A disc bulge is not the same as a disc herniation. In the case of a disc bulge it just the result of simple aging or degeneration of the disc. The softer center of the disc shrinks so the disc “collapses” or sags, if you will, and the outer part has to go somewhere so it bulges out a little.
Typically, in and of itself the disc has no effect. In combination with other, more advanced changes of the spine, this can lead to nerve compression. This most often seen in spinal stenosis.
What is most important to understand about bulges, which, if you read your MRI report are often described, is that they represent overall disc degeneration. I have seen this in teenagers but mostly in people past the age of 30 or so. It is believed that disc degeneration is the most common cause of back pain. The most challenging part of treating this problem is that many people can have terribly degenerative disc changes and have never had significant back pain while some will have minimal disc changes and terrible pain. The exact way this causes back pain for some and not others is not at all understood.
As with disc herniation, we almost always strive to treat this problem with non-operative means.
For many people with this problem, the symptoms of back pain will be episodic and usually respond to these simple measures. It is when the back pain is constant and disruptive to your lifestyle that we start to consider surgery Spinal Fusion.