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Dr. Kevin Barton using a model of the spine to explain a disc bulge to a patient seated across from him.

For people in San Antonio who just saw "disc bulge" on a report and don't know how worried to be

A bulging disc is a warning,not a verdict.

Find out if your bulge matters What your report actually means

Disc bulges are common. Plenty of people are walking around with one right now and feel nothing at all. But when a bulge is the reason your back aches and your leg tingles, it's telling you something worth hearing: that disc is losing its fight against the load on it. This page shows you how to tell the two apart — and what can be done while a bulge is still just a bulge.

23 years in practice
21 years using the DRX9000
2,000+ patients treated on it

Yours probably didn't start with one dramatic moment. It crept.

Stiff for the first twenty minutes every morning. An ache after the drive home. A warning twinge when you lift something you've lifted a thousand times. Sitting through a meeting got harder. Then a movie. Then maybe your leg started chiming in — not screaming, just a hum of tingling down one side that shows up when you've been in a chair too long.

So you finally got imaging. And the report came back with words you didn't expect to be reading at your age: broad-based disc bulge at L4-L5. Maybe L5-S1 too. Maybe "degenerative changes," which sounded a lot worse than anything you feel.

Then you did what everyone does. You searched it. And you found two internets.

One says a bulging disc is nothing — everybody has them, forget the report, go for a walk. The other has a clinic near you that wants to see you today, before this "turns into a herniation," and has a treatment package ready.

Both of those are selling something. One is selling reassurance it can't actually give you without examining you. The other is selling a program. Here's the version with nothing to sell you until we've laid hands on your spine.

Start here

Bulge, protrusion, extrusion, herniation — what your report actually means

Start with the disc itself.

Between each pair of bones in your spine sits a disc — a shock absorber. Picture a jelly donut with a very tough shell. The shell is a ring of hard fibers called the annulus. The center is a soft, water-rich gel called the nucleus. A healthy disc is roughly 90% fluid. That water is what lets it absorb load.

Now the four words your report might use. They're a ladder, not four different diseases — they describe increasing amounts of the same thing.

Bulge.

The whole disc is squeezed enough that it spreads past its normal edge — like a tire with low air. The shell is intact. It's just being pushed wide under the weight. A bulge is not a herniation, and most bulges never become one.

Protrusion.

Inner material has pushed through part of the shell and is sticking out — but the base is still wider than the part that's poking out. Think of pressing your thumb into the inside of a balloon: a broad, contained lump.

Extrusion.

The material has squeezed all the way through the shell, and the part that's outside is now wider than the neck it came through. Like toothpaste pushed through a small hole and mushrooming on the other side.

Sequestration (or "free fragment").

A piece has broken off completely and is sitting loose in the canal, no longer connected to the disc it came from.

Where does "herniation" fit? It's the umbrella word for the bottom three. A protrusion is a herniation. An extrusion is a herniation. A sequestration is a herniation. A bulge is not. So if you've been reading about herniated discs and quietly assuming it applies to you — it may not.

The one-sentence version: a bulge is a squashed disc with an intact shell; a herniation is a disc whose shell has been breached, and protrusion, extrusion and sequestration describe how far through the material got.
Illustration of a spine from the side showing a normal disc, a degenerative disc, a bulging disc spread evenly past its edge, a herniated disc with material pushed out at one spot, and a thinning disc.
Side-on, the difference is easy to see: the bulging disc spreads evenly past its edge with its shell intact, while the herniated disc has material pushed out at one spot.

Two more things patients always want to know here.

First: a bulge is not a small herniation. It's a different finding — the difference between a tire running low and a tire with a puncture. If the two words got used interchangeably when someone talked to you, that wasn't you failing to keep up. They get mixed up constantly, including by people who should know better.

Second: a bulge is wide, and a herniation is focal. A bulge usually involves a broad stretch of the disc's rim rather than one spot — which is why your report probably says "broad-based." A herniation is one place. That's part of why a bulge is less likely to be jammed into a single nerve.

"Bulge" describes a shape, not a diagnosis.

It tells you what the disc looks like. It does not tell you whether that disc is what hurts. The rest of this page is built on that sentence.

Before any treatment talk

The part we tell you up front: bulges show up in people with no pain at all

Here's the thing that ought to change how you read your own report.

Researchers have scanned people with no back pain at all — volunteers, healthy, symptom-free — and found disc bulges in a large share of them. Not a handful. A large share. Pooling 33 studies of 3,110 pain-free people, about one in three of the twenty-somethings already had a disc bulge, and by age 80 it was more than four in five.6 Those studies ran across more than twenty-five years of changing MRI equipment, in volunteers who aren't necessarily typical of everyone, so read the numbers as a direction rather than a precise count. The direction is not in doubt: the older the group, the more bulges turned up, whether or not anyone hurt.

Which means a disc bulge, all by itself, can be an ordinary feature of a spine that has been used. Like gray hair, or the wear on a pair of boots you've walked a lot of miles in. The scariest words on your report are also printed on the reports of people out playing golf right now.

Now the other half, because the straight version has two. The same researchers ran the comparison the other way — people with back pain against people without it — and found that bulges, extrusions, protrusions and degeneration genuinely are more common in the group that hurts.7 That comparison covered only adults under 50 and its estimates are loose, so don't lean on the size of the difference. But it rules out the lazy conclusion that scans mean nothing. Your imaging is real information. It just can't tell you by itself that it's the thing causing your pain — which takes an examination read alongside the film.

So when a report says "disc bulge," it has not established that the disc is the problem. It has established that you have a disc bulge. Those are different sentences, and the gap between them is where a lot of money gets spent.

This is also why the imaging is not the diagnosis. An MRI is a photograph of a spine holding still, taken while you're lying down and nothing hurts particularly. Your problem is something your spine does at hour six of a workday. A picture can show what's there. Only an examination can connect what's there to what you feel.

That's not a technicality. It's the reason we won't quote you a treatment plan over the phone from a report you read to us, and it's the reason the consultation starts with an exam and not a price.

And once the exam is done, the imaging gets its turn — with you watching. Patients tell us the same thing all the time: nobody ever showed them the pictures. There's a reason. The doctor most trained to read your MRI — the radiologist — writes the report and never meets you. The doctors who do meet you usually work from that report, and a surgeon's schedule rarely has room to sit down and walk through the images with you. Nobody did anything wrong — and you still ended up owning a spine you've never seen.

We think that's backwards. Your consultation happens in front of a screen with your MRI on it. We go through the pictures — not just the report — and show you what's pressing on what, why it hurts the way it does, and exactly what we plan to do about it. You leave understanding what your spine looks like and how we intend to fix it.

Your actual question, answered

How to tell whether your bulge matters

There's a straight test, and it isn't the MRI on its own. It's whether three things agree: the level on the report, the pattern of your symptoms, and what your spine does under examination.

When all three point at the same disc, that bulge is earning its place on your report. When they don't, something else is going on — and treating the bulge would be treating a bystander. Here's how to think about each one.

1. Does the level match the map?

Nerves leave your spine at specific levels and travel to specific places. That's not approximate — it's a map, and it's the same map in everybody.

  • The nerve at L5 runs down the outside of your calf, across the top of your foot, and into your big toe.
  • The nerve at S1 runs down the back of your calf, into your heel, and out to your little toes.
  • Higher levels — L3, L4 — show up in the front of the thigh and the knee, and can weaken the muscle that straightens your leg.

So: your report says a bulge at L5-S1 pressing toward the right. Your symptoms are a tingling ache down the back of your right calf to the outside of your foot. That's a match. The picture and the story are describing the same nerve.

Now the other version. Your report says a left-sided bulge at L4-L5. Your pain sits in the right side of your low back and never travels. That's not a match. It doesn't mean your pain isn't real — it means the bulge on the report isn't the explanation for it.

2. Does your pain behave like a disc?

Disc pain has a personality. It's a pressure problem, so it answers to pressure. Signs your pain behaves like a disc:

  • Worse with sitting — especially long car rides, desk hours, low soft couches
  • Worse bending forward, or getting up out of a chair after sitting a while
  • Worse with a cough, a sneeze, or straining — those spike the pressure inside the disc
  • Stiff and sore in the morning, easing after you move around
  • Often better standing or walking than sitting

And here's the useful part — other things that cause back pain behave differently:

  • Pain that's better sitting and worse the longer you stand or walk, with both legs getting heavy or tired, behaves more like stenosis — a narrowing of the space the nerves travel through.
  • Pain that flares when you lean back or twist, sits low and to one side, and doesn't travel far down the leg behaves more like the facet joints — the small joints at the back of each spinal level.
  • Pain deep in the buttock that shows up when you cross your legs or climb stairs, with no back pain to speak of, often isn't the spine at all — it can be the hip or the sacroiliac joint wearing a spine costume.

A bulging disc on your report doesn't cancel any of those out. People have more than one thing wrong at a time, constantly.

3. Does the exam agree?

This is the part imaging can't do. At the exam we're looking for physical evidence that the nerve named on your report is actually irritated:

  • Reflexes — a knee or ankle reflex that's noticeably weaker on one side than the other
  • Strength — can you walk on your heels? On your toes? Push against resistance evenly on both sides?
  • Sensation — does the numb or tingling patch on your skin fall where that nerve's map says it should?
  • Nerve tension tests — specific ways of moving the leg that put a stretch on an irritated nerve root and reproduce your symptoms
  • How your spine moves — which directions ease your symptoms and which provoke them, which is often the most informative thing we do all visit

When the exam lights up at the same level the report named, and your symptoms follow that nerve's map, you have three-for-three. That bulge is your problem.

Dr. Joshua C. Huffman examining a patient's lower back with his hands during a candidacy evaluation.
The exam comes first. Dr. Joshua C. Huffman, D.C. The report names a level; the exam tests whether that level is actually the one doing the talking.

The three ways this test comes back "no"

Being straight about this cuts both ways, so here are the three answers that don't lead to treatment here:

1. The incidental bulge.

The finding is real, nothing about your symptoms or exam points at it. It's mileage on your spine. It needs sensible habits and a recheck if things change — not a program.

2. The report with four findings on it.

Many reports list bulges at several levels plus "degenerative changes" everywhere. Almost never are all of those the problem. The exam's job is to find which one, if any, is doing the talking.

3. The pain that isn't the disc.

Hip, sacroiliac joint, facet joints, or a muscular problem — and a bulge sitting on the report the whole time, taking the blame.

If you're one of those three, you should hear it. Out loud, at the first visit, before anyone talks programs or prices with you.

The question under the question

Does a bulge turn into a herniation?

Some do. Most don't. And nobody can look at your report and tell you which one you're holding — so be careful with anyone who says they can.

What we can tell you straight is the mechanism.

Illustration looking down through a lumbar vertebra from above: the disc's outer rings in blue, the soft centre pushed backwards through the wall, and the nerve root inflamed red-orange where the disc reaches it.
Where a bulge is heading if the load doesn't change. Here the centre has broken through the outer rings rather than just stretching them — the difference between a bulge and a herniation, in one picture.

The shell of a disc — the annulus — isn't one solid wall. It's built in layers, like a radial tire — sheets of tough fibers running in alternating directions, one on top of the next. That design is extremely good at handling pressure, and it's why a bulging disc can spread outward for years without anything giving way.

What wears it down is repetition, not force. Under years of load — and especially in a disc that's already lost water and flattened — small tears can develop between those layers, starting from the inside. If enough of them line up into a path through the shell, inner material can start to follow that path outward.

Dr. Barton pointing at a lumbar spine model while explaining a disc bulge.
A bulge, a protrusion and an extrusion are three different things on a model — and three different conversations in the room.

When that finally happens, the moment itself is usually unremarkable. That's the part people can't get over afterward: "all I did was bend over to pick up a sock." They're not wrong. The sock wasn't the cause. It was the last item on a very long bill.

Here's what's actually useful to watch, and it isn't your imaging. It's the direction your symptoms travel.

  • Symptoms moving further down the leg over weeks — from the back, to the buttock, to the calf, to the foot — means the nerve is more involved than it was. That's the direction you don't want.
  • Symptoms retreating back up toward your spine — the foot quiets down, then the calf, and what's left is low back — means the nerve is less involved. That's the direction you want, and it's the change we look for first during treatment.
  • New numbness or real weakness — a foot that slaps when you walk, a leg that gives — means the nerve is losing function, not just complaining. Get that looked at soon rather than eventually.

And the emergency exception, which applies to any disc problem: new loss of bladder or bowel control, rapidly worsening weakness, or numbness in the groin, the inner thighs, or the area you sit on — what doctors call saddle anesthesia — means an emergency room today. Not an appointment, not with us. That's rare. It's also the one thing on this page that can't wait.

The genuine good news

Why this is the best-case version of a disc problem

If you're going to have a disc problem, this is the one to have. Three reasons, all of them mechanical.

The shell is still intact. Nothing has escaped the disc. There's no fragment loose in the canal, no hole in the shell that has to close. The tissue you'd want to preserve is all still where it belongs.

The disc still holds fluid. A bulging disc is a dehydrated, flattened disc — but it's still a functioning shock absorber, and it can still take water back in. Rehydration works on something that's there.

The inflammation is usually lower. A lot of the vicious leg pain in a herniation comes not just from pressure but from the chemistry — inner disc material is irritating to a nerve when it makes direct contact. With a bulge, that contact usually hasn't happened.

So what does that mean for your odds? Better than they'd be with a ruptured disc — but that on its own isn't the answer, and you should distrust anyone who hands you a number.

The bigger question is what you've already tried. If this is your first time in anyone's office and you've never had conservative care, decompression is not automatically where we start. Plenty of bulging discs settle down with straight chiropractic care, therapy, and changing what's loading the disc all day. If you've already been through that and the disc is still winning, decompression becomes a different conversation.

And a lot of it comes down to what you want from your spine. What your goals are, and what you're willing to do to get there, shapes the plan as much as the picture does. Some bulges don't need a program at all right now — sometimes the answer is changing the load, getting stronger, and rechecking in a couple of months. We say that a lot, and saying it earns us nothing. You'll hear which one you are at the exam, not from a report.

Why it isn't getting better on its own

The load story — why your disc is losing, and why "rest" hasn't fixed it

Your disc has an unusual problem: it's an injury that never gets to stop working.

A cut on your arm heals because nothing keeps re-opening it. Your disc doesn't get that. Every step, every lift, every hour in a chair keeps pressure on the exact tissue that's trying to recover.

And here's the part that surprises people: the heaviest thing your disc does all day isn't standing or walking. It's bending forward to pick something up. Pressure recorded directly inside a living lumbar disc runs far higher bent over a load than standing upright — roughly a third higher again with a rounded back than with bent knees8 — though that was measured in only a handful of people, decades ago, and the experiment can't be repeated now. You do it dozens of times a day without counting.

Sitting is a quieter problem, and the straight version isn't the one you've probably heard. A chair doesn't press on the disc harder than standing does — that claim gets repeated everywhere and the measurements don't back it up. What a chair does is hold the load still, and a disc under a steady load slowly gives up fluid and height, taking them back only when the load comes off.

Add it up on a normal Tuesday. Eight hours at a desk. Forty minutes each way in the car. Two hours on the sofa. That's most of your waking life spent under a load that never lets up — punctuated by every stand-up and every reach forward, which puts a bending load on a disc that's been quietly compressing for an hour. Long and still, then flexed and loaded. Meanwhile your body's own strategy for protecting the disc, which is moving, sits unused.

There's a second reason that matters, and almost nobody explains it. A disc has no blood supply of its own. It doesn't get fed the way your muscles do. It feeds by movement — the pressure changes of walking, bending and shifting pump fluid and nutrients in and squeeze waste out, like a sponge. Sit still and you don't just load the disc. You stop feeding it.

Which is why the advice you were probably given — take it easy, rest it — so often disappoints. Rest takes the movement away and leaves the load on. That's the worst of both.

Meanwhile the tissues around the disc adapt to the situation, and not helpfully. As the disc loses height, the small facet joints behind it get squeezed and irritated. The muscles around the injury tighten up to guard it, which locks your motion down and loads everything else harder. And if the bulge is crowding a nerve, that nerve gets less room every year the disc flattens further.

Look at your treatment history through that lens and it stops being mysterious. Anti-inflammatories calm the inflammation — for a while. An adjustment frees the joint — for a while. A shot quiets the nerve — for a while. Stretching gives the muscles temporary permission to let go. Every one of those touches a real tissue. None of them changes the pressure inside the disc, which is the thing your bulge is actually complaining about.

That's why everything worked for a while, and nothing held.

A patient being positioned for lumbar X-rays at Texas Spine Clinic.
Flexion-and-extension films — the ones that show whether a segment is stable. An X-ray can't show a disc, but it can rule you out: instability of the spine has to be ruled out before anyone goes on the table.

The mechanism

If your bulge does matter: how we treat it

If the three things agree — level, symptoms, exam — then the goal is simple to say and hard for most treatments to do: get the load off that disc so it can take fluid back in and recover some height, instead of flattening further while the load stays exactly the same.

That's what the DRX9000 does. It's an FDA-cleared, computer-controlled decompression system. You lie on the table in a harness for about 25 to 30 minutes while it applies a precise, gentle, rhythmic pull aimed at the specific level being treated. Inside the disc, that unloading creates a negative pressure — a vacuum effect — that draws fluid, oxygen and nutrients back toward the center.1 The disc can rehydrate. The facet joints get their motion back. The guarding muscles finally get permission to let go, and the nerve gets a little more room.

Think of it as taking the thumb off the bruise.

The DRX9000 page — the full mechanism, the program, and the doctor-as-patient video series.

A Texas Spine Clinic team member fitting the DRX9000 pelvic harness around a patient's hips before treatment.
Getting set up. Fully clothed — the pelvic harness goes on over your own clothes before you lie down.
A patient lying on the DRX9000 table while a team member sets the console and Dr. Huffman reviews her chart.
On the table. About 25–30 minutes. The pull is aimed at the one level being treated, on a force curve set by hand and adjusted as you respond.

Now the three questions people are too polite to ask.

"Isn't this just traction?"

Same family, different animal. Hanging from a pull-up bar or an inversion table pulls your whole spine bluntly, and your muscles fight it — you can't target a level and you can't control the force. The DRX9000 measures and adjusts its pull continuously, targets a specific disc level, and works below the threshold that triggers muscle guarding. That control is the entire point. It's also why the home version isn't the same thing — though if hanging or floating in a pool gives you relief, keep doing it. It's free and it isn't hurting anything.

"How do I know it will be done right?"

Ask us the hard questions — we like them. Here's how care is decided here, and you can hold us to every line: a doctor reviews your actual MRI before anyone discusses a plan or a price. A disc is never diagnosed from an X-ray, because an X-ray can't show one. The exam decides who is treated — fusions, fractures and severe bone loss are screened out, not talked past. Which brings us to the next section, because screening is the thing we'd most like you to judge us on.

"Why would this take so many visits?"

Because the disc is avascular, meaning it has no blood vessels of its own, which is why it's one of the slowest-healing structures in your body. It rehydrates gradually, and it only holds what it takes in if the sessions repeat. There's no version of this that's one dramatic appointment.

And decompression isn't the whole program. One program, two parts: decompression, and the core strengthening and therapy that rebuild the support around the disc so the load stops winning. That half matters more on this page than on any other condition page we have, because your bulge was made by load over time, and the only durable answer to load over time is a spine that can carry more of it.

Weigh it against the alternative

The case for trying this first

Whatever else you decide about this program, weigh what it asks of you. No incision. No anesthesia. No hardware in your spine. No fusion. No narcotics and nothing to wean off. No recovery period, and no time off work — sessions run about half an hour and you drive yourself home afterward.

And nothing about it closes a door. Whatever options you have today — an injection, a surgical consult, a second opinion — you'll still have every one of them when you're done here. That isn't true in the other direction. A fused segment doesn't come back, and scar tissue doesn't unform. Trying the reversible thing first isn't a compromise; it's the order that makes sense.

Why this works

Why this works — and who we won't treat

Start with the one that costs us the most: a lot of people who find this page don't need treatment. A bulge with no matching symptoms and a clean exam doesn't need a program. It needs better habits and a recheck if something changes. You'll hear that from us at the first visit if it's true.

The two reasons this program works when it is the right call

The first is the machine — and knowing how to run it. The DRX9000 is genuinely effective at what it does, but owning one and knowing how to use it are different things. Every protocol is set by hand: the angle of pull, the force curve, the specific level being treated, adjusted as your spine responds week to week. We've been doing that for 21 years. That experience is the difference between a table and a treatment.

The second matters just as much, and almost nobody in this industry will tell you about it:

We screen patients the way a spine surgeon screens surgical candidates.

We have turned away more patients than we can count — including people who pushed, pleaded and offered to pay in full. Saying no costs us money every time. It's also the only reason we've been able to do this for 21 years and still have the reputation we have.

The exam and your imaging — not the machine, and not your credit card — decide whether someone is treated here.

Who we won't put on the table

  • A spinal fusion or hardware at the level being treated — no exceptions
  • Severe osteoporosis
  • A spinal fracture, tumor, or infection
  • Severe bony stenosis — that's a surgical referral, and we'll make it
  • Unstable spondylolisthesis — a slip that shifts more than 5 mm on the flexion-and-extension X-rays we take to check. A stable slip, of any grade, can still be a candidate.
  • Pregnancy
  • The cauda equina warning signs above — which mean an emergency room rather than an appointment

What can happen in the early weeks

Some patients flare in the first week or two before things turn — soreness, sometimes a temporary echo of the leg symptoms. It's common enough that we tell you now instead of at session four. Most patients who respond notice real change somewhere in the middle of the program, not in the first days.

The real checkpoint

We assess whether your spine is responding around the second week, after eight to ten sessions. If it isn't, we say so then — not after another month of visits — and you don't pay for the rest.

What it costs

You'll have your figure in writing before you commit to anything.

The decompression program isn't a covered benefit under any plan. If you carry a commercial health plan, we can usually generate an insurance credit through it, which we apply against your cost. How big that credit is depends on your specific benefits. So expect an out-of-pocket investment, and expect to know exactly what it is before you commit. We verify your benefits at no charge, paying at time of service earns a discount, and CareCredit, Affirm and in-office payment plans are available. You only ever pay for care you actually receive — if you paid ahead and the program stops being right for you, the unused portion comes back to you. Cost & Insurance — how the investment works.

What we stand behind

We don't publish a success rate, and we don't make predictions about your particular bulge — anyone who does is selling. What we do promise is an clear read of your spine with the pictures on the screen, a plan that has an end date, your number in writing before you commit, and a straight answer at the two-week mark.

And we bring some mileage to that judgement. Dr. Barton has been in practice since 2003 and has run this machine since 2005 — 21 years and more than 2,000 patients on the DRX9000. That's long enough to know which spines respond to it and which ones don't, and to tell you which one you are early instead of late.

The research

What it looks like in numbers

The research on decompression has mostly studied disc herniations — the next step down the same road a bulge is on.

The mechanism is the same, and disc height and hydration are exactly what a bulging disc has lost. Here's what the research shows.

The vacuum effect was measured, not imagined. Researchers publishing in the Journal of Neurosurgery put pressure sensors inside human lumbar discs during decompression and recorded the pressure dropping to −100 to −160 mm Hg1 — a true vacuum, measured inside a living disc.

Herniations shrank more than with a sham treatment. In a randomized trial of real decompression against a sham — so patients couldn't tell which they got — the herniation index fell 27.6% with real treatment against 7.1% with sham, with better leg pain and disability scores at follow-up.3

Discs measurably gained height. Thirty patients scanned before and after a six-week DRX9000 program showed average disc height rising 7.5 mm → 8.8 mm, with pain falling 6.2 → 1.6 out of 10 — and the two changes tracked together.2

Leg pain responded most. In 73 patients compared against physiotherapy plus conventional traction, radiating leg pain and disc height improved far more with decompression.5

Across working clinics. The largest recent series followed 267 patients across multiple clinics: average pain fell from 6.9 to 2.5, with measurable improvement in reflexes and daily function.4

Want to go deeper? Does spinal decompression really work? — the research behind decompression.

What the change looks like on MRI

Before-and-after sagittal lumbar MRI scans shown side by side, with the disc visibly reduced in the second scan.
Before and after, side-on. Imaging is how disc change is measured in the studies on this page — and how your own progress gets shown to you rather than described to you.
Before-and-after axial lumbar MRI scans of the same patient, seen from above, with a red arrow marking the same spot on each.
The same disc from above — the arrow marks the same spot on both scans, before and after a course on the DRX9000.

Who you'll see

Your care team

We work as a team. Dr. Barton and Dr. Huffman have practiced side by side for more than 18 years, and your care is a team effort from your first visit.

Dr. Kevin S. Barton, D.C.

Kevin S. Barton, D.C.

Chiropractor · In practice since 2003

Dr. Barton has been in practice since 2003 and has used the DRX9000 since 2005, with more than 2,000 patients treated on it. He's the author of the treatment philosophy here: find the source of the pain and treat it there, without surgery and without narcotics. He completed advanced scrambler therapy training in Rome with Dr. Giuseppe Marineo, the inventor of the treatment.

In 2025 he went through the DRX9000 program himself, for one of the worst herniated discs he'd seen in his career, and filmed the whole course of treatment, MRIs included. Watch his nine-part series.

Dr. Joshua C. Huffman, D.C.

Joshua C. Huffman, D.C.

Chiropractor · In practice since 2007

Dr. Huffman earned his Doctor of Chiropractic degree from Texas Chiropractic College in Pasadena, Texas, and completed his internship at Moody Health Center, with a rotation at the Michael E. DeBakey VA Medical Center in Houston. He has advanced training in myofascial release technique and is certified as a designated doctor for the State of Texas.

A Texas native, he was born and raised in Matagorda County. When he isn't getting patients well, he's hunting, fishing, kayaking and hiking with his wife, Kendra, and their two children, Titus and Alley.

How the program runs

You're not on your own afterward

Decompression is not the finish line, and for a bulging disc that's more true than usual.

Your disc got here by carrying more load than it could absorb, for years. Taking the pressure off buys the disc a chance to recover. What keeps it recovered is a spine that can carry more. That's why core strengthening and therapy are part of the same program, not a separate one — rebuilding what Dr. Barton calls your structural margin, so you finish stronger instead of fragile.

We re-examine on a schedule during the program, and you see your own progress rather than being asked to take it on faith. At the end you'll get the specific things that apply to your job and your day — how to break up sitting, what to change about the drive and the desk, which movements to keep doing and why.

Your program has an endpoint. After it, periodic maintenance treatments are part of protecting the result: the disc that got overloaded still lives in the same spine, and taking the pressure off from time to time is how you keep the margin you just rebuilt. We'll recommend the schedule that fits your case, and tell you why.
A patient working through guided core-strengthening therapy at Texas Spine Clinic.
The same program, further along. Core strengthening and therapy — the part that makes the result hold after decompression has done its work.

Patients

Patient stories

Video thumbnail: Elaine Wild — how she avoided surgery for a 10 mm disc herniation.
Elaine WildResearch scientist — a 10 mm herniation, no surgery. She read the research herself before she agreed to anything.
Video thumbnail: Cameron Beckman — how he avoided back surgery.
Cameron BeckmanPGA golfer — drop foot resolved, won a Champions Tour event at 51.
Video thumbnail: Breanne Weber — no back surgery, back to jump squats.
Breanne WeberFitness instructor — back to jump squats within three months.
Video thumbnail: From a pain level of 10 to running his ranch again.
The rancherPain level 10 — back to running his ranch.
Video thumbnail: Rick — from a ruptured disc back to the tennis court.
RickRuptured disc — back on the tennis court.
Video thumbnail: How he avoided back surgery after nine months of pain.
Nine months of painSurgery avoided after nine months of it.
Video thumbnail: Herniated disc at 24 — how she avoided surgery.
Herniated at 24Young, herniated, and told surgery was next. It wasn’t.
Video thumbnail: He was told he needed back surgery — what he did instead.
Told he needed surgeryHe did this instead.
Video thumbnail: Chef Andrea — how we helped her avoid neck surgery.
Chef AndreaA neck case — three-level fusion avoided.
4.6 out of 5 · 112 reviews on Google
“I am so grateful to Dr. Huffman and Texas Spine Clinic for offering Non-Surgical Spinal Decompression treatment. After a few short series of treatments, I always leave pain-free… The team, the physical therapists and Jennifer (the receptionist), are so attentive and caring.”
Katie Breedlove · Posted on Google
“When I started the program, I was in pain all day and had trouble sleeping at night due to pain. I was using a walker at home and struggled with a cane when I went to the doctor. I was confined at home with pain killers. Now, I don’t take pain medication… I have made so much progress, and my activity level has improved greatly.”
Betty Cisnero · Posted on Google
“Dr. [Huffman] and his Physical Therapists have been dedicated in healing my back and sciatica problems. I appreciate all that they have done in helping my relieve my pain and suffering They communicate well and I can’t say enough how they have helped my healing process.”
Alfred Hawkins · Posted on Google

Reviews quoted verbatim from our public Google profile.

Individual results vary. These are real Texas Spine Clinic patients who consented to share their stories.

Questions patients actually ask

Before you call

Will a bulging disc heal on its own?

It can get better, especially if what caused it changes — more movement through the day, less uninterrupted sitting, better mechanics when you lift, and a stronger core. What a bulge rarely does is improve while every condition that produced it stays exactly the same. If your symptoms have been trending worse over a few weeks rather than better, the load is winning.

Can a bulging disc become a herniation?

Some do, most don't, and no one can tell you from a report which yours is. The mechanism is repetition, not one bad lift: under years of pressure, small tears can form between the layers of the shell, and if they line up, inner material can follow that path through. What's worth watching isn't your imaging — it's whether symptoms are traveling further down your leg or retreating back toward your spine.

Why does sitting make it so much worse?

Not because a chair presses harder than standing — that's a common claim and the measurements don't support it. It's that a chair holds the load steady and never lets up, and a disc under a steady load slowly gives up height and fluid. Then every reach forward and every stand-up adds a bending load, and bending genuinely is the heaviest thing a disc does. There's a second reason too: discs have no blood supply and get fed by movement, so long stretches of sitting both load the disc and starve it. That's why "rest" alone so often disappoints.

Do I need an MRI, or is an X-ray enough?

An X-ray cannot show a disc. X-rays image bone; a disc is soft tissue, and on an X-ray it's the empty-looking gap between two vertebrae. An X-ray can show that the gap has narrowed, which suggests a disc has lost height, and it can show alignment, arthritis, slippage and fractures — all genuinely useful, and reasons we sometimes take them. What it can't show is whether a disc bulges, which direction it goes, or whether it touches a nerve. So if anyone diagnosed your bulging discs from an X-ray, treat that as a red flag — same for a clinic showing you "before and after" X-rays as proof a disc rehydrated. It can't. An MRI is how a disc is actually seen.

My report lists bulges at three levels. Is my spine falling apart?

Almost certainly not. Multi-level findings are extremely common, and they rarely mean multiple problems. Usually one level is doing the talking and the rest are background. The exam is what separates them — which is exactly why we won't build a plan from a report alone.

What does "degenerative changes" mean? I'm not old.

It doesn't mean your spine is elderly or crumbling. It means a disc has been losing water and height under years of load. It's the most over-frightening phrase in radiology, and plenty of pain-free people have it on their scans.

Is decompression worth it for something as minor as a bulge?

Sometimes it isn't — and we'd rather say that than sell it to you. It's worth it when the finding, your symptoms and your exam all agree, when the problem has already outlasted the obvious fixes, and when the load on that disc isn't going to change on its own. If your case doesn't meet that bar, we'll tell you what to do instead, and it won't involve us.

What if I do nothing?

For some people, that's a defensible plan, and we'll say so. A bulge is not an emergency and it is not a countdown. But "do nothing" only works as a decision if you know what you're deciding about — which is the entire point of getting examined once, by someone whose answer is allowed to be "you're fine."

Footnotes

  1. Ramos & Martin, J Neurosurgery 1994 — intradiscal pressure during vertebral axial decompression. ↩
  2. Apfel et al., BMC Musculoskeletal Disorders 2010 — disc height with the DRX9000. ↩
  3. Choi et al., Int J Clinical Practice 2022 — randomized sham-controlled trial. ↩
  4. Schueren et al., Military Medicine 2025 — 267-patient multi-clinic series. ↩
  5. El-Zayat et al., Egyptian Rheumatology & Rehabilitation 2019 — decompression vs. physiotherapy with traction. ↩
  6. Brinjikji et al., AJNR Am J Neuroradiol 2015;36(4):811–816 — systematic review of imaging features of spinal degeneration in asymptomatic populations; 33 studies, 3,110 pain-free individuals. ↩
  7. Brinjikji et al., AJNR Am J Neuroradiol 2015;36(12):2394–2399 — MRI findings of disc degeneration are more prevalent in adults with low back pain than in asymptomatic controls. Footnotes 6 and 7 are a pair and are never cited apart. ↩
  8. Wilke et al., Spine 1999;24(8):755–762 — in vivo intradiscal pressure in daily life; the source for the bending-and-lifting comparison. ↩

Full citations on the evidence page.

The ask

Find out which kind of bulge you're carrying.

Call (210) 741-9166 or request your consultation below. The consultation is $49 — and it isn't a sales pitch. Here's exactly what happens:

  1. You call or send the form, and we schedule your consultation. Bring your MRI if you have one — the disc, not just the report. If you don't have imaging, we'll talk through whether you need it.
  2. The doctor examines you first, then looks at your imaging — in that order, on purpose. Then your MRI goes up on the screen and you go through the pictures together, not just the report: the levels, the millimeters, the "degenerative" line that scared you.
  3. You leave with one of three answers. This bulge needs treatment. This bulge needs watching, and here's what to watch. Or this pain isn't the bulge at all, and here's who should look at it. All three are useful, and two of them earn us nothing.
  4. If the answer is yes, your first treatment is included. The $49 covers the examination, the imaging review and your first session on the table. If the answer is no, it's no.
Call (210) 741-9166

Book your $49 consultation

No referral needed. Same-day appointments available.

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Rather book by phone? Call (210) 741-9166.

P.S. The unhelpful truth about a bulging disc is that it will not force your hand. It won't put you in an ambulance, and it won't announce a deadline. It just quietly gets a little more of your life each year — one less hour of sitting comfortably, one more thing you don't lift, one more chair you avoid at a friend's house. The best time to deal with a disc is while the shell is still holding, and right now yours is. One visit tells you whether that's a problem to treat, a habit to change, or nothing at all — and you get that answer whether or not you ever become our patient.