Answer:

A disc bulge occurs when an intervertebral disc loses its normal physiological shape. The outer fibrous ring stretches, tending to protrude, mainly backward. At this stage, the inner nucleus pulposus remains contained within the fibrous ring, not yet escaping to compress nerves or the spinal cord. Consequently, patients often experience no clear symptoms or only mild, fleeting back pain.

A disc bulge represents an early stage of disc degeneration and can progress to a herniated disc if individuals continue heavy physical labor or lift objects with improper posture. Over time, the fibrous ring may further weaken and tear. When this happens, the inner nucleus pulposus exits its normal position, resulting in a herniated disc.

A physical therapist guides a patient through exercises to strengthen back and core muscles. *Illustration: Tam Anh General Hospital*.

Not all disc bulges progress to herniation. The rate of progression depends on various factors, including age, degree of spinal degeneration, nature of work, body weight, lifestyle habits, and adherence to spinal protection measures.

Upon diagnosis of a disc bulge, limit activities that increase pressure on the lumbar spine, such as prolonged sitting or standing in one posture, sudden bending, or heavy lifting. For office workers who sit for many hours, change posture every 30-45 minutes and incorporate gentle walking to alleviate disc pressure.

Maintaining a healthy weight and regularly performing exercises that strengthen back and abdominal muscles, such as swimming, walking, or physical therapy as advised by a doctor, are also important. These exercises provide better spinal support, slowing degenerative processes. Patients should have regular check-ups or seek early medical attention if pain increases, radiates to limbs, or if they experience numbness, muscle weakness, or motor dysfunction.

Doctor Nguyen Duc Anh

Head of Neurosurgery and Spine Department

Tam Anh General Hospital Hanoi