How does a herniated disc hurt symptoms. Intervertebral hernia of the lumbosacral spine. What kind of diet do you need

The spine consists of many individual bones - vertebrae, which, located one above the other, form the spinal column. Between the vertebrae are flat and round pads (intervertebral discs) that act as shock absorbers that prevent the vertebrae from rubbing against each other. Within each disc is a soft, gel-like center, the nucleus pulposus, surrounded by a hard, fibrous outer sheath called the annulus fibrosus.

A herniated disc occurs when pressure from the upper and lower vertebrae pushes part of the nucleus pulposus through a weakened or torn area of ​​the annulus fibrosus. Once in the spinal canal, the nucleus pulposus can compress the nerves adjacent to the disc, resulting in pain.

Intervertebral hernias most often appear in the lower (lumbar) and cervical sections of the spine: nevertheless, the formation of a disc herniation in the thoracic region is also possible, especially in the presence of various curvatures of the spine. A herniated disc is the most common cause of neck, back and/or leg pain (sciatica).

What you need to know about intervertebral hernia?

• Intervertebral discs are flat cushions that act as shock absorbers between the vertebral bodies, minimizing the pressure that the vertebrae exert on each other as the spine moves.
• Each disc consists of a gel-like center (nucleus pulposus) surrounded by a hard outer shell (annulus fibrosus).
• An intervertebral hernia occurs when a part of the nucleus pulposus is squeezed out into the spinal canal through a crack or tear in the annulus fibrosus.
• Most often, an intervertebral hernia appears between the fourth and fifth lumbar vertebrae (L4-L5).
• If a herniated disc is large enough, it can compress nearby spinal nerves exiting the spine at the same level as the herniated disc.
• A medical examination, an MRI scan can help diagnose a herniated disc.
• Depending on the severity of the symptoms, the treatment of an intervertebral hernia can be carried out using conservative methods (spinal traction, massages, therapeutic exercises). Indications for surgical treatment are rare.
• Surgical treatment does not eliminate the cause of the formation of an intervertebral hernia, but is used in case of a threat of irreversible complications. However, the surgery itself can cause serious complications.

What is the structure of the spine and intervertebral discs?

Intervertebral discs are located between the vertebral bodies (the body is the largest component of the vertebrae). The spine consists of 7 vertebrae in the cervical spine (cervical vertebrae), 12 vertebrae in the thoracic spine (thoracic vertebrae) and 5 vertebrae in the lumbar spine (lumbar vertebrae). In addition, at the level of the buttocks, under the fifth lumbar vertebrae, there is the sacral spine, which then passes into the coccyx.

The spine is designed in such a way that the vertebrae, located one above the other, form a whole, which is a mobile support structure that, among other things, protects the spinal cord (nerve tissue located in the spinal canal) from damage. Each vertebra has a spinous process, which is a bony protrusion behind the spinal cord that protects the spinal cord from injury. The vertebrae also have an imposing bony "body" located in front of the spinal cord and serving as a platform that bears most of the load on the spine.

Discs are flat and round cushions that act as shock absorbers between the vertebral bodies to minimize the pressure exerted on the spinal column during movement. Each disc has the same structure: a gel-like center (nucleus pulposus) surrounded by a hard shell (annulus fibrosus). Ligaments are tough fibrous soft tissue that tightly binds bones to each other. When ligaments are damaged as a result of degeneration of the intervertebral disc, this can cause localized pain in the affected area.

Causes of intervertebral hernia

As described above, each intervertebral disc consists of a gel-like nucleus pulposus surrounded by a dense and durable membrane (annulus fibrosus). If, as a result of tissue damage or deterioration that has appeared with age, the process of disc degeneration begins, part of the nucleus pulposus may be squeezed out through a gap in the outer shell. This phenomenon is called intervertebral hernia.

Most often, a herniated disc appears between the fourth and fifth vertebrae in the lumbar spine. This area is constantly under pressure as it must support the weight of the entire upper body. This becomes especially true when sitting or standing. In addition, the lower spine is actively involved in the movement of the body during daily activities, such as when we turn the torso from side to side or bend and straighten the back when bending or lifting various objects.

Symptoms of an intervertebral hernia

Symptoms of a herniated disc can vary depending on the location of the hernia and the type of soft tissue that is damaged. They can range from the complete absence of pain or mild pain symptoms, if only the intervertebral disc is damaged, to acute and unrelenting pain in the cervical or lumbar spine, radiating to the areas innervated by those nerve roots that turn out to be pinched by a hernia. Often, a herniated disc is not diagnosed immediately when patients come to the doctor with hip, knee, or foot pain of unknown origin. Other symptoms may include sensory changes such as numbness, tingling, muscle weakness, paralysis, paresthesia, and altered reflexes. If the disc herniation is located in the lumbar spine, the patient may develop sciatica due to irritation or compression of one of the nerve roots of the sciatic nerve. Unlike throbbing pain or pain that comes and goes, which can be caused by muscle spasm, the pain of a herniated disc is usually permanent or at least constantly felt in a certain position of the body. It is possible that if a herniated disc is present, the patient will not experience pain or other noticeable symptoms due to the location of the hernia. If the material in the nucleus pulposus does not exert pressure on the soft tissues and nerves, a hernia may not cause any symptoms until a certain time.

Usually symptoms affect only one side of the body. If the hernia is very large and compresses the spinal cord or cauda equina in the lumbar region, both sides of the body can be affected, often with serious consequences. Compression of the cauda equina can cause severe nerve damage or paralysis. Nerve damage can cause loss of bladder and bowel control, as well as sexual dysfunction. This condition is called cauda equina syndrome. Other complications include chronic pain.

Pain in the intervertebral hernia

At the moment, the scientific community has recognized the importance of the so-called. "chemical sciatica" in the formation of pain in the spine. The main focus of surgery is to relieve or relieve mechanical compression of the spinal cord or nerve root. But more and more people are recognizing that spinal pain, instead of being caused solely by pressure on nerve structures, can also be due to chemical inflammation. There are studies pointing to a specific inflammatory mediator of this pain. An inflammatory molecule called tumor necrosis factor (TNF, tumor necrosis factor-alpha, English tumor necrosis factor, TNF), is produced not only in herniated intervertebral discs, but also in cases of cracking in the fibrous ring, problems with facet joints, and also with spinal stenosis (narrowing of the spinal canal). In addition to causing pain and inflammation, TNF can also contribute to disc degeneration. However, the isolated use of drugs against tumor necrosis factor is also unjustified (such studies are increasingly found in scientific articles). This approach does not affect the compression of the nerve root of the hernia itself, and the treatment of the intervertebral hernia is not only ineffective, but also unreasonably expensive. To eliminate the chemical factors of inflammation in disc herniation, we successfully use hirudotherapy in the complex of treatment.

In most cases, intervertebral hernia occurs in the lumbar and cervical spine. The thoracic region is rarely affected. Hernias are characterized by a posterolateral location, since in this area the annulus fibrosus (the outer shell of the disc) is most susceptible to various influences and is not supported by the anterior or posterior longitudinal ligaments.

In the cervical spine, a symptomatic posterolateral herniated disc can compress the nerves leaving the spinal canal between these two vertebrae on one side. So, for example, a right posterolateral disc herniation between C5 and C6 vertebrae will compress the right C6 nerve root. The rest of the spinal cord, however, is positioned differently, so a symptomatic posterolateral herniation between two vertebrae will compress the nerve down from the next foramen. So, for example, an intervertebral hernia between the vertebrae L5 and S1 will compress the nerve root S1, which emerges between the vertebrae S1 and S2.

Diagnostics of the intervertebral hernia

Your doctor will begin your assessment with a complete physical examination and a medical history that includes detailed information about your symptoms. He or she will perform a neurological exam to check muscle reflexes, sensation and muscle strength.

Your doctor may also recommend other diagnostic tests to confirm the diagnosis or to learn more about the location and size of a herniated disc.

These tests may include:

• x-ray. X-rays use small doses of radiation to reproduce an image of the body. An x-ray of the spine may be needed to rule out other causes of lower back or neck pain;
• computed tomography (CT). A CT scan is a diagnostic image created after a computer reads an x-ray. CT can show the shape and size of the spinal canal, its contents, and nearby structures, including soft tissues. However, visual confirmation of a herniated disc may be difficult for this study;
• magnetic resonance imaging (MRI). This is a diagnostic test that produces three-dimensional images of our body structures using powerful magnets and computer technology. It can show the spinal cord, nerve roots and surrounding areas, as well as degeneration and tumors. MRI shows soft tissue better than CT. A high-field MRI scan usually provides the most convincing evidence of a herniated disc. T2-weighted images allow you to see a clear visualization of disc material in the spinal canal;
• myelogram; A myeogram is an injection of a contrast agent into the spinal canal during a CT scan. A myelogram helps to more accurately determine the size and localization of an intervertebral hernia. This study may pose a risk to the health of the patient.
• electromyelogram (EMG); In EMG, small needles are inserted into various muscles to measure electrical activity. EMG measures the muscle response, which indicates the degree of nerve activity. An EMG can help determine which nerve root is being compressed by a herniated disc.

The gold standard for diagnosing a herniated disc is still an MRI of the affected spine. It is logical to conduct other studies after the MRI.

Treatment of an intervertebral hernia

For the vast majority of people suffering from intervertebral hernias, the so-called. "conservative" treatments, which may include:

• traction of the spine to increase intervertebral distances;
• specially designed therapeutic exercises (LFK);
• manual massage;
• acupuncture;
• reflexology;
• vacuum massage;
• various types of massages, for example, using ebonite rolls, etc.

In rare, most severe cases, patients need to consult a neurosurgeon to select the most appropriate surgical method. Patients opting for surgery should remember that spinal surgery can lead to a number of serious and persistent complications, so before going for surgery, it is better to consult a neurosurgeon who will help you make a choice that is adequate to the situation.

Surgery may be beneficial for patients with a herniated disc that causes cauda equina syndrome, often associated with a herniated disc in an anatomically narrow spinal canal.

A discectomy (partial removal of the disc causing pain in the leg) may provide relief faster than non-surgical treatments. Discectomy has better results after one year, but not after 4 and 10 years. Studies of less aggressive microdiscectomy showed no significant difference in outcomes.

We do not recommend the use of surgical treatment with the installation of various metal fixators, since in the future the patient cannot receive adequate conservative treatment of the intervertebral hernia and must undergo repeated operations.

Over the past 2 years, we have not been able to accept a single patient for conservative treatment after a complete disc replacement due to the instability of the artificial disc and the presence of fixation devices, and we were forced to refer these patients for repeated operations, which greatly increases the possibility of patient disability.

The choice of surgical treatment of intervertebral hernia should be carefully justified due to the presence of frequent complications and low efficiency of the operation.

Risk factors for the development of a herniated disc

Factors that increase the risk of a herniated disc may include:

• the weight. Excess body weight causes additional pressure on the discs of the lumbar spine;
• Kind of activity. People engaged in physical work have a greater risk of spinal problems. Repetitive lifting of heavy objects, twisting, etc. may increase the risk of herniated discs;
• genetics. Some people inherit a tendency to develop herniated discs.

How common are herniated discs?

Intervertebral hernias are very common. They usually occur in people between the ages of 35 and 55. Men suffer from herniated discs more often than women.

What to do with an intervertebral hernia?

Our spinal cord ends at the bottom of the spinal canal. Just below the waist, it divides into groups of long nerve roots (cauda equina; "ponytail"), which resemble the tail of a horse. In rare cases, a herniated disc compresses the entire cauda equina. If this happens, urgent medical attention may be needed to avoid permanent weakness or paralysis.

Seek emergency medical attention if:

• your symptoms get worse. Pain, numbness, or weakness may increase to the point where you cannot carry out normal activities;
• there is a loss of sensation during urination and / or defecation. People who have cauda equina syndrome may experience incontinence or have trouble urinating even when their bladders are full;
• saddle anesthesia. This progressive loss of sensation affects areas that would otherwise come into contact with the saddle: the inner thigh, the back of the legs, and the area around the rectum.
• the pain radiates to the leg and goes to the foot.
• limitation of hand movement.
• jumps in blood pressure.

Prognosis for intervertebral hernia

The prognosis for effective conservative treatment is favorable. To maintain the effect of treatment, it is necessary to do special exercises every day. People who work in jobs that require heavy lifting need to change the type of activity in order to avoid injury to the spine.

Intervertebral hernia does not affect life expectancy, only its quality. A threat to life can occur only during surgical treatment or after it due to severe inflammation at the site of the operation.

Prevention of intervertebral hernia

It is not always possible to prevent a herniated disc, but here are steps you can take to reduce your risk:

• use proper lifting techniques. Don't bend at the waist. Bend your knees with a straight back and use the strong leg muscles to help support the load;
• maintain a healthy weight. Excess weight puts additional stress on the spine;
• practice proper posture when walking, sitting, standing or sleeping. For example, stand upright with your shoulders slightly pulled back, your stomach in, and your lower back flat. Sit with your feet flat on the floor or slightly raised. Sleep on a firm mattress, on your side or back, but not on your stomach;
• perform spinal stretching exercises if you have to sit for a long time;
• do not wear high heels;
• play sports in order to maintain the tone and strength of the muscles of the back, legs and abdomen. Do aerobics regularly. When compiling a program, try to find a balance between strength exercises and flexibility exercises;
• stop smoking;
• Eat healthy, well-balanced meals.

Differential Diagnosis

Differential diagnosis is carried out with conditions such as:

• mechanical pain;
• spinal stenosis (stenosis (narrowing) of the spinal canal);
• abscess;
• hematoma;
• discitis/osteomyelitis;
• benign neoplasm/cancerous tumor;
• myocardial infarction;
• aortic dissection.

More and more people between the ages of 25 and 50 are facing spinal problems. The risk group primarily includes men and women whose work is associated with weight lifting. Pathology of the spine can also affect those who, by virtue of their profession, are forced to be in a sitting position for a long time. In this article we will talk about such a common disease today as an intervertebral hernia.

An intervertebral hernia is a pathology that occurs as a result of a rupture of the fibrous ring, the main component of the hard shell of the intervertebral disc.

Its contents flow out of the fibrous ring - a liquid that, spreading, negatively affects the nerve endings of the spinal cord. In other words, she pinches them. For this reason, the intervertebral disc is compressed and protrudes in different directions. This is how a hernia appears.

What can cause an annulus rupture? Doctors have identified several factors that can provoke an intervertebral hernia:

1. age factor

Bone tissue becomes fragile during the aging process. In addition, the blood vessels that feed it, perform their main function worse, because they narrow.

1. Injuries

The intervertebral discs can shift if a person gets a spinal injury. Due to this displacement, a rupture of the fibrous ring occurs.

This applies to people who are self-employed in gyms. If the load is incorrectly calculated, the intervertebral discs may shift, which will lead to a hernia.

1. Sedentary lifestyle

If you do not engage in physical education or swimming, then the blood supply to the intervertebral discs will be disrupted, and this can lead to rupture of the fibrous ring of the intervertebral disc in any part of the spine.

1. Overweight

If a person's body weight is several times higher than normal for his height and age, then this is fraught with serious pathologies for the spine. After all, in this case, all the burden is placed on him, which he is not able to withstand.

Intervertebral hernia: symptoms

Signs of an intervertebral hernia depend on the place of its localization, since the spinal nerves carry signals to different internal organs.

But in any case, the symptoms of a herniated disc are very serious and should be treated accordingly.

1. Intervertebral hernia of the lumbar will make itself felt like this:

• The person begins to experience strong pain in the intervertebral hernia in the lumbar region and lower extremities. They increase with physical activity.
• There are problems with the organs of the urethra and the reproductive system.
• The patient may feel numbness in the perineum.

The same symptoms are typical for intervertebral hernia of the sacral region.

1. Intervertebral hernia of the cervical region appears a little differently:

• The patient feels pain in the neck. Pain can spread to the shoulders, arms and head.
• Dizziness often occurs, and blood pressure jumps all the time, since there are zones in the cervical spine that are responsible for its regulation.
• Numb fingers.

1. Intervertebral hernia of the chest department can be recognized by the characteristic pain in the chest. Many may confuse this pathology with heart disease.

Intervertebral hernia: stages of the disease

Doctors distinguish 4 stages of intervertebral hernia:

1. First stage:

• There is a hernia 2-3 mm thick
• Local tissues swell
• The patient feels backache in the area where the hernia appeared

1. Second stage:

• The size of the hernia is 4-15 mm
• The patient feels a dull pain in the area of ​​protrusion formation.

1. Third stage:

• Hernia size 15-20 mm
• The spine can atrophy
• The person loses the ability to walk

1. Fourth stage:

• The hernia increases in size
• Pain sensations disappear
• Complete paralysis sets in

Intervertebral hernia: treatment

Feeling the first even slight pain in the spine, you need to see a doctor. He will examine you, and then send you for an additional examination:

• x-ray

The results of this study will show exactly where the hernia formed, at what stage of its development it is. The technique that the doctor will choose for the effective treatment of intervertebral hernia will depend on these data. We will describe to you all the existing options.

How to treat an intervertebral hernia with medication

According to numerous reviews, intervertebral hernia effectively treated with medication. If the stage of the intervertebral hernia is initial, then the doctors will prescribe the patient a two-week course of painkillers:

• Ibuprofen
• Diclofenac
• Meloxicam

The above medicines the patient can take orally at home. If they are not effective, then the doctor will offer the patient an X-ray-controlled blockade. It is performed in a hospital under local anesthesia. The place where the hernia has formed in the patient is pierced with a special needle. Through it, the doctor injects hormones and potent painkillers.

If this procedure does not help the patient, then you will have to treat intervertebral hernia surgery. There are several types of surgery:

1. Standard:

• A small tissue incision is made at the site of the hernia (no more than 4 cm)
• Under a microscope with a scalpel, a hernia and arches of adjacent vertebrae are removed
• A week later, the patient is already discharged.

1. Endoscopy:

• Several punctures are made in the area of ​​​​hernia formation
• With the help of special devices, a hernia is removed

1. You can also remove intervertebral hernia with laser the tissues of the destroyed intervertebral disc and the hernia itself are “evaporated” using the latest medical instrument.

It should be noted that removal of the intervertebral hernia - it is a very painful process. The patient after the operation will have to undergo a long course of rehabilitation.

Intervertebral hernia: rehabilitation

After removal of the intervertebral hernia the patient will recover within a year using the following procedures:

1. In the first 14 days:

• Doctors inject the patient with antispasmodics
• Prescribed to wear an orthopedic corset

1. In the next 45 days, the patient is recommended to do restorative therapeutic exercises.
2. Over the next 10 months, the patient will need to visit the office of a therapist and a massage therapist so that they perform the necessary physiotherapy for him.

How to treat an intervertebral hernia without surgery?

Treat an intervertebral hernia at home it is possible without medical intervention, but only if the disease is at the initial stage of its development. For this, special herniated disc exercises developed by the orthopedist and creator of alternative neurology Sergey Mikhailovich Bubnovsky.

How to treat intervertebral hernia according to the method of Bubnovsky:

• First you need to get on all fours and relax the spinal muscles. Then, being in the same position, you need to bend your back, inhaling, and then arch it, exhaling.
• While in the same position, straighten your right arm forward and at the same time your left leg back. All the same must be repeated several times, stretching the left arm forward and the right leg back.
• After that, you need to lie on your back, place your hands behind your head, bend your legs at the knees, and press your chin to your chest. In this position, you need to try to reach your elbows to your knees.
• Lower your arms at your sides and rest your palms on the floor. It is necessary to tear off the pelvis from the surface, taking a deep breath with each rise.

We present you a detailed video instruction, which shows an example of which exercises to perform:

Alternative treatment of intervertebral hernia

Alternative medicine in its arsenal also has several recipes that can be used to treat a herniated disc:

1. Massage with honey
2. Drink comfrey root oil
3. Drink lime or chamomile tincture
4. Use a decoction of bran instead of water for two weeks

According to traditional healers, these procedures restore cartilage tissue and give elasticity to muscle fibers.

Intervertebral hernia: photo

Intervertebral hernia: complications

If you neglect the treatment of an intervertebral hernia, dangerous complications may arise:

• The work of the heart will worsen
• There will be sciatica
• Bronchitis will develop
• Decreased blood circulation in the brain
• Increased risk of strokes
• Inflammation of the pancreas or lining of the colon
• There will be complete paralysis

Prevention of intervertebral hernia

It is not difficult to prevent the formation of an intervertebral hernia. For this you need:

• Exercise, or at least run, swim
• Eat right so you don't gain weight
• Give up bad habits (tobacco and alcohol)
• Don't lift weights
• Follow your posture

If it was not possible to avoid protrusion, then do not despair. In our time, medicine has stepped forward. Doctors help patients to get rid of intervertebral hernia as quickly and effectively as possible and return to their former full-fledged life.

Video: "Herniated disc: signs and symptoms"

An intervertebral hernia is a protrusion of the internal nucleus pulposus beyond the anatomical localization. The vertebral nucleus is made up of cartilaginous tissue rich in hyaluronic acid, which gives it a jelly-like but firm texture. Along the circumference of the vertebral body, the nucleus pulposus is protected by an annulus fibrosus, which also consists of cartilaginous tissue, but of dense collagen fibers. The structure of the intervertebral discs ensures smooth movements of the spine.

A hernia, in fact, is a protrusion of an internal organ or part of it beyond the anatomical localization. Two factors play a decisive role in the formation of this pathology:

• Increased internal pressure;
• Destruction of the barrier that encloses the internal organs.

With a long-term inflammatory process, dystrophic changes in the fibrous ring occur. The distance between the fibers increases, cracks appear. However, pain in spinal hernias does not appear from the fact that the cartilage tissue is destroyed, but from compression of the nerve endings and vascular bundles of the spine by the prolapsed tissue of the nucleus pulposus, the soft and elastic structure of which, outside the anatomical localization, undergoes ossification - ossification. The resulting bone ridges compress the nerve endings and small vessels.

Pain mechanisms in spinal hernias

When a part of the nucleus of the spinal disc exits in one direction or another, the nerve bundles emanating from the spinal cord in the region of each vertebra are compressed. The central nervous system of the spinal cord has a segmental structure. There are the following departments of innervation of certain areas:

• cervical;
• Thoracic;
• Lumbar;
• sacral.

Nerve fibers emanating from the spinal column on both sides of the body provide motor activity and sensitivity to the right or left half. Accordingly, there are pains with hernias of the spine in those departments where the anatomical destruction of the intervertebral discs is localized.

What are the pains with a hernia of the spine with localization in different parts of the spinal cord

Pain in herniated intervertebral discs differ not only in intensity, but also in localization.

Hernias of the cervical region provoke pain in the upper limbs and shoulder girdle, and are also characterized by severe, paroxysmal headaches. With the progression of the disease, pain in hernias of the cervical spine provokes muscle spasm. As a result, the patient cannot turn his head. Often, hernias of the cervical spine are accompanied by dizziness caused by changes in blood pressure. Patients are diagnosed with vegetative-vascular dystonia, which is treated symptomatically. However, the cause is not removed. Meanwhile, the herniated disc is progressing. Headache in this pathology has some features. It does not appear on the affected side of the spinal column, but has a diffuse character. Starting from the occipital region, headaches with spinal hernias spread throughout the cranium. The person cannot assume a comfortable sleeping position. With a high pillow, the head hurts, with a low pillow, the intensity of pain does not decrease. Insomnia develops. Sleeping pills have no effect, since inhibition of the central nervous system does not eliminate the mechanical cause of compression of the nerve roots.

Damage to the intervertebral discs of the thoracic region appears as intercostal neuralgia, which at first imitates cardiac pathology. There are pains behind the sternum due to damage to the nerve plexus. Further development of the disease leads to a violation of the innervation of the heart and to a failure of myocardial automatism. Arrhythmias without areas of anatomical myocardial damage often accompany hernias of the thoracic spine.

The lumbar is physiologically combined with the sacral. In the region of the lumbosacral joint, an anatomical formation is localized, called the "cauda equina of the spinal cord." With its defeat, pain in hernias of the spine is accompanied by disorders of the functions of the pelvic organs. Urination is disturbed in the form of urinary retention or incontinence, constipation is interspersed with diarrhea.

The initial stage of the disease is characterized by acute pain of the type of backache - lumbago. At the moment of an acute attack, a person freezes, can neither bend nor unbend. These are the pains with a hernia of the spine that are alarming in the first place, because with long-term osteochondrosis, the patient gradually adapts to pain, gets used to the fact that his movements are limited by pain. If a herniated disc is formed, all previous efforts to overcome it cease to be effective.

Why and how does the leg hurt with a hernia of the spine

The innervation of the lower extremities depends on the specific segments of the spine, more precisely, on the outgoing nerve bundles in the region of the fourth and fifth lumbar vertebrae. With damage to the intervertebral disc between L 4 and L 5 (the Latin letter "L" - "lumbalis", means "lumbar"), a radicular syndrome develops with damage to the femoral nerve. At the same time, the leg hurts with a hernia of the spine on the outside: from the thigh to the little finger. When a hernia is formed at the level of L 5 -S 1 ("lumbalis-sacralis": in the lumbosacral region), pain in the lower limb spreads along the sciatic nerve. The pain zone starts from the buttock and continues along the back of the thigh to the big toe. With further progression of the disease, impaired sensitivity and muscle atrophy develop.

How to relieve pain with a hernia of the spine

Acute pain, accompanied by paralysis of the legs or arms, is not relieved by any medication. Disorders of the pelvic organs in the form of "ponytail syndrome" are subject only to surgical treatment. Anesthesia in this case gives general anesthesia, and the subsequent removal of the intervertebral disc and its sequester guarantees the absence of pain after the operation.

But it is possible to relieve pain with a hernia of the spine in a conservative way. To date, there are two methods of stopping pain in intervertebral hernias. Proponents of the classical approach to treatment recommend bed rest in the acute period. To relieve swelling of the nervous tissue, non-hormonal anti-inflammatory drugs are used. In a state of improvement, massage, physiotherapy, and therapeutic exercises are prescribed. With acute, shooting pain, blockades are made with painkillers and vitamins.

Proponents of active tactics suggest relieving pain in spinal hernias with the help of exercises that stretch the spinal column. The hood relieves the load on the vertebrae and pressure inside the nucleus pulposus. As a result, pain decreases or disappears completely.

The active technique requires the supervision of a doctor, since independent attempts to stretch the spine can lead to loss of part of the disc and the formation of a sequester.

Video from YouTube on the topic of the article:

Intervertebral hernia is a fairly rare pathology, but experts have noted an increase in the number of patients with this disease in recent years. Often, a hernia occurs against the background of other diseases of the spine, it rarely becomes an independent pathology. It is worth knowing about the main ways in which a hernia of the spine occurs, the main symptoms and methods of treatment.

Intervertebral hernia: what is it?

An intervertebral or simply vertebral hernia is a degenerative disease in which inflammation and deformation of the intervertebral disc, its displacement, destruction of the fibrous ring and other negative changes occur. A hernia can cause severe pain and serious disturbances in the normal functioning of the spine.

Most often, an intervertebral hernia of the lumbosacral region occurs, since it is this department of the spinal column that usually has the greatest load, it is easiest to injure it. Such a degenerative lesion of the cervical region is much less common, cases of a hernia in the thoracic region are extremely rare, they are almost isolated.

According to statistics, a vertebral hernia is one of the most common causes of surgery associated with back pain. Experts note that for a number of reasons, this pathology is beginning to occur more often, the diseases leading to its occurrence are becoming extremely common.

There are several stages of hernia development, the earlier the disease is detected, the easier it is to treat:

1. Protrusion of the intervertebral disc. At this stage of the development of the pathology, a rupture of the fibrous ring is observed, a fragment of the nucleus begins to come out. At this stage, specialized treatment and surgical intervention are not required; you can try to cope with the disease on your own. The pain syndrome at the same time is poorly expressed, the pain is of a shooting character, intensifies after exertion.
2. Partial prolapse of the intervertebral disc. The nucleus pulposus begins to bulge more strongly, because of which the pain becomes permanent, quite pronounced. There is a violation of the blood supply to the intervertebral disc.
3. Complete prolapse of the intervertebral disc. The nucleus almost completely leaves the fibrous ring, but its normal shape is preserved. The pain syndrome increases, noticeable motor disorders begin to develop, the pain can begin to radiate to the legs, the pelvic region, if the lumbar region is affected, if the cervical region is affected, there is a severe headache, a feeling of numbness in the shoulder blades and other symptoms.
4. Sequestration. Fragments of the nucleus begin to fall out of the fibrous ring, due to the displacement of the intervertebral disc, the occurrence of a full-fledged hernia, pinching of the nerve endings in the spine occurs. The pain becomes permanent, the mobility of the spine is significantly impaired.

Important! In the later stages of the development of an intervertebral hernia, surgical intervention is often indispensable.

When a disease is detected, treatment should begin as soon as possible. In advanced cases, degenerative damage to the spine can lead to serious consequences, severe restrictions on mobility and other problems. At the moment, there are quite effective methods to get rid of the pain syndrome and avoid the consequences.

There are several reasons for the development of this disease, various factors lead to the occurrence of a hernia, often they are combined. The more factors present at the same time, the greater the likelihood of developing the disease:

1. Insufficient level of physical activity. In the absence of a normal level of mobility, the back muscles weaken, the spine becomes less functional. This leads to the development of various degenerative diseases, the most common is osteochondrosis, and very often an intervertebral hernia is a consequence of this pathology.
2. Increased load on the spine. Constant heavy loads on the musculoskeletal system, especially in the absence of the necessary physical preparation, lead to back diseases. Also, athletes who neglect a sufficient warm-up before exercising or the necessary rest and care after training can encounter hernias.
3. Various spinal injuries. Bumps, bruises, any mechanical damage and trauma can lead to displacement of the vertebrae and intervertebral discs, which can lead to the development of hernias of various types.
4. Age. Experts note that most often hernias occur in older people, especially against the background of other diseases of the spine. The risk group includes women over forty and men over thirty.
5. Floor. It is noted that the disease occurs more often in men due to the structure of cartilage tissue. In women, it is much better developed, as a result of which female representatives are much less likely to experience severe complications such as hernias.

Also, risk factors include overweight due to increased stress on the spine and heredity. It is believed that if there are people with degenerative diseases of the spine in the family, the likelihood of their occurrence increases. People with unfavorable heredity should pay more attention to the rules of prevention.

Symptoms

Symptoms of intervertebral degenerative lesions depend on the location. There are several varieties of degenerative disease depending on the localization, in each case the symptoms will be different.

With an intervertebral hernia of the cervical region, in addition to pain in the neck and back, a headache occurs, accompanied by severe dizziness. Muscle numbness may occur, due to a lack of cerebral blood supply, the patient begins to get tired more often. Also, patients often have violations of blood pressure, hypertension.

Important! With a hernia of the cervical region, the likelihood of ischemic stroke increases.

With an intervertebral hernia of the lumbar, which is more common than other varieties, there are sharp pains in the lumbar region, resembling a backache. The pain syndrome is especially pronounced, there are various motor disorders. The sensitivity of the skin on the legs disappears, normal blood circulation in the lower extremities is disturbed. In especially neglected cases, there are violations in the work of the pelvic organs.

Thoracic hernia

With an intervertebral hernia of the thoracic region, which is extremely rare, the pain syndrome is not so pronounced, since the load on the thoracic spine is usually small. The pains are aggravated by coughing, sneezing, after physical exertion, they can be given to the stomach. At the level of the thoracic region, the normal sensitivity of the skin sometimes disappears due to damage to the nerve endings.

If these signs of the development of an intervertebral hernia appear, you should consult a doctor - a neurologist or surgeon. To make a correct diagnosis, an examination is carried out, an x-ray of the affected part of the spine, an MRI or CT to confirm the disease is taken. Other studies may be prescribed depending on the individual characteristics of the course of the disease.

In the early stages of the disease, the pain syndrome is usually mild, often the discomfort is attributed to fatigue or physical overexertion. In the later stages of the pathology, the pain syndrome is quite noticeable, it does not depend on the level of physical activity and is present almost constantly.

Effects

Advanced degenerative disease of the spinal column can lead to severe complications without treatment. The main danger is damage to the spinal cord and nerve endings located in the region of the spinal column, which can occur during protrusions and compression of the hernia.

Due to such lesions of the nerve endings, the sensitivity of the skin may disappear, paralysis may occur, and the normal mobility of the limbs may disappear. In exceptional cases, motor function may be completely lost without the possibility of recovery.

Intervertebral hernia is a contraindication to military service in the vast majority of cases. This pathology is extremely rarely independent, the development of complications always leads to complete disrepair. Hernia is an extremely dangerous disease, especially in the later stages.

To get a deferment from the army, you need an official diagnosis from a doctor, information that the patient went to the clinic due to back pain, and the results of examinations.

Intervertebral hernia during pregnancy

During pregnancy, the likelihood of a degenerative disease of the spinal column increases, since when carrying a child, the load on the spine and the body as a whole increases. When a hernia appears during pregnancy, in no case should the disease be started, it is necessary to start its treatment as soon as possible.

The main difficulty in the treatment of a hernia during pregnancy is the inability to use most medications and therapeutic exercises, these techniques can harm the baby. In the initial stages, they manage with the most benign methods - up to the use of folk remedies.

During childbirth against the background of a hernia, maximum care must be taken and the disease of the expectant mother should be taken into account. Immediately after the birth of a child in advanced stages of the disease, surgical intervention is recommended.

Treatment without surgery

Treatment of a hernia at home after consulting a doctor is acceptable, especially in the early stages of the disease. They try to avoid surgical removal of an intervertebral hernia, this method usually has to be addressed if the disease is extremely advanced, complications develop, sensitivity is lost. This should be discussed with your doctor.

Usually, the following methods are used for treatment at home and without surgery:

1. Medical treatments. Usually, various painkillers are used, first they try to try non-hormonal drugs: Ibuprofen, Diclofenac, Nimesulide and their analogues. If the pills do not help, they use a local blockade, most often based on novocaine and its analogues.
2. Physiotherapy. Various therapeutic exercises are extremely important for treatment in the early stages of the disease and for rehabilitation after hernia removal. The exercise plan is usually selected by the attending physician, and caution should be exercised when performing gymnastics. In the initial stages of a hernia, it is permissible to include elements of yoga in gymnastics. The main thing is to avoid heavy loads, heavy lifting.
3. Physiotherapy. Physiotherapeutic procedures should be carried out strictly according to indications, in some cases they are completely contraindicated. Usually, electrophoresis, phonoresis with caripain, acupuncture and other techniques are performed.

Treatment with folk remedies

To alleviate the symptoms, you can use folk remedies with caution. This problem is usually well dealt with by bee products, infusions and decoctions of medicinal herbs when taken orally. The main condition in the treatment of folk remedies is not to heat, not to use warming substances.

Taking dried apricots, prunes and figs every day will help alleviate the condition of a hernia. You need to eat five pieces of dried apricots and one piece of figs and prunes. It is believed that this combination helps to strengthen the spine, in combination with conservative means, it will help to achieve a positive result faster.

To mitigate the pain syndrome, a compress based on potatoes and honey is used. A small amount of raw potatoes should be grated, mixed with a couple of tablespoons of honey, put on a sore spot and covered with cellophane, covered with a blanket on top. Hold the compress for a couple of hours, then rinse. You should not additionally heat the compress.

In more advanced stages with complete destruction of the annulus fibrosus, surgical intervention is recommended. Operations to remove a hernia are considered minimally invasive - small incisions and punctures are used for removal, through which the nucleus pulposus is removed with minimal harm to the patient.

There are several different methods of performing the operation, the attending physician selects the appropriate one, it all depends on the individual characteristics of the course of the disease. In any case, the intervention is usually well tolerated.

The operation is performed with anesthesia, after removal the pain is minimal, after a few days after the operation, you can return to a normal, familiar way of life.

Important! Surgery is resorted to only if conservative treatment does not help.

Laser treatment

There is another method for treating an intervertebral hernia in advanced stages, in which there are no traces left, and the recovery period is minimal. A needle is inserted through the puncture into the disc, after which the pressure inside the disc is relieved by a directed laser beam. The pressure on the nerve endings is reduced, pain and other symptoms of a hernia disappear.

The procedure lasts about an hour, it is performed under local anesthesia, after a few days a person can leave the hospital. This technique is preferred in younger patients or in the absence of disc rupture.

Removal of an intervertebral hernia does not require a long recovery period, since the intervention in the body is minimal. However, it should be borne in mind that if the rules for the prevention of degenerative spinal disease are not followed, it recurs.

Therefore, after the operation, therapeutic exercises are recommended, exercises aimed at strengthening the back muscles and developing the flexibility of the spine, correcting posture. With the permission of the doctor, physiotherapeutic procedures can be prescribed, with a lack of substances necessary for the normal functioning of the musculoskeletal system, vitamin-mineral complexes can be prescribed.

Against the background of excess weight, it is recommended to switch to a light diet with a minimum amount of fat and “fast” carbohydrates. Preference should be given to fruits, vegetables, dairy products, you need to drink more water and monitor the amount of calories consumed every day.

Can a hernia resolve?

A vertebral hernia never goes away on its own, degenerative changes are often irreversible. With the right treatment, it turns out to remove the pain syndrome, the main symptoms, stop further destruction and displacement of the intervertebral discs.

Is it possible to warm the intervertebral hernia

In no case should a hernia be subjected to heating and warming procedures. With this disease, there is an inflammatory process, which will intensify when exposed to high temperatures. Warming procedures can lead to a worsening of the course of the disease.

In general, with properly selected therapy, the prognosis is favorable. The main thing is to strictly follow the recommendations of the doctor; with a hernia, it is easy to provoke a deterioration in well-being if you use inappropriate methods of treatment.

According to statistics, such a misfortune most often happens to the representatives of the stronger sex, due to their lifestyle. Moreover, as a rule, young men aged 25 to 45 suffer from the disease ...

To understand how this "trouble" appears, you need to remember the anatomy. Between the vertebrae are special shock-absorbing discs that prevent the bones from hitting each other when moving. They consist of an outer strong ligament, which is called the annulus fibrosus, and an inner part, which has a jelly-like consistency, the nucleus pulposus. If for some reason the disc cracks, fluid flows out and pinches the nerve endings of the spinal cord. This is the hernia. Of course, the nerve fibers do not like such oppression at all, so they begin to actively express dissatisfaction, causing pain.

24/7 surveillance

However, the pain caused by a herniated disc is far from the worst thing that can happen. This disease can provoke disruption of the internal organs, loss of sensitivity in various parts of the body and, oh horror, paralysis of the arms and legs. To avoid such a development of events, you need to monitor the health of your lover, then you will be able to catch an intervertebral hernia at the initial stage and stop its development. Young ladies, whose machos are at risk, should be especially careful.

Don't lift the bar

Of course, intervertebral discs do not crack just like that. Most often, this trouble happens as a result of an injury. If your loved one spends days on end pulling iron in the gym, dreaming of building biceps, just like the famous Arnold Schwarzenegger in his best years, congratulations: he is at risk. One awkward movement with a barbell or dumbbells in your hands - and the intervertebral disc can move to the side or crack. Unfortunately, even experienced pitching players who know all the intricacies of working with heavy sports equipment are not immune from this trouble.

Don't sit at the computer

However, if your darling is not at all friendly with sports, spends the whole day at the office at the computer, and when he returns home, he immediately runs to the laptop to start his favorite shooter, you should also be wary. Jumping around virtual worlds in the form of a reckless commando or a monster covered with gray-brown-raspberry bumps, unfortunately, you can’t build up your own muscles, and the health of the spine directly depends on their well-being. The intervertebral discs do not have a personal vascular system, so they have to feed on other tissues, in particular the back muscles. When the missus sticks to the computer chair, the body does not receive the necessary load. Metabolism slows down in the muscles, and the intervertebral discs begin to starve. Not receiving the necessary nutrition, they gradually lose their elasticity and eventually crack. The same trouble can happen if your sweetheart is not all right with the connective tissue of the spine. Any of its diseases is fraught with the fact that insufficient water is supplied to the shock-absorbing pads, and they become brittle.

Don't hustle

It is worth worrying even if the beloved does not follow the posture and is constantly hunched over. This is a direct path to osteochondrosis, which many experts consider the initial stage of the development of an intervertebral hernia. By the way, keep in mind that spinal diseases are often inherited. Therefore, be sure to ask the faithful if someone in his family had an intervertebral hernia. If precedents have happened, then your darling has every chance of becoming the next in line.

Without amateur performance

Unfortunately, a hernia does not resolve itself, and you cannot cure it with miraculous pills, and lost time can result in the development of serious complications. Most importantly, do not place high hopes on pain-relieving drugs and do not let the faithful take them thoughtlessly. Unpleasant sensations will disappear, but, alas, there will be no improvement. The damaged nerve will still suffer friction and compression and send signals to the man that he won't even feel. The pain will recede, but the disease will progress. If in the early stages of the development of an intervertebral hernia, the problem can be solved with the help of physiotherapy exercises, massage, reflexology and wearing a soft corset, then in advanced cases you will have to lie on the operating table under the surgeon's scalpel. Therefore, as soon as you suspect something is wrong, immediately send your man to an appointment with a therapist and a neurologist.

Photo for memory

X-ray of the spine, as a rule, becomes the first stage of diagnosis. It's simple, fast, but, unfortunately, not very informative. The discs are not visible on the pictures, and their condition must be judged by the gap between the vertebrae. A more accurate result can be obtained with the help of discography. In fact, this is the same radiography, only, before “photographing” the spine, a special contrast agent is injected into the discs with a suspected hernia with a needle, which “shows” them in the picture.

If you know that the lumbar region will be visible to your loved one, make sure that 2-3 days before the X hour, he refuses to eat fruits and vegetables, black bread, milk and sweets. These foods cause fermentation and flatulence in the intestines, and the accumulated gases can make it difficult to read the x-ray.

Working with sound

Ultrasound allows you to get more complete information about the state of the intervertebral discs and has significant advantages over x-rays. Firstly, ultrasound can be done as often as you like, since it is not accompanied by harmful radiation. Secondly, the intervertebral discs will be perfectly visible on the monitor even without the participation of a contrast agent. True, a hernia in the thoracic region, with all the desire to see it, will not work. The spine in this area is securely hidden behind the ribs, and the bone structures are impervious to ultrasound. But the cervical and lumbar regions can easily be illuminated with acoustic waves and examined for the presence of an intervertebral hernia.

There is no need to prepare your loved one for this procedure. However, keep in mind that the picture will be clearer if you put him on a starvation diet 6 hours before the study.

Half an hour in the tube

Magnetic resonance imaging is the most informative, accurate and, by the way, expensive method for diagnosing intervertebral discs. Your beloved will be placed in a strong magnetic field, and a special apparatus will begin to send electromagnetic signals of a certain frequency to the intervertebral discs. The tomograph will catch the response impulses, decode them and build a three-dimensional image of the intervertebral discs under study. The procedure lasts about half an hour, and all this time your man will have to spend inside a special tube-scanner or in a small room.

If your macho is afraid of closed spaces, buy him a sedative drug and let him drink half an hour before the “execution”. Otherwise, from excitement, the faithful will begin to fidget in place, and unnecessary movements will not be reflected in the best way on the results of the study.

How to recognize a hernia

In the cervical region. If a man complains of pain in the spine, backache in the neck and neck when coughing and sneezing, frequent dizziness, constant pressure surges, discomfort in the shoulder joints and numbness of the fingers, sound the alarm. These symptoms may indicate the presence of an intervertebral hernia in the cervical region.

In the chest. If the life of the faithful is poisoned by unpleasant sensations in the vertebrae between the ribs and shoulder blades, coupled with tingling of the heart and shortness of breath, there is reason to suspect the presence of an intervertebral hernia in the thoracic region.

In the lumbar. If your significant other suddenly had a sore lower back, and the next day one leg weakened, you can safely suspect a hernia of the lumbar spine. In this case, the inner side of the foot and the outer part of the lower leg often become numb, or, conversely, the outer side of the foot and the inner side of the lower leg. When walking, bending and turning, the pain intensifies, becoming so unbearable that the darling can fall on the bed and lie in one position for hours, afraid to move and get another backache.

Expert opinion

Dmitry Krylov, therapist:

To date, there is an improved version of radiography - computed tomography. The diagnostic apparatus in this case is a special device that rotates around the body and takes pictures at different angles. Then the images are processed by a computer, and the necessary section of the spine appears before the eyes of a specialist, which can be examined in detail from all angles. But in any case, X-rays can only see bone structures well. Therefore, in order to obtain reliable information about the state of the intervertebral discs, they will first have to be injected with a contrast agent.