Intervertebral hernia of the lumbar region - how to treat. Exercises for the lumbar spine. What is an intervertebral hernia? Treatment of lumbar intervertebral hernia at the Doctor Ignatiev Medical Center

Our body is perfect, but there are very vulnerable areas on it, one of which is Bottom part back experiencing increased stress. The lumbosacral region accounts for greatest number injuries, as well as very unpleasant illnesses. Dangerous neuralgia often develops in this area - intervertebral hernia.

It is important to know what a vertebral hernia is! Between each vertebra there is a disc that acts as a stabilizer, shock absorber, and prevents injury. Inside the intervertebral disc is a gel-like substance known as the nuclear pulp. Due to mechanical damage or biological tendency, this substance can break through the membrane and begin to compress the nerve processes. The size of the hernia serves as a supporting factor when choosing a therapy technique.

Patients are usually interested in the dangers of interdisc herniation. One of the most common consequences is pain, which occurs when lifting heavy weights, sharp turns of the body, or simply during normal walking (). However, this pathology is not all that the disease threatens; if detected late, muscle weakness or even paralysis of the limbs can develop.

The disease described is quite painful, but with properly selected therapy, two to four weeks are enough to significantly improve the well-being of 2/3 of those affected.

Symptoms of a hernia of the lumbar spine

The primary signal of a herniated disc in the lumbosacral region is pain in the area. Symptoms may appear acutely, but quickly disappear after a few days. Soreness begins in the lower back or gluteal muscle and moves down to the lower leg.

Useful video on the topic:

Let's figure out what phenomena signal an intervertebral disc herniation! In adults, with a vertebral hernia, the following alarm signals appear:

• pain radiating to the legs;
• general feeling of weakness, “needles” piercing the limbs;
• reduction in available range of motion;
• Rarely, there is a violation of control over the retention of secretions from the bladder and sphincter. As soon as this symptom appears, you must go to the hospital.

When a visit to a doctor is not made immediately, a herniated disc may begin to affect the functioning of the pelvic organs. Symptoms in men are sexual dysfunction. The symptoms in women are no less sad and dangerous - gynecological problems, including the inability to conceive.

Don’t forget, only a qualified physician knows how to identify an illness. You should not listen to unprofessional advice.

Signs of a lumbar hernia

Research shows that intervertebral herniation with most likely manifests itself in the area between L4 and L5, as well as between the sacrum and the vertebra that terminates the spinal column.

The manifestation of the disease is almost equally likely in both women and men. Various types of pain due to intervertebral hernia are considered a typical manifestation.

If the hernia is located in the lumbar region - vertebrae L4 and L5, unpleasant sensations will appear, localized in lumbar region, radiating to the buttock, upper leg. With an injury between the lumbar and sacral vertebrae, severe pain will radiate down the back of the thigh to the knee, shin and ankle.

The main signals about problems with a lumbar hernia:

• lumbago, back pain;
• increased pain in the simplest movements, including hiking, prolonged standing, straining the body, legs, laughing or coughing;
• you are quite capable of indicating exactly where the most acute pain is;
• at first, pain in the lower back due to a hernia and other first signs go away if you lie down and take a comfortable position;
• crunch in the lumbosacral spine;
• the range of available movements is reduced;
• the feet turn into a painful area, dry out, or, on the contrary, sebum begins to be released in excess.

Causes of hernia

There are the following causes of hernia of the lumbar spine:

• injuries;
• degenerative changes;
• obesity is the answer to the question of why your back hurts;
• deterioration in oxygen supply to the paravertebral region;
• prolonged sitting;
• disruptions in metabolism.
• Prerequisites for the appearance of the disease:
• low activity;
• age over 35;
• hereditary tendency;
• monotony of movements.

Consequences of a hernia

Even slight neuralgia can lead to sad consequences, especially if she presses nerve roots. This will be expressed not only in increased pain, but also in significant muscle weakness, limited movement, the appearance of swelling.

The consequences of an intervertebral hernia are the need to change your usual life, the inability to exercise labor activity, constant stay in bed.

What you can and cannot do for a hernia

Main contraindications for intervertebral hernia:

• lifting weights over 5 kg, even small loads should be lifted exclusively with a straight back;
• sudden movements, strokes (when swimming);
• general power loads.

Is it possible to heat a hernia?

The decision to warm the lower back if it starts to hurt or tighten is quite common. Hot compresses, warming ointments, belts made of dog hair and so on. measures, however, such steps are not always for the good.

Warming up is prohibited if:

• acute pain;
• prolapse of lumbar hernia;
• deformation of the dural sac;
• hernia size over 5 mm.

Walking with a hernia

This habitual and ordinary process can affect the deterioration of the patient’s condition with neuralgia. Our body was created to move barefoot on the ground, but modern man walks in hard shoes on hard asphalt or stone surfaces.

In case of intervertebral hernia, especially during exacerbations, experts recommend moving exclusively in an orthopedic manner. the right shoes, trying to choose soft surfaces.

Sauna

Experts do not oppose visiting a sauna or steam bath for patients with a lumbar hernia; only the duration of stay and temperature are specified.

Mattress for lumbar disc herniation

Sleeping on an orthopedic mattress is a mandatory passive measure for the treatment of the described pathology. With its help, it is possible to ensure the correct position of the body and reduce the load on the spine.

Alcohol

By taking a dose of alcohol, you may notice a decrease in pain, general relief state. However this effect temporary, because there is no effect directly on the cause of the disease, ethyl alcohol dulls the work of the brain neuron, giving pseudo-relief.

Bike

Cycling is not the best The best decision If you have a hernia, if you can’t refuse them, you must follow the following recommendations:

• do not travel during periods of acute pain;
• keep your back straight. Installing a comfortable seat with a backrest, like on an exercise bike, can help in this matter;
• no shaking. Make your route exclusively on smooth roads without potholes.

Run

One of the prerequisites for a speedy recovery is reasonable physical activity. But is it possible to run at least on treadmills?

Only the attending physician can judge the admissibility of athletics. But in any case, you can start them only when the acute period is over and the muscles are strengthened.

Sports for hernia

Physical activity for intervertebral hernia is highly recommended if the patient wants to recover quickly. But keep in mind that you can only visit the gym under the supervision of a trainer.

It is important to know! Fans of bodybuilding, when performing deadlifts or squats with a barbell, expose their spine to enormous loads that can not only worsen the condition of an existing hernia, but also cause its appearance. Be sure to check with your trainer whether it is possible to squat with your diagnosis and ask him to teach you how to do it correctly.

Push-ups and pull-ups should be performed with great care when dealing with a hernia. Whether it is possible to do push-ups and how to do it correctly can be advised by a qualified trainer or rehabilitation doctor. For creation lovers thin waist Using a hula hoop, we also recommend checking whether you can spin a hoop, because this simple exercise machine is usually strictly prohibited.

Moderate exercise allows you to:

• distribute the load evenly across all muscle groups;
• activate recovery processes;
• return the vertebrae to the correct position (hanging on a Swedish wall is often used for this purpose).

• Pilates;
• swimming;
• water aerobics;
• fitness.

Experts have noted that yoga for a hernia of the lumbosacral spine strengthens, heals the body, and allows you to find inner harmony.

How to live with a hernia of the lumbar spine

The lifestyle of a patient with an intervertebral hernia needs careful review and adjustment. He will have to seriously take care of his own health, and also learn how to sleep, lie down, and sit correctly.

You should check with your doctor about other restrictions on living with a hernia.

• get rid of excess weight;
• switch to healthy rich in vitamins nutrition;
• limit strength training;
• sleep on an orthopedic mattress.

Nutrition for hernia

Diet for hernia plays an important role in the process of overcoming the disease, because often its cause is metabolic failures.

Your doctor will tell you how to eat properly, but usually the recommendations include giving up fatty, smoked, salty foods and switching to foods rich in vitamins and minerals.

Exacerbation of lumbar hernia, what to do

Doctors consider the disease described to be severe; exacerbation of a lumbar hernia alternates with a period of almost complete recovery. Traditional methods can alleviate the condition, but do not completely eliminate the causes.

With surgery, it is possible to completely recover, but relapses are common.
If symptoms worsen, you should immediately consult a doctor, the severity and duration of the exacerbation depends on this.

Prevention

Most often, the cause of the disease lies in age-related changes, which we are not able to prevent. However, this does not mean that there are no measures at all that can prevent relapses.

• rejection of bad habits;
• shoes for spinal hernia should be soft and comfortable;
• Lifting heavy objects should only be carried out with the back held straight from a sitting position, etc.

Treatment of hernia of the lumbar spine

Intervertebral hernia of the lumbosacral region is an ailment that most patients are unaware of. They attribute everything that happens to banal fatigue and other excuses.

Let us note that the answer to the question whether it is possible to cure such a pathology on your own will always be negative. At severe pain in the back, numbness of the limbs, you should contact a medical institution and ask them which doctor is treating your illness.

It is important to know how to treat a vertebral hernia correctly! Only a qualified doctor can select an adequate treatment regimen, suggest how to cure your specific case, how to reduce a hernia, and give advice on how to get rid of existing ones. unpleasant consequences at home.

Treatment methods for intervertebral hernia offered by modern medicine:

• conservative treatment. It involves taking medications to relieve pain and spasms; a neurologist will tell you how to treat your case. The medication intake is supplemented with modern methods of physiotherapy;
• invasive methods. Currently used only in extreme cases, when acute pain and the onset of paralysis. Treatment after surgery is carried out under close medical supervision.

Is it possible to completely cure a load with folk remedies? Alternative medicine– effective treatment, but only if it is used in combination with other methods. You should not completely rely on medicinal herbs, compresses, decoctions and poultices; ask your neurologist whether your case is treated with them, which plants are best to give preference to.

Hernia treatment without surgery

In 70% of cases, the elimination of unpleasant symptoms occurs without invasive interventions. Therapy with modern medications, epidural injections, physiotherapeutic procedures, exercise therapy, etc. is used. If the above steps do not improve the condition, then surgical intervention is considered.

Blockade

This measure helps alleviate the patient's condition. However, its implementation is associated with the risk of damage spinal cord, nerve processes and other consequences, so you should not give consent without carefully considering all possible options, weighing the positive and negative sides.

Massage

The decision about whether it is possible to do a back massage to cure the described neuralgia is made by the doctor individually for each patient. Carrying out this procedure requires professionalism and must be carried out taking into account existing contraindications and following the technique. When massaging the lower back, do not apply direct pressure to the damaged area.

Exercise therapy

Exactly physiotherapy- the most effective method in the fight against neuralgia. The complex of exercise therapy for injuries of the lumbosacral region requires careful selection, taking into account the severity of the patient’s diagnosis.

Exercise therapy for pain begins with exercises on the toes, ankle joint. Afterwards, the number of movements increases, the knee is included in the process, then the thigh. The main condition is not to perform exercises that can cause painful sensations and worsening of the interdisc herniation.

Manual therapy

When performed correctly, the technique reduces pain, relieves spasms, and expands the range of available actions. Its effectiveness in cases of damage to the sacral spine depends on the level of qualification of the chiropractor. Otherwise there may be dangerous complications, including paralysis of limbs.

A specialist should not be chosen on the advice of friends and relatives; preference may be given to a chiropractor recommended by a neurologist.

Acupuncture

Acupuncture is an effective manipulation that directly affects the bio active points. With its help, it is possible to reduce pain, relieve swelling, and unblock muscle tissue.

Electrophoresis

Relieves the main symptoms, with its help improves blood flow in the affected area, restores metabolic processes, and increases the effectiveness of medications.

Physiotherapy

Physiotherapy is one of the key stages conservative therapy. It is usually prescribed after overcoming an acute period of pain. The physiotherapy complex includes electrophoresis, magnetotherapy, phonophoresis, etc.

Hirudotherapy

This procedure perfectly relieves swelling. However, it is recommended to use leeches for hernia only in a specialized office. Do not try to self-medicate with insects caught in the nearest swamp, otherwise you will add a bunch of new ones to your existing problems.

Kuznetsov applicator

This effective device, when used in combination with other methods of conservative therapy, shows excellent results. It helps relieve tension, relax muscles, and has a mild analgesic effect.

Applicator Lyapko

The structure of this type of applicator is extremely simple; it consists of medical rubber to which thin needles are attached. Its action is similar to the electrophoresis procedure.

Drug treatment: tablets for hernia

Hernia treatment medications help relieve muscle spasms and soreness. Typically, medications belonging to the groups of non-steroids (NSP), analgesics, cardiovascular drugs, and muscle relaxants are used. The range of drugs acceptable for use is large. They are produced in a wide variety of forms (injections, droppers, warming ointments and tablets).

Which injections are suitable for each patient is determined by a neurologist individually.

How to relieve lower back pain due to hernia

How to relieve pain in the sacral spine?

It is important to know! Under no circumstances should you apply cold directly to your body. Instead, put ice in a bag, wrap it in a towel, and place it on the affected area for 15 minutes.

• Immediately after the onset of symptoms, cold compresses are applied and non-steroidal anti-inflammatory drugs and medications are taken. In the first 14-48 hours, cold helps relieve pain, reduce swelling and eliminate muscle spasms;
• The list of acceptable medications may include anti-inflammatory and painkillers to relieve acute pain. They are taken in the form of injections or tablets. Your doctor will tell you how to most effectively relieve pain during an exacerbation;
• in case of minor pain, NPP drugs can also provide pain relief;
• heat therapy is indicated 48 hours after an exacerbation. By heating, blood flow increases and muscles relax. As with cold, heat should not be applied directly to the skin.

Removal of hernia of the lumbar spine

Surgical treatment of a vertebral hernia is usually prescribed if non-surgical methods turned out to be ineffective.

Indications for surgery:

• continuous pain;
• weakening, loss of control of limbs;
• urinary incontinence;
• large dimensions of the formation (the size of the hernia for surgery is 6-7 mm);
• groin numbness.

Previously, such interventions were performed using the classical method. The hernia was removed through a fairly large trepanation window, resulting in severe muscle damage and a long and not always successful recovery. At the same time, patients continued to experience pain after removal, and the disease often reappeared.

In modern realities, preference is given to progressive, minimally invasive techniques that minimize the risk of relapse:

• reconstruction using a laser, which evaporates liquid from the exposed nucleus, thereby eliminating compression of the nerve roots;
• percutaneous dissection. It is performed with a special needle inserted into the skin and sucking out the formation;
• installation of a disc prosthesis.

Is the operation dangerous? Like any surgery, hernia procedures carry some risks that you should ask your doctor about. Therefore, their implementation should only be trusted experienced specialist, and for the success of the postoperative period, it is necessary to follow all recommendations after removal prescribed by the rehabilitologist.

Rehabilitation after surgery usually does not require specialized supervision. After removing the sutures, it is recommended to take walks and gradually build up the muscle corset by performing a set of exercises at home.

Back pain is a disease of the 21st century, as sedentary work, long hours spent behind the wheel and other risk factors come to the fore. That is why it is important to know the symptoms of a disease such as intervertebral hernia of the lumbar spine. Remember that only a doctor can prescribe effective treatment.

Due to vertical walking, the human spine suffers from severe stress. Therefore, quite early, already from 30-40 years of age, wear and tear of the spine begins. The spine, in addition to being a support human body, in its cavity contains the spinal cord with its roots and vessels.

With the development of degenerative changes in the spine, it turns from a protector of the spinal cord into a source of damage. These injuries are medically called vertebrogenic. These injuries have become especially relevant due to the sedentary lifestyle of most people. It is believed that every second person has experienced back pain in his life. Among the diseases that are accompanied neurological disorders, the most common are spondylosis deformans.

Mechanism of hernia

Osteocondritis of the spine is a degenerative injury to the intervertebral disc with the development reactive changes from the side of adjacent vertebral bodies. The nucleus pulposus is primarily affected by osteochondrosis. Under the influence of static-dynamic loads, the core begins to lose its properties. First it dries, then falls into pieces.

Under the influence of mechanical loads, with the loss of spring properties, the intervertebral disc shrinks. Its fibrous ring begins to protrude beyond the boundaries of the vertebral bodies. This is called a disc bulge. At further progression process, cracks appear in the annulus fibrosus. Through them, pieces of the nucleus fall out - disc prolapse (herniation) occurs. A disc herniation is the prolapse of fragments of the nucleus pulposus beyond the boundaries of the vertebral bodies.

Types of hernias

A herniated disc puts pressure on the spinal structures adjacent to the disc, the spinal cord and its roots. Depending on the direction of the hernia prolapse there are: lateral(lateral) and middle(medial) disc herniation.

Sometimes a herniated disc does not protrude into the spinal canal, but through the hyaline plate into the vertebral body. This is called cartilaginous hernia of the vertebral bodies - Schmorl's hernias. They do not have strong clinical significance. True, if they are in large quantities, they can provoke chronic back pain.

Clinic

Depending on which structures are pathologically affected by the damaged spine, there are compression and reflex syndromes.

Vertebrogenic reflex lumbar pain syndrome is called lumbago with acute development of the disease and lumbodynia with subacute occurrence or with a chronic course. Lumbago manifests itself as acute shooting pain in the lower back. Sciatica– pain that occurs in the lower back and radiates to the leg and buttock.

A disc herniation can compress any root. However, the disks L4-L5 and L5-S1 wear out most often. Therefore, the 5th lumbar and 1st club roots are most often compressed.

L5 spine (L4-L5 disc). Compression of the 5th lumbar root occurs after a long period of lumbar pain. The clinic is quite difficult. The pain spreads from the lower back to the buttock, along the outer edge of the thigh, along the anterior inner surface of the leg and to the first toe. In the same zone it is revealed increased sensitivity. Extensor strength also decreases thumb legs, decreased tone and atrophy of the tibialis anterior muscle. It is difficult for the patient to stand on his heels.

Spine S1 (disc L5-S1). It is damaged very often, since the herniated disc is not held for a long time by a narrow and thin ligament at this level. The pain spreads from the lower back and buttock to the outer edge of the foot and to the 5th toe. Sensory disturbances are noted in the same area. The strength of the triceps surae and toe flexors decreases. Especially the flexor of the 5th finger. It is difficult for the patient to stand on his toes.

Diagnostics

To identify a hernia of the lumbar spine, you should contact a neurologist. He will conduct a special neurological examination and send you for examination. These include neuroimaging of the lumbar region using computed tomography or magnetic resonance imaging. Also, in certain situations, you may need to consult a neurosurgeon to resolve the issue. surgical intervention.

Principles of treatment

The correct position of the spinal column is of great importance when treating patients. The mattress should be firm and even. A wooden board should be placed under the mattress.

Physical therapy and physiotherapeutic methods are of great importance. They are aimed at strengthening the back muscle corset, relieving pain and inflammation.

Physiotherapy

The main means are . They relieve pain and inflammation.

For severe muscle tightness, muscle relaxants are used.

In case of root pathology, vascular drugs are necessarily used to improve the blood supply to the nerve endings.

Neurotrophic drugs are also used that restore damaged roots.

Effective use after an exacerbation, due to which cartilage discs are renewed.

Which doctor should I contact?

If you have back pain, you can consult a general practitioner, family doctor or neurologist. After the examination, the patient may be referred to a neurosurgeon or orthopedist. Treatment assistance will be provided by a physiotherapist, chiropractor, massage therapist, or osteopath. Sometimes back pain is caused by damage to the spine due to systemic diseases connective tissue, then the patient is treated by a rheumatologist. If the cause of the pain is not a hernia, but a tumor lesion, the patient is referred to an oncologist.

Neurosurgeon A. Zuev talks about intervertebral hernia of the lumbar spine.

The spinal column is a collection of 34 vertebrae connected in pairs by intervertebral discs. It is not straight: from the head to the coccyx it makes several alternating bends: a bend with a convexity forward - in cervical spine, convex back - in the chest, then in the lumbar region a forward bend occurs again, and then the sacrum along with the coccyx bends back.

All this is necessary to provide the shock absorption associated with walking on two legs. But this structure also causes the center of gravity to be concentrated in the lumbosacral region.

Nature provided for this by making the lumbar vertebrae the thickest and strongest, and the sacral vertebrae completely soldered together.

All vertebrae, except the sacrococcygeal ones, have special structure. They consist of a cylindrical body, which bears the main load, and processes that provide us with the ability to bend in different directions, turn, and twist.

The two parts are connected by two semicircular arches on both sides so that there is a gap in the middle. This is the spinal canal, and it is intended for the spinal cord.

The latter is a kind of “checkpoint” of the second rank (after the brain), carrying impulses from the brain to the organs and vice versa.

The peripheral endings of the myelon (the so-called spinal cord) are the spinal nerves that emerge from it as part of the roots. The anterior roots are motor.

They carry commands to the muscles. Posterior roots– sensitive, directed, on the contrary, from the organs to the brain.

At first, the roots are not divided into anterior-posterior, but only into right-left, emerging laterally from the spinal cord through the hole between the processes of the upper and lower vertebrae.

Having passed the bone ring, separation immediately occurs.

Compression of the spinal cord itself by a hernia leads to disruption of a large number of functions at once: internal organs stop working, sensitivity and movement of the limbs are impaired (in the case of the lumbosacral region - only the lower ones).

If the disc begins to protrude towards one of the roots, this will cause sensory-motor disturbances in only one limb.

Now about the hernia itself. This is a protrusion of the central part of the disc, which normally has the consistency of a very dense and springy jelly.

This structure is called the nucleus pulposus and is the main shock-absorbing element and can move inside the disc and spread out depending on the direction and force of the load on nearby vertebrae.

At the same time, normally the surrounding tissues do not change their structure and do not suffer, remaining in density the same as the tendon of any muscle. As soon as thinning of the fibers occurs in the peripheral part of the disc (fibrous ring), the nucleus pulposus, under the influence of load, rushes into weakness.

While it has not yet gone beyond the disc, it is not yet a hernia, and the situation can still be corrected.

In fact, the fibrous ring is not so easy to destroy, because it consists of fibers lying in several layers and intersecting in three planes. But this is possible either due to a single action of high pressure on the nucleus pulposus, or when replacing the usual disc tissue with scar tissue. The latter occurs when the disk power supply fails. How does he eat?

When visiting an orthopedist, many patients complain of back pain. Most often, the cause is an intervertebral hernia.

The disease is a displacement of the spinal disc and rupture of the fibrous ring, consisting of strong collagen fibers. The contents of the disc (nucleus pulposus) can begin to compress the spinal cord and nerve roots.

A hernia is the result of damage to the intervertebral disc. Part of the gelatinous tissue of the disc core, when the disc itself is deformed, is compressed and protrudes into the spinal canal.

There this fabric presses on nerve endings located, in great abundance, in the region of the spinal column. The nerve roots are pinched by the bulging hernia and cause tissue swelling.

And swelling, in turn, gives severe pain.

In this case, it is impossible to ignore the pain. And it is not necessary! On the contrary, urgent measures need to be taken.

Symptoms of hernial strangulation

This type of disease is the most common. This was due to the functional feature of the lower back, which differs from other parts in that it is maximally exposed to the full severity of the endured physical activity.

A herniated disc, also called a herniated intervertebral disc or prolapsed disc, by its nature is the prolapse or complete prolapse of the nucleus pulposus, which is located inside the intervertebral structure.

The hernia develops deformation of the disc, which begins to bulge. In this case, the ring ruptures, in which all the contents can fall out.

There are several types of intervertebral hernia. All of them are divided depending on the location of the hernia:

• education in the cervical spine;
• dumping in thoracic region;
• the disease developed in the lumbar region.

Most often, a person experiences a herniated disc in the lumbar region. It is this part of the human body that suffers more than others from excessive stress and stress. In addition, the structural features of the lumbosacral junction also have an effect.

In second place in terms of the number of formations is cervical disc herniation. This part is the most mobile, so it can often be overloaded and tired.

Intervertebral discs are flexible “sleeves” between the vertebrae. Their main working area is the space for the spinal nerves, which exit the spinal cord through bony windows (the so-called intervertebral foramina), and act as shock absorbers.

The discs are made of two separate parts.

Fibrous ring. The annulus is the outer part of the disc. It consists of ligamentous rings (can be compared to the rings on a tree). Part of the center pulposus contains the jelly nucleus. The liquid cannot be compressed, so these jelly centers act as shock absorbers.

As you bear the weight, the pressure pushes the core toward the outside of the disc through 360 degrees. When you lean forward, the core is pushed more towards the back of the disc. The annular fibers are generally stiff enough to contain the disc during normal activities, including work.

But when there is too much discal pressure, these layers can become ligamentous and begin to break down from the inside. As the innermost layers begin to tear, the core jelly begins to be forced out to the outer (right or left or both) rear portions of the disc. The larger the gap, the larger the bulge.

Injuries that cause intervertebral discs to herniate. This can be caused by either acute trauma or repetitive physical activity. Mechanical stresses act on injured or weakened annular ligaments and allow the jelly to bulge outward.

If a bulge (often referred to as a herniated disc) protrudes over a small area (less than 25% of the disc circumference), then we refer to it as the focal point of the disc.

However, too often, the spinal disc can bulge over large areas (up to 50% of the disc circumference). This pathology is called diffuse herniated disc.

The differences in the two cases are minor. Focal disc bulges are more localized, causing pain that is usually focused in one area.

This happens because there are fewer nerves involved. It is important to keep in mind that a herniated disc can often cause sciatica.

Because diffuse disc swellings occupy more space, they tend to cause a wider range of symptoms. Pain is often on both sides. But due to the pressure on the cord, it can give other symptoms due to several spinal nerves.

Pain helps you know what type of disc herniation you are dealing with. Recovery time may be longer for a diffuse type of hernia.

Causes

Most often, lumbar spinal hernias appear with osteochondrosis, when, due to age-related changes, the trophism of the fibrous ring worsens, it becomes drier and brittle. However, osteochondrosis and intervertebral hernia are various diseases.

A hernia can also be caused by:

The main reasons for the formation of intervertebral hernia are, oddly enough, absolutely polar:

• inactive life, which involves low level mobility;
• constant sedentary work;
• excessive activity of athletes;
• physical type of work.

As described above, each intervertebral disc consists of a gel-like nucleus pulposus surrounded by a dense and durable membrane (annulus fibrosus).

If disc degeneration begins as a result of tissue damage or wear and tear that occurs with age, part of the nucleus pulposus may be squeezed out through the gap in the disc. outer shell.

This phenomenon is called intervertebral hernia.

The intervertebral disc has four concentric layers: the outer fibrous ring, consisting of dense collagenous fibrous plates; internal fibrous ring, consisting of fibrous cartilage tissue; transition region; and the central nucleus pulposus.

So, the intervertebral disc consists of collagen fibers of the annulus fibrosus, which provide strength, and proteoglycans of the nucleus pulposus, which provide resistance to compression.

Several factors, including genetics and changes in hydration and collagen, play a role in the development of degenerative disc disease. It is generally accepted that the ability of the nucleus pulposus to bind water plays a significant role in physical properties disk.

In a healthy disc, the nucleus pulposus distributes the load evenly throughout the entire annulus fibrosus. Decreased disc hydration may reduce the cushioning effect, resulting in asymmetric load distribution on the fibrous membrane, which can lead to damage.

Increased collagen content in the nucleus is also considered to be one of the factors responsible for disc degeneration.

• 1. Incorrect posture (scoliosis, kyphoscoliosis), undeveloped muscle corset, pathological motor and positional stereotypies.
  2. Sedentary lifestyle, prolonged stay in a monotonous position, static loads.
  3. Power and contact types sports, improper lifting of weights.
  4. Injuries.
  5. Congenital anomalies of the development of bone, cartilage, connective tissue, and spinal column.
  6. Age-related changes, osteoporosis.

The main cause of the formation of intervertebral hernia in the section in question is considered to be osteochondrosis. However, there are other reasons predisposing to the development of this condition:

• violation metabolic processes in organism;
• various types of trauma, mostly in road accidents, namely after a sharp jerk of the head forward;
• excessive physical activity, heavy lifting (especially jerking), excessively sharp bends;
• pathology hip joint, curvature of the spinal column - in particular, scoliosis;
• obesity;
• in some cases - structural changes spinal column in case of tumor processes, syphilis, congenital anomalies, syphilis.

READ ALSO: Umbilical hernia surgery in children

There are also many associated factors:

• weakness of the back muscles;
• infections;
• physical inactivity;
• bad habits;
• age-related changes;
• hereditary factors;
• a profession that requires a long stay in a “sitting” position (secretary, crane operator, driver, programmer, etc.).

Important! The listed factors lead to accelerated aging and rapid wear of tissue - cartilage and bone - and this subsequently becomes the cause of the formation of intervertebral hernial protrusion.

As a rule, a lumbar hernia is a consequence of the development of lumbar osteochondrosis.

There are factors that provoke the development of degeneration:

Among the causes of pathology, viral and bacterial etiology. Some microorganisms have excellent adaptability to nervous tissue and can use these cells for invasion and subsequent reproduction.

Infection with the herpes virus is in first place among the causes of intercostal neuralgia.

Kinds

Depending on the location, the hernia can be located in the cervical, thoracic, lumbar or sacral spine. Based on the location of the hernia relative to the vertebrae, there are the following types of hernia:

Depending on which direction the center of the disc (nucleus pulposus) protrudes, a herniated L5 S1 disc can be:

(if the table is not completely visible, scroll to the right)

The larger the volume of the L5 S1 hernia, the more intense the pain in the lower back, perineum or leg.

Severe advanced forms of the disease may require surgical treatment.

Last stage diseases - sequestered hernia, when the contents of the disc drain into the spinal canal. It manifests itself in four signs:

strong “lumbago” in the lower back;

pain increases with coughing, straining, laughing;

one leg goes numb and becomes inactive, up to the development of paralysis;

The independent ability to defecate and urinate may be impaired.

If there is a suspicion of sequestration of the hernia, urgent treatment is required.

Click on photo to enlarge

Disc herniation is a pathology in which parts of the damaged and altered nucleus pulposus are squeezed out through a defect in the annulus fibrosus, causing its rupture or excessive protrusion beyond normal physiological boundaries and fall into the cavity spinal canal or “pressed” into the vertebral body.

If the fibrous ring is intact, its protrusion under the influence of sequestration of the altered nucleus pulposus is designated as protrusion (bulging) of the disc.

Often the term "protrusion" is used to refer to the size of the hernia, which leads to misinterpretation of the condition.

Due to the fact that in most cases, a hernia is formed precisely in the lumbar region of the spinal column, it is worth paying more attention to this area, highlighting individual types of pathology, as well as localization features.

First of all, let's talk about the general classification of dorsal hernias; in total, there are 5 types:

Intervertebral hernias are divided into three types:

1. By size:

• Protrusion – protrusion of the disc by 1-3 mm.
• Prolapse - prolapse of a disc by 3-6 mm.
• The development of a hernia is a protrusion of the disc by 6 to 15.

2. By type of tissue, intervertebral hernias:

• Bone (spondylous osteophyte) - diagnosed very rarely (in 1% of cases) in older people.
• Cartilaginous (osteophytes) – develop in 15% of patients.
• Pulpous (Schmorl's hernia) - are formed in 84% of cases.

3. In the direction of exit in accordance with the center of gravity of the spinal segment:

• Foraminal - hernial protrusion occurs through the hole from which the nerve endings emerge
• Median disc herniation - characterized by a split of the round disc cartilage along the radius. The exit gate in this case is directed to the periphery from the circular platform of the vertebral body
• Left-handed
• Right-handed
• Front
• Rear

Lumbar hernia is usually divided into two types:

1. L4-L5 – when the nerve root is pinched between the lumbar vertebrae 4 and 5;
2. L5-S1 – infringement occurred between the 1st sacral and 5th lumbar vertebrae.

Stages of development

The process of hernia formation occurs in stages:

The progression of the pathology varies from sudden to slow onset of symptoms. There are four stages:

1. Disc protrusion
2. Dropped disc
3. Disc extrusion
4. Absorbed Disk

Stages 1 and 2 are called incomplete disc herniation, while stages 3 and 4 are complete herniations. Neurological deficits may include sensory changes (ie, tingling, numbness) and changes in movement (weakness, impaired reflex function).

These changes are caused by compression of the nerve caused by pressure from the internal disc.

Hernia progression

• Cervical - pain spreads to the neck, shoulders and arms.
• Thoracic - pain spreads to the chest.
• Lumbar - pain spreads to the buttocks, hips, legs.

Cauda equina syndrome occurs from a central disc herniation and is a serious pathology requiring immediate surgical intervention. Symptoms include bilateral leg pain, loss of perianal (anal) sensation, bladder paralysis, and anal sphincter weakness.

Signs of the disease

With a hernia of the localization in question, the following symptoms may be observed:

• intense pain in the projection of the sacrum;
• feeling of "heavy legs" general weakness;
• pain that intensifies while walking and radiates to the thigh area;
• stiffness of movements;
• in advanced cases – disturbances in physiological functioning genitourinary organs;
• local numbness in the lower extremities.

The pain syndrome “evolves” as the disease develops as follows:

1. At the initial stage of development of the pathology, the pain is dull and aching in nature, localized only in the lesion, intensifies with exercise and may be completely absent at rest.
2. The pain increases, spreading to the lower back muscles.
3. The process also involves lower limbs, the patient’s legs hurt, the pain is sharp with “shooting”. May affect different parts of the leg, perineum.

The pathological process occurs in the following stages:

1. Prolapse - minimal displacement. The disc, in the absence of any deformation, can return to its place. The manifestation of pain syndrome is insignificant.
2. Protrusion. The disc is still limited by the vertebral bodies, but has already undergone one more, additional displacement after it has already been displaced.
3. Extrusion and sequestration. Between the vertebrae the nucleus, displaced outward, sags. Subsequently, the capsule breaks and its contents flow out.

The most common signs are:

The first thing that is necessary for a speedy recovery is to pay attention to alarming symptoms in time. This will make it possible to start treatment in the early stages of the disease, and this significantly increases the chances of success. So, you should be wary if you notice the following symptoms:

Photo: compressed roots between discs

Symptoms

The first thing the patient needs to pay attention to is pain that extends to the hip, knee and lower leg. Such sensations have characteristic features:

• Dull, debilitating pain.
• With any tension in the spinal muscles, the pain increases.
• After taking a horizontal position, pain decreases.
• Pain is felt in a certain area of ​​the back.

The symptoms depend on which part of the spinal column the hernia has formed. Common symptom is back pain.

Cervical calving is characterized by the appearance frequent dizziness and headaches, numbness in the fingers, increased blood pressure, possible memory impairment and deterioration in concentration.

This pathology occurs infrequently, but poses a particular danger to the patient, since the vessels leading to the brain can be infringed. Incorrect, sudden movement of the neck can lead to poor blood circulation.

All symptoms can be divided into 2 groups: irritation and damage.

Symptoms vary greatly depending on the location of the hernia, but the stage of progression of the pathological process, the size of the formation, the factor of pinching nerves, blood vessels, etc. also play a significant role here.

A common symptom for all types of hernias is pain. In the early stages, the pain in the back is quite insignificant, periodically many even ignore it.

However, as the disease progresses and the formation grows, the pain intensifies and becomes constant. The larger the hernia, the more unbearable the pain; ultimately, it becomes impossible to bear it without painkillers.

Lumbar

Signs of the disease do not appear immediately; in some cases, the first stages pass without symptoms. Symptoms of an intervertebral hernia will differ depending on the department in which the formation of the bulge began.

The main complaint from patients is sharp, severe pain. It is caused by a prolapsed disc that puts pressure on a nerve root.

Each of them is responsible for the functioning of a specific organ, so vertebral prolapse affects the spinal cord and nearby nerve endings.

Dorsal intervertebral disc herniation is usually asymptomatic, but sometimes the following symptoms are observed: discomfort, pain in the lower back, which continues for a long time.

Over time, the pain becomes stronger. She begins to be convulsive.

Discomfort is especially felt after physical activity in one position. The patient may hear clicking or crunching sounds in the back.

During the pain syndrome, the pain is intense, even during breathing and coughing. Over time, the pain begins to radiate to the leg. As a result of worsening back discomfort, it is difficult to straighten the leg, the knee reflex worsens, and other symptoms are observed.

Symptoms of the disease depend on the size of the hernia and its location:

There are many symptoms of arthritis: increased pain in the joints at night, stiffness in the body and joints, which only goes away within an hour or two. The most alarming sign of arthritis is regular stiffness of the hands in the morning, a feeling of “imaginary gloves” on the hands immediately after waking up.

You should also be wary if you have swelling of the wrist joints, that is, those located at the base of the fingers.

With dumping syndrome of the operated stomach, the main symptoms are the following:

• Vascular and neurovegetative: attacks of weakness, palpitations, paleness or a feeling of heat with redness of the face, trembling of fingers and hands, dizziness, darkening of the eyes, cold sweat. These complaints are directly related to food intake and are observed exclusively during an attack of dumping syndrome.
• Dyspeptic and abdominal discomfort: lack of appetite, nausea, regurgitation, vomiting, rumbling in the abdomen, loose loose stools, constipation. This category of complaints is associated with a violation of the motor-evacuation activity of the gastrointestinal tract and disorders exocrine function pancreas.
• Complaints related to insufficient digestion, metabolic disorders: emaciation, anemia, general weakening of the body, decreased ability to work, physical impotence, impotence.
• Various pain sensations, most often caused by inflammatory process in the hepato-pancreatic-duodenal system, duodenostasis and adhesive process in the abdominal cavity.
• Psychoneurological disorders and personality asthenia: irritability, tearfulness, insomnia, headaches, imbalance, fixation neurasthenia.

Diagnostics

To make a diagnosis, the doctor will conduct a survey, visually examine the patient, and palpate problem areas. Additionally, the following examination will be ordered:

A medical examination should begin with a visit to the doctor. In this case, consultation with a neurologist is necessary. The specialist will interview and examine the patient, after which additional diagnostics may be necessary.

Currently, the most informative methods include computed tomography and magnetic resonance imaging. Thanks to these methods, you can find out the exact location of the hernia, its size and effect on the spinal canal and nerve roots.

The doctor will begin assessing your condition with a complete medical examination and compilation medical history, including detailed information about symptoms. He or she will perform a neurological examination to check muscle reflexes, sensation, and muscle strength.

READ ALSO: Rehabilitation after removal of a hernia of the lumbar spine

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

These tests may include:

Pain in the lumbar or cervical region does not always indicate the presence of intervertebral hernia. Only an experienced doctor can determine it during a comprehensive examination of the patient. A neurologist or neurosurgeon will make a final diagnosis after additional examination using the following methods:

• MRI (Magnetic Resonance Therapy), MRI is the most reliable diagnosis;
• spondylography;
• X-ray examination.

To establish the exact location of the hernia, the degree of progression of the pathology, the size of the formation and associated complications, a full diagnosis is necessary, which involves:

To establish a diagnosis, doctors initially use the simplest methods: they use special tests to identify symptoms of the disease, and check tendon reflexes.

Such a test allows you to determine how damaged the spinal column is. However, without the use of hardware diagnostics, it is quite difficult to determine the presence of an intervertebral hernia in a patient.

It is difficult to suspect the formation of a lumbar hernia in the initial stages, since it clinical picture similar to the symptoms of uncomplicated osteochondrosis and the onset of other pathological processes(lumbar spondylosis, lumbar spondyloarthrosis, lumbarization, sacralization, etc.

). Patients themselves often turn to a neurologist, orthopedist or vertebrologist only at the stage of radicular syndrome.

To accurately diagnose a lumbar intervertebral hernia, it is necessary to conduct a number of examinations in a medical institution:

Despite the fact that the symptoms of such a disease are difficult to ignore, familiarization with the symptoms alone is not enough to make a diagnosis. A number of additional studies are needed. Among them:

• Neurological test.
• X-ray.
• Magnetic resonance imaging. Allows you to take a kind of “photo” of soft tissues and track the protrusion of the intervertebral disc.
• CT scan.
• Electromyogram.

Treatment

The correct position of the spinal column is of great importance when treating patients. The mattress should be firm and even. A wooden board should be placed under the mattress.

A few simple and effective exercises for intervertebral hernia

Physical therapy and physiotherapeutic methods are of great importance. They are aimed at strengthening the back muscle corset, relieving pain and inflammation.

Physiotherapy

The main drugs are non-steroidal anti-inflammatory drugs. They relieve pain and inflammation.

For severe muscle tightness, muscle relaxants are used.

In case of root pathology, vascular drugs are necessarily used to improve the blood supply to the nerve endings.

Neurotrophic drugs are also used that restore damaged roots.

It is effective to use chondroprotectors after an exacerbation, thanks to which cartilage discs are renewed.

The course of therapy is prescribed by a neurologist on an individual basis. When choosing the right direction, gender, age, diagnostic indicators, and external examination will be taken into account.

The attending physician may have at his disposal the main methods of treatment (conservative, surgical) and a number of additional procedures(massage, resonance wave therapy, acupuncture, hirudotherapy).

The duration of treatment for non-advanced stages of the disease is from three to six weeks.

Surgical treatment (surgical intervention) is rarely used, provided that the lumbar hernia cannot be cured with medication.

The surgeon’s manipulations are carried out under general anesthesia to remove the protrusion, reduce the risk of complications on the muscles, and the bone of the inflamed area using modern techniques (laminectomy, microdiscectomy).

After removing the inflammation, you must follow the instructions of specialists for a week, and then follow preventive measures.

Conservative (drug) treatment is considered the main one, while the use of one or another type of drug depends on the stage, symptoms and accompanying symptoms. For the treatment of lumbar hernia, the following are used:

• non-steroidal anti-inflammatory drugs (Ibuprofen, Diclofenac, Baralgin);
• novocaine blockade with the addition of corticosteroids (done locally to quickly relieve pain);
• chondroprotectors for the restoration of cartilage tissue (Chondroxid, Alflutop, Structum);
• general muscle relaxants (Mydocalm, Sirdalud);
• vitamin complexes with increased content group B for the restoration of nerve tissue (Neurovitan, Milgamma, Neurobeks).

Additional methods (physio- and manual therapy, acupuncture, exercise therapy, hirudotherapy) are used in subacute or recovery period, this helps restore mobility to the body.

A prerequisite in order not to damage problematic discs through your actions: alternative treatment methods must be carried out under the supervision of a specialist.

Often, the treatment of a disc herniation involves the use of conservative methods, physiotherapy, manual therapy and physical therapy. First of all, you will need drug therapy aimed at relieving pain and eliminating spasms of the muscle corset.

For this purpose, painkillers and anti-inflammatory (non-steroidal) medications are prescribed: Movalis, Diclofenac, Ibuprofen, Indomethacin, Meloxicam.

They produce painkillers in the form of tablets, gels and ointments for local application, injections.

A mandatory component of therapy are B vitamins. Under their action, nerve tissue is restored and the passage of impulses improves.

To prevent the development of degenerative-dystrophic changes in bone tissue and cartilage, it is necessary to take chondroprotectors: “Teraflex”, “Artrofon”, “Chondroitin”, “Rumalon”.

Improves blood circulation in the problem area and reduces tension in muscle tissue by taking muscle relaxants: Mydocalm, Venoruton. They are usually combined with non-steroidal anti-inflammatory drugs.

There are two main methods of treatment: surgical and conservative.

There is only one method of surgical treatment - surgery.

The conservative method has a wider range of effects on lumbar hernia:

A prolapsed intervertebral disc is treated using the usual traditional method. Surgery is indicated only in extreme cases. This is the reason why it is very important to catch intervertebral disc disease in time in order to avoid surgery.

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

A herniated disc is treated using conservative or surgical methods. The main goal of treating a person with this disease is his desire to return to normal life without pain, restoration of activity in movements, return to work.

Traditional treatment

To get rid of disc herniation, conservative treatment is preferable, which consists of performing following procedures:

Conservative therapy is the most preferable treatment strategy for intervertebral disc herniation. It is complex in nature.

The medicinal component includes drugs to relieve pain (ketoprofen, ibuprofen, diclofenac, naproxen, meloxicam, etc.), muscle relaxants to relieve muscle-tonic syndrome (tolperisone hydrochloride), vitamin complexes necessary for maintaining nervous tissue (B1, B6, B12), decongestants.

To relieve intense pain, local administration of corticosteroids and local anesthetics in the form of paravertebral blockades.

In the initial stages, chondroprotectors (chondroitin sulfate, glucosamine, etc.) are effective.

Disc herniation L5 S1 is treated conservatively and operational methods.

Surgery is resorted to only if problems with urination or defecation have developed, or the legs have become paralyzed. In other cases, conservative treatment is first used.

Conservative therapy

Conservative treatment must be comprehensive:

Yulina's swing

Operation

Such treatment is carried out in extreme cases: in case of ineffectiveness of conservative therapy, development of paralysis or “cauda equina syndrome”. At modern operations Through an incision or puncture, a section of the intervertebral disc pressing on the nerves or spinal cord is removed.

The disc is evaporated by laser or sucked out using negative pressure. Very in rare cases carry out " major surgery", when the damaged disc is removed using conventional neurosurgical instruments through a relatively large incision.

As mentioned earlier, treatment of a sequestered hernia is carried out based on the results obtained during diagnosis. Treatment necessarily involves the involvement of a doctor. Only a specialist makes a decision about what means will be used in the treatment of pathology.

The fact is that for complete treatment an integrated approach is important if we're talking about about conservative methods.

In cases where it is possible to do without surgical intervention, that is, there is a threat to life important functions there is no patient’s body, an integrated approach involves the following methods of control:

• Drug therapy.
• Physiotherapy.
• Acupuncture.
• Physiotherapy.

Conservative treatment

Such therapy, which involves taking medications and using physical therapy, is carried out only if the nucleus pulposus is not completely divided. This means that part of the sequestrum has protruded beyond the disc, but is still retained by the gelatinous substance.

The essence of conservative treatment is to prevent the final loss of the sequestrum until the final necrosis of its tissues. A process of ossification will occur in this area, due to which the hole in the annulus fibrosus will close.

During treatment, it is important to ensure that new bone formations do not damage nerve tissue.

Conservative treatment includes:

• The use of medications that have analgesic and anti-inflammatory effects.
• Physiotherapy.
• Massage course.
• Muscle rest, etc.

Acupuncture

Acupuncture or acupuncture is a type of conservative treatment. Its essence is to influence biologically active points to stimulate various processes in the body.

Thanks to acupuncture, you can get rid of back pain, restore nerve function to prevent problems with internal organs and disorders of musculoskeletal functions. Acupuncture should only be performed by a highly qualified specialist.

At initial manifestations painful and neurological syndromes caused by disc herniation, pharmacotherapy is used. They use analgesics, steroidal and non-steroidal anti-inflammatory drugs, vitamin therapy, chondroprotectors, muscle relaxants, anticonvulsants, and drugs that improve blood circulation.

Drug therapy can be combined well with physiotherapeutic treatment. Methods such as exposure to diadynamic currents and magnetic therapy have proven themselves to be positive.

There are techniques for introducing certain drugs into the affected area using electrophoresis.

If the severity of the pain syndrome decreases, you can resort to the help of a chiropractor or massage therapist. It is useful to use techniques such as post-isometric relaxation, underwater and dry traction, and exercises on the Evminov board.

And, of course, physical therapy to form correct posture and muscle corset.

Do not forget about acupuncture and pharmacopuncture.

There are methods of surgical treatment of herniated intervertebral discs. Indications for such operations are very limited: increasing paresis, dysfunction pelvic organs, disabling pain syndrome.

Some doctors believe that the presence of a sequestering hernia is also an indication for surgical intervention. There are several methods of surgical treatment; the most suitable method is chosen for each patient individually.

Any of the treatment methods involves changing lifestyle, forming correct stereotypes of physical and static activity, and working on oneself. Without this, treatment will be ineffective and the disease may return.

TV channel “Russia-1”, program “About the most important” on the topic “Intervertebral hernia”:

ABOUT THE MOST IMPORTANT THINGS Intervertebral hernia

Channel One, “Live Healthy” program with Elena Malysheva on the topic “Intervertebral hernia”:

Intervertebral hernia: symptoms and signs

A dorsal herniated disc requires immediate treatment with the mandatory involvement of a doctor. All measures to combat pathology are based on the obtained diagnostic data.

Intervertebral hernias and other troubles associated with the spine - osteochondrosis, rheumatism, arthritis, arthrosis - all this is humanity's retribution for walking upright.

Previously, it was believed that older people began to grab their backs, having accumulated, along with the years they had lived, degenerative changes in the spine.

As a rule, men are more likely to suffer from this scourge after the age of 30. And in 90% of cases we are talking about a hernia of the lumbar spine, today we will talk about how to get rid of this disease at home using folk remedies.

Reasons for appearance

Today, doctors are sounding the alarm: hernias are getting younger and the main reason for this is a sedentary lifestyle, prolonged static loads, such as sitting in front of a computer monitor for hours and days on end. The load on the spine in this case, no matter how strange it may seem, is enormous and the consequences are very unpleasant.

5 main causes of lumbar hernia:

• Sedentary, inactive lifestyle.
• Injuries (old back bruises can also make themselves felt).
• Overweight.
• Experiences and stress.
• Lifting weights. Excessive physical activity.

Comment: There may be several reasons. The sum of factors is not excluded.

What is a hernia, and how does it manifest itself?

A hernia is the result of damage to the intervertebral disc. Part of the gelatinous tissue of the disc core, when the disc itself is deformed, is compressed and protrudes into the spinal canal. There, this tissue puts pressure on the nerve endings, located in great numbers in the spinal column. The nerve roots are pinched by the bulging hernia and cause tissue swelling. And swelling, in turn, gives severe pain.

In this case, it is impossible to ignore the pain. And it is not necessary! On the contrary, urgent measures need to be taken.

Symptoms of hernial strangulation

• Aching pain in the lumbar spine. ( Attention! Pain with similar symptoms also occurs with inflammatory gynecological diseases in women. Therefore, the first thing a neurologist does is exclude the gynecological component from the causes.)

• Shooting, sharp pain in the back, at the slightest, even harmless, movement, for example, when sneezing. People call such pains “lumbago.” The roots of the nerve endings pinched by the hernia make themselves felt.
• Numbness in the legs. Numbness usually spreads to one leg - the one towards which the hernia is displaced. And such numbness is a bad sign. It means that the process has started, and it is no longer possible to limit yourself to home remedies and methods. You need to see a doctor!
• Cramps your legs. Sensations similar to those that occur with the legs in cold water when swimming. The pain is unbearable, making it impossible to walk. And the person takes a gentle pose - gets on all fours. This symptom, especially if it is constantly repeated, is a direct path to disability. There is usually only one way out - surgery.
• Muscle weakness of the legs. Numbness of the toes, more often - the thumb. If the process is started, numbness may remain, even after the pain is relieved. Calf muscle, long time, which has not received enough “nutrition”, dries and decreases in size. Her tone decreases sharply. Often there is a tingling sensation in the leg, cramping pain or pain similar to electrical discharges - sharp, piercing.

Why is a hernia dangerous?

And it is dangerous due to complications. It is with them that neurologists fight after first aid - pain relief. And the recovery process is very long. It requires a painstaking, systematic approach and a clear diagnosis - you need to know where exactly the hernia is hidden, what size it is, . Is she alone?..

Fortunately, today there are no problems with diagnosis - it is enough to do an MRI of the lumbar spine.

If the pain continues for a month or more, and you continue to wait for it to “go away on its own,” then the path to a wheelchair is very likely.

• The most pessimistic scenario for the development of events

Gradually, your hernia will increase in size to such an extent that it completely blocks muscle nutrition, damaging the nerve fibers. Paralysis will develop, your legs will become “wobbly” and will no longer obey you. With a hernia of the lumbosacral spine, paralysis can also affect the ability to defecate and urinate.

• A less pessimistic scenario for the development of events

Limited movement and physical activity. Constant discomfort when bending over. Over time, the muscular system of the leg limbs weakens and atrophies. The frequency of muscle spasms increases. ABOUT full life there is no question.

A hernia of the sacral spine in women can lead to reproductive dysfunction.

Methods for treating intervertebral hernia

There are two main methods of treatment: surgical and conservative.

There is only one method of surgical treatment - surgery.

The conservative method has a wider range of effects on lumbar hernia:

• Drug treatment. This includes pills, intravenous drips, intramuscular injections– hormonal, analgesic, anti-inflammatory therapy, psychotropic drugs.
• Physiotherapy. To classical electrophoresis, which has proven itself in the treatment of spinal diseases since Soviet times, today a wide range of new physiotherapeutic possibilities has been added. Among them is acupuncture, which came to us from China; hirudotherapy (treatment with leeches), apitherapy (treatment bee venom), dry traction, various hardware techniques (ultrasound, laser, magnetic resonance).

• Manual therapy. This includes not only massage, but also osteopathy.

“Bone setters,” as they are popularly called, indeed, back in the old days, manually set not only dislocations, but also hernias. But such a skill is of a high class and is rarely mastered by anyone. Therefore, there is a very high risk of falling into the hands of an incompetent “manipulator” and after his session going to the ambulance in surgery.

• Exercise therapy. Physical therapy is indicated for lumbar hernias.

But! This type of treatment is started only after the patient has recovered from the acute period and his pain syndrome has been relieved.

The therapeutic and physical training complex is selected for each patient individually and is performed by the patient systematically, daily and for a long time. Ideally, daily morning back exercises should become a habit and become a permanent factor in the prevention of osteochondrosis and exacerbation of intervertebral hernia at home.

Basic physical therapy exercises

1.Series of stretching exercises. Their goal is to reduce the pressure of the vertebrae on the intervertebral disc and stop its deformation.

Such exercises include: fetal position, sleeping baby position or praying position oriental man– on the stomach, knees bent, arms extended forward as much as possible or lying relaxed along the bent body. The goal is to press as close to the floor as possible and relieve the load on the spine.

Cat pose– standing on all fours on the floor, while inhaling, try to arch your back upward as much as possible (like a cat). As you exhale, lower your back, even bend it down if possible. Breathe openly, noisily, powerfully taking in and releasing air from yourself.

2. A series of exercises to strengthen the muscular frame. It is necessary so that the spine “does not wobble”, but is fixed by a natural frame - made of muscles.

These exercises include strengthening the abs and back muscles: – lying on your back, straighten your legs and bend your knees. Hands behind the head or along the body and legs do not help.

– Lying on your back, without lifting your legs off the floor, raise your upper body. Hands behind your head.

Important! Exercises should not cause discomfort. On the contrary, they should bring relief and a pleasant feeling of lightness and flexibility. This way there is a greater chance that you will get used to them and will not be able to live without them later.

In case of hernial manifestations, exercises with twists, sudden movements and jumps are contraindicated.

But! The water should be at a comfortable temperature. No contrasting douches.

• Folk remedies. They have also proven themselves well in the treatment of lumbar intervertebral hernias. They are attractive both for their efficiency and affordability - many manipulations can be done at home, on your own. The material costs for them are not high and are not comparable with the cost of surgical intervention.

But there are cases when home therapy for intervertebral hernia is not effective and even dangerous.

Contraindications

Factors that cannot be ignored at home treatment spinal hernias in the lumbar region: – patient’s age,

1. his professional daily activity,
2. accompanying illnesses,
3. the presence of sensory loss and paralysis.

Traditional methods are effective if:

• The diagnosis was made correctly.
• The hernia is not very large and the disease has not progressed too far.
• Treatment methods with folk remedies do not contradict the principles of traditional medicine and do not go against it.

According to the goals and objectives, folk remedies for the treatment of hernia of the lumbar spine are divided into three groups:

1. To relieve pain.
2. Release the compressed nerve.
3. Do not allow it to re-compress.

The sequence of actions is important. And it is important not to limit yourself to just one achievement, for example, pain relief. If the nerve remains pinched by the hernia, then everything will return to normal and at double the scale.

Attention! During the acute period, hot baths, steam rooms, and massages are unacceptable.

Folk remedies that you can do at home

The role of anti-inflammatory drugs is played by tinctures, decoctions and ointments made from natural products and herbs.

• The lumbar region of the back is rubbed St. John's wort oil(fresh St. John's wort is infused for two weeks sunflower oil in a dark place until it turns red), birch leaf oil(see St. John's wort oil).
• Apply to the sore spot horse fat, wrapped in gauze. The compress is worn for a day. Repeated up to 10 times.

• Compress with red clay It is done by analogy with horse fat. The clay is pre-soaked in warm water until it becomes liquid. The compress is kept until the clay dries completely.

• Garlic compress– grated garlic is infused with vodka in a dark place for 10 days. The resulting pulp is wrapped in gauze and applied to the lower back.
• Iodine mesh. Iodine, in addition to its well-known antiseptic effect, also has an anti-inflammatory effect. It is well absorbed by the skin and is able to penetrate deeply to the site of inflammation. Therefore, when treating lumbar hernias at home, we cannot replace it. The easiest way to use it is iodine mesh on a sore spot. The sore spot then needs to be kept warm, it is better to wrap it up.

Advice: folk remedies will perform better if they are combined with therapeutic exercises, drug pain relief, restriction of mobility and providing rest to the back.

It is also important to review your diet - exclude salt, alcohol, spicy and smoked foods from it, expand vegetable menu, rich in fiber, microelements and vitamins.

Specialty: General Practitioner
Education: First Moscow State Medical University named after. Sechenov in 2010

If a patient develops a lumbar spinal hernia, treatment should begin as early as possible. The lack of necessary therapeutic measures leads to the fact that the patient may develop. What are the main symptoms of a lumbar hernia and methods of effective treatment?

How does the disease develop and what are its symptoms?

Intervertebral hernia in the lumbar region occurs much more often than in other parts of the spine. This is due to the fact that the lower back experiences heavy loads. It has 5 vertebrae, and they are all connected by discs. Without them, there would be no normal depreciation of the vertebrae; they help to normally distribute the load across the entire spine. The disc contains a hard shell or ring, and inside it is a soft core.

When the annulus fibrosus is destroyed, a lumbar hernia is formed. The liquid core penetrates the spinal canal. As a result, the nerve endings are pinched. In severe cases, compression of the spinal cord develops; if help is not provided to the person, paralysis develops.

The signs of a hernia are as follows:

• pain and stiffness in the lower back;
• lumbago - the appearance of sharp, sudden pain in the lower back;
• sharp pain when bending or turning;
• pain in the buttock, leg and even foot;
• the appearance of girdling pain in the legs;
• decreased sensitivity in the legs;
• disruption of the bladder, intestines, muscle atrophy and paralysis (this happens in advanced cases).

What are the types of pathology?

There are different types of spinal hernias, which are classified according to certain characteristics. Thus, a hernia is primary if it develops in the spine after injury. Usually such a diagnosis does not cause difficulties. If a hernia is a complication of degenerative processes in the spine, then it will be secondary.

There is a classification depending on the part of the hernia protruding beyond the vertebra. Highlight:

• protrusion - a hernia not exceeding 3 mm;
• prolapse - protrusion up to 5 mm in size;
• the hernia is developed (its size exceeds 6 mm), in which case the disc ring ruptures and the nucleus comes out.

Depending on the direction of growth, the hernia is classified into:

• anterior (that is, the bulge is directed to the anterior side), this pathology does not show symptoms and is considered the most favorable for the patient;
• lateral (side) hernia - it can extend from the vertebral body, affecting the nerve roots of the spinal cord;
• posterior hernia - it protrudes directly into the spinal cord and is characterized by the least favorable manifestation;
• or vertical spread.

A hernia can be:

• free (connection with the intervertebral disc is preserved);
• wandering (it loses contact with the disk where the pathological changes and is able to move in the spinal cord canal);
• moving - it can either move or come back.

A moving hernia is most dangerous because it can compress nerves.

The following signs indicate that the patient has compressed nerve roots:

• increasing weakness in the lower limb;
• urinary retention or incontinence;
• violation of defecation, sometimes loss of control over this process;
• numbness in the perineum;
• gait disorder.

If such symptoms of spinal damage are noted, treatment should begin as early as possible, without waiting for the disease to cause severe complications.

You should urgently contact a neurosurgeon in the following cases:

• if the patient loses control over the process of urine excretion;
• there is a sharp weakness in the lower extremities;
• the person feels paralyzed.

Immediate surgical treatment is necessary for the development of cauda equina disease.

Danger of hernial protrusion

A hernia of the lumbosacral spine is dangerous for everyone. Women are at risk of developing poor circulation in the pelvic area. This can lead to gynecological problems and bladder dysfunction.

Spinal hernias cause muscle tension. This is how the body strives to maintain the position of the spine. If muscle spasms occur frequently and continue for a long time, a person may develop scoliosis.

The dangerous consequences of a herniated disc in the lumbar spine is that it can compress a nerve root. A person's sensitivity to the area of ​​skin where this nerve sends its impulses decreases. Often people suffering from a hernia feel a lumbago. Sharp pain due to compression of the spinal nerve may not subside for several days. Other complications of the disease associated with impaired motor function may also occur.

The most severe consequences of lumbar intervertebral hernia are as follows:

• motor dysfunction due to sharp pain and spasms;
• weakening and sometimes complete disappearance of the knee reflex;
• impaired muscle sensitivity, their atrophy;
• paralysis.

Pain relief measures at home

If a person develops a lumbar disc herniation, symptoms may appear at any time of the day. Sometimes the pain is so severe that strong painkillers are necessary.

Nonsteroidal anti-inflammatory medications can significantly improve the condition of a person suffering from a hernia:

• Diclofenac;
• Ibuprofen;
• Meloxicam;
• Acetaminophen;
• Naproxen and others.

Bed rest is sometimes required to relieve pain. It is not recommended to stay in bed for more than 3 days. This leads to further weakening of the spinal muscles. The feeling of pain in such cases will only intensify.

In the first weeks after an attack you should not do special exercises and even more so to engage in sports that involve increased stress on the spine. Slow, leisurely walking will help normalize motor function and improve a person’s condition.

Diagnostic measures

Diagnosis of lumbar disc herniation is necessary to select the optimal treatment. First, the doctor collects an anamnesis, conducts initial examination patient. He will be interested in symptoms indicating that the nerve roots are being compressed.

Decisive in staging correct diagnosis are the following procedures:

1. MRI or magnetic resonance imaging. Diagnosis uses a magnetic field that does not harm humans. The doctor receives detailed and high-quality images of the internal structures of the body. MRI is used to determine the location of the hernia. This examination is also prescribed if the patient is suspected of having a hernia of the sacral spine.
2. CT or CT scan shows the condition of the bones well. This type of examination uses x-rays.
3. Radiography is used to confirm previously made diagnoses.

If necessary, a person may be prescribed other types of diagnostics. Everything will depend on his state of health and prevailing symptoms.

Hernia treatment

In most cases, a hernia can be treated without surgery. This can be explained by the fact that over time it “shrinks out”. The average duration of such a process is from six months to a year. There is no way to speed up this process, because it is natural. Typically, such conservative treatment of a hernia is associated with a set of measures that alleviate the patient’s condition. The main components of non-surgical methods of treating intervertebral herniation of the spine include:

1. therapy. The patient is prescribed painkillers to help relieve pain. For severe pain, the use of stronger narcotic drugs is recommended. Drug therapy cannot be permanent.
2. X-ray controlled blockade. Applies in cases where drug treatment not effective. Under the control of an X-ray machine, an anesthetic solution is injected with a special needle directly to the place where the nerve root is pinched. This procedure is performed only under local anesthesia. In half of the cases, this therapy can speed up the recovery process. Even advanced intervertebral hernia of the lumbosacral spine proceeds much easier thanks to such.
3. Manual treatment. Used in the first month after an attack to reduce pain. Before carrying out such treatment, it is necessary to carry out special diagnostics to exclude malignant tumors.
4. Trigger point injections. Care should be taken not to damage the vertebrae during such injections.
5. Acupuncture can reduce the severity of pain in the spine.
6. Ultrasound treatment significantly alleviates the patient's condition.

If after 6 weeks of therapy the pain remains quite severe, the patient may need. It is necessary to prevent diseases associated with hernia. The “gold standard” of surgical treatment is microdiscectomy. It is performed using local anesthesia and lasts no more than half an hour. The operation is minimally invasive: the pain goes away quite quickly, and the postoperative period is reduced.

If the patient does not have indications for microdiscectomy, then he can undergo laser removal of the hernia. This therapy is an alternative to conservative measures.

Treating a hernia at home

This disease can be treated at home using traditional medicine. Before you start using them, you should consult a doctor.

A mixture of birch, St. John's wort and comfrey oils helps in the treatment of this disease. It has anti-edematous, analgesic, anti-inflammatory activity. It should be used to rub the affected parts of the spine.

For a hernia, make a compress from a Kalanchoe leaf. You need to remove the film from it, apply it to the sore spot and secure it with a band-aid.

Garlic tincture is used in the form healing compresses(it is used in the form of a mixture of crushed garlic and alcohol). Compresses are made from it and left overnight. This type of treatment will be even more effective if such tinctures are alternated with turpentine baths. It is recommended to be treated in this way for a month.

Prevention of hernia development

Prevention of intervertebral hernia consists of following the following recommendations:

1. Physical education classes. Regular physical exercise strengthens the back muscles, supports the spine in correct position, normalize disk nutrition processes. Performance physical exercise must be agreed with your doctor. Strong physical exertion should be avoided in the first month after the attack.
2. The key to preventing hernia is correct posture. It reduces the load on the musculoskeletal system. Particular care must be taken to maintain correct posture while sitting for a long time or when working at a computer.
3. Losing excess weight significantly reduces the likelihood of developing a hernia.
4. Smoking significantly increases the risk of developing a hernia. That's why competent prevention Such a state is impossible without giving up this bad habit.
5. It is also necessary to stop drinking alcoholic beverages.

Lumbar intervertebral disc herniation is a disease that cannot be ignored. If the first symptoms of spinal damage appear, you should consult a doctor. Timely initiation of therapeutic measures helps to completely avoid surgical intervention and resume normal functioning of the spine.