm or leg
- Sciatica
- Numbness or tingling
- Muscle weakness
- Pain aggravated by sitting, bending, lifting, coughing, or sneezing
- Restricted spinal movement
A lumbar disc herniation may irritate nerves traveling into the buttock and leg, while a cervical disc problem may produce symptoms that travel into the shoulder, arm, or hand.
What Causes Disc Bulges and Herniations?
Disc problems can develop gradually or follow an injury. Contributing factors may include age-related degeneration, repetitive loading, prolonged sitting, lifting injuries, trauma, reduced spinal mobility, poor conditioning, and genetic factors.
Spinal conditions such as spinal stenosis may also exist alongside degenerative or herniated discs and influence a patient’s symptoms and treatment plan.
How Are Herniated Discs Evaluated?
Dr. David Kulla, DC evaluates each patient individually. The examination may include a detailed health history, orthopedic and neurological testing, assessment of strength and reflexes, movement and postural evaluation, and review of available MRI or X-ray images.
Imaging findings should be considered together with the examination. A disc abnormality on MRI does not necessarily mean that the disc is responsible for a patient’s symptoms.
When progressive neurological changes, unusual symptoms, or other clinical findings suggest the need for additional evaluation, patients may be referred for diagnostic imaging, medical consultation, or specialist assessment.
Conservative Treatment for Bulging and Herniated Discs
Treatment depends on the patient’s diagnosis, symptoms, neurological findings, level of function, and individual goals. Conservative care may incorporate chiropractic manipulation or mobilization, rehabilitation, therapeutic exercise, physical therapy, activity modification, and other treatment methods when appropriate.
The goal is not simply to treat an MRI image. Treatment focuses on improving movement and function, reducing mechanical irritation when possible, and helping the patient safely return to normal activities.
Cox Flexion-Distraction for Disc Conditions
Cox Flexion-Distraction Technique is performed on a specialized segmented table that allows controlled flexion and distraction of selected areas of the spine.
Dr. Kulla may incorporate Cox Flexion-Distraction into care for selected patients with lumbar or cervical disc problems, sciatica, restricted spinal mobility, or other mechanical spinal conditions. The amount of movement and force is individualized according to examination findings and patient tolerance.
Spinal Decompression for Disc-Related Symptoms
Spinal decompression is another conservative treatment option available at Synergy Wellness. It uses controlled mechanical forces to gently unload selected areas of the spine.
Spinal decompression and Cox Flexion-Distraction are different techniques. Dr. Kulla determines whether either approach may be appropriate after evaluating the patient’s condition, symptoms, imaging, and clinical findings.
Do Herniated Discs Always Require Surgery?
No. Many people with disc bulges or herniations are initially managed with conservative care, particularly when there is no progressive neurological deficit or other indication for urgent surgical evaluation.
Surgery may be appropriate in certain cases, including progressive neurological loss, significant weakness, severe persistent symptoms that have not responded to appropriate conservative treatment, or specific structural conditions requiring surgical management.
Our goal is not to discourage appropriate medical or surgical treatment. It is to help patients understand their findings and determine whether a reasonable conservative approach may be appropriate before more invasive treatment is considered.
When a Disc Problem Requires Urgent Medical Attention
Seek prompt medical attention for new bowel or bladder dysfunction, numbness in the groin or saddle region, rapidly worsening weakness, severe loss of coordination, fever associated with significant spinal pain, or symptoms following major trauma.
These findings may indicate a condition that requires immediate medical assessment rather than routine conservative treatment.
Herniated Disc Exercises and Rehabilitation
Appropriate movement and rehabilitation are often important parts of recovery. Exercises should be selected according to the location of the disc problem, neurological findings, pain pattern, strength, mobility, and stage of recovery.
Rather than prescribing the same exercises to every patient, Synergy Wellness develops an individualized rehabilitation plan when exercise and physical therapy are appropriate.
Schedule a Bulging or Herniated Disc Evaluation in NYC
If you have been diagnosed with a bulging or herniated disc, have an MRI report you do not fully understand, or are experiencing back pain, neck pain, sciatica, numbness, tingling, or weakness, Dr. David Kulla, DC can evaluate your condition and help determine appropriate next steps.
Synergy Wellness Chiropractic & Physical Therapy is located at 237 First Avenue near East 14th Street in Manhattan. Call (212) 533-4900 to schedule an appointment.