With the news that Tiger Woods withdrew from The Players Championship last week with pain and soreness in his neck, many experts speculate that he has a bulging disc in his cervical (neck) spine. His symptoms are fairly typical for a bulging disc: pain localized in his neck with tingling sensations radiating down his arm and into his fingers. An MRI can confirm this diagnosis.
UPDATE 5/13/10: Tiger Woods was diagnosed with inflammation of a facet joint in his neck after a complete MRI was performed. The facet joint is a small stabilizing joint located between and behind adjacent vertebrae that provides about 20% of the torsional (twisting) stability in the neck and low back. Learn more about facet joints and the treatment options for facet joint pain.
We often hear the term bulging disc when talking about injuries to athletes, but to most people the meaning is unknown or confusing at best. For many, the confusion comes from the terminology itself, since the condition can be referred to as a bulging disc, herniated disc, ruptured disc, pinched nerve, along with others. Unfortunately, there is little agreement among health care professionals as to the definition of these terms so it is often frustrating when patients hear their diagnosis referred to by different terms by different doctors. Rather than try to understand the terminology for their disc problems, it is usually more productive to understand the actual cause of their back pain, neck pain or other symptoms.
So what is a bulging disc and why does it occur so frequently in athletes?
A bulging disc is a condition in which the nucleus (inner portion) of a spinal disc remains contained within the annulus fibrosus (outer portion) and protudes, unlike a herniated disc in which the nucleus leaks out of the disc. This protrusion or bulge can put pressure on the surrounding nerve roots which can lead to pain that radiates down the back, neck and/or other areas of the body depending on the location of the bulging disc. A bulging disc can be described like a tire in which the tube pushes out through the tough outer shell of the tire and makes a bulge or bubble but does not completely rupture through the tire shell.
Although athletes are generally in better overall shape than the average person, it is the nature of what they do that puts them at risk for various back conditions including bulging and herniated discs. The stress put on the spinal discs from running, lifting weights, twisting/turning, general trauma and physical contact (especially in contact sports such as football) can take a toll on spinal discs and the surrounding structures. Many people may have a bulging disc and not even know about it since the bulge has not herniated or put enough pressure on the nerve roots to cause any symptoms. In the case of Tiger Woods, the extreme torque put on the spinal column over the years by his swing could be a possible cause of damage to his spinal discs.
The good news is that bulging discs can often heal on their own or after engaging in conservative (non-surgical) treatments to provide pain relief such as physical therapy, rest (followed by slow mobilization), chiropractic manipulations, epidural steroid injections and pain medications. Typically, 6 to 12 weeks of conservative care is recommended before surgical options are considered, but each treatment plan is usually individualized for each patient.