Intervertebral hernia of the lumbar - how to treat. Exercises for the lumbar spine. Intervertebral hernia of the lumbar spine

Our body is perfect, but there are very vulnerable areas on it, one of which is the lower back, which experiences increased stress. The lumbosacral region accounts for the largest number of injuries, as well as very unpleasant ailments. In this area, dangerous neuralgia often develops - an intervertebral hernia.

It is important to know what a vertebral hernia is! Between each vertebra is a disk that acts as a stabilizer, shock absorbing, preventing injury. Inside the intervertebral disc is a gel-like substance known as the nuclear pulp. Due to mechanical damage or biological inclination, this substance can break through the sheath and begin to compress the nerve processes. The size of the hernia serves as a reference factor in the choice of therapy.

Usually patients are interested in what is dangerous interdiscal hernia. One of the most common consequences is soreness, which manifests itself when lifting heavy weights, sharp turns of the body, or simply during ordinary walking (). However, this pathology is far from all that the disease threatens; with late detection, muscle weakness or even paralysis of the limbs may develop.

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

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 be acute, but quickly disappear after a few days. Soreness begins in the lower back or gluteal muscle, descends 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;
• a general feeling of weakness, "needles" piercing the limbs;
• reduction in the available range of motion;
• rarely found a violation of the control of retention of secretions from the bladder and sphincter. Immediately, as this symptom manifests itself, it is necessary to go to the hospital.

When the appeal to doctors does not occur immediately, the disease of the intervertebral hernia can begin to affect the functioning of the pelvic organs. The symptoms in men are sexual dysfunction. Symptoms in women are no less sad and dangerous - gynecological problems, including inability to conceive.

Do not forget how to determine the disease, only a qualified physician knows. Do not listen to unprofessional advice.

Signs of a lumbar hernia

Studies show that a herniated disc is most likely to occur between L4 and L5, and 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. Diverse pain in the intervertebral hernia is considered a typical manifestation.

When the hernia is located in the lumbar region - the vertebrae L4 and L5, there will be discomfort, localized in the lumbar region, extending to the buttock, upper leg. In 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:

• shooting, back pain;
• increased soreness of the simplest movements, including walking, prolonged standing, straining the body, legs, laughing or coughing;
• you are quite capable of pointing out exactly where the most acute soreness is;
• at first, lower back pain with a hernia and other first signs disappear 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, conversely, sebum begins to be released in excess.

Causes of a hernia

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

• traumatism;
• degenerative changes;
• obesity - this is the answer to the question of why the back hurts;
• deterioration in the nutrition of the paravertebral region with oxygen;
• prolonged sitting;
• metabolic disturbances.
• Prerequisites for the appearance of the disease:
• low activity;
• age over 35;
• hereditary tendency;
• monotonous movement.

Consequences of a hernia

Even a slight neuralgia can lead to sad consequences, especially if it squeezes the nerve roots. This will be expressed not only in increased soreness, but also in significant muscle weakness, limited movements, and the appearance of swelling.

The consequences of an intervertebral hernia are the need to change habitual life, the impossibility of working, constant stay in bed.

What can and cannot be done with a hernia

The 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 pull is quite common. Hot compresses, warming ointments, dog hair belts, etc. are used. measures, but not always such steps are good.

Heating is prohibited if:

• acute pain;
• prolapse of the 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, while a modern person walks in hard shoes on hard asphalt or stone surfaces.

With an intervertebral hernia, especially during exacerbations, experts recommend moving only in orthopedically correct shoes, trying to choose soft surfaces.

Sauna

Specialists do not oppose visiting a sauna or bath for patients with lumbar hernia, only the duration of stay and temperature are stipulated.

Mattress for hernia of the lumbar spine

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, reduce the load on the spine.

Alcohol

After taking a dose of alcohol, you can find a decrease in soreness, a general relief of the condition. However, this effect is temporary, because there is no effect directly on the cause of the disease, ethyl alcohol dulls the work of a brain neuron, gives pseudo-relief.

Bike

Cycling is not the best solution in the presence of a hernia, if you can’t refuse them, you must follow the following recommendations:

• do not drive during periods of acute pain;
• keep your back straight. The installation of a comfortable seat with a back, like on an exercise bike, can help in this matter;
• no shaking. Route only on smooth roads without bumps.

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 already over, and the muscles are strengthened.

Sports with a hernia

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

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

With great care, push-ups and pull-ups should be performed with a hernia. Is it possible to do push-ups and how to do it correctly can be suggested by a qualified trainer or a rehabilitation doctor. We also recommend that fans of creating a thin waist with the help of a hula hoop clarify whether it is possible to twist the hoop, because this simple simulator is usually under the strictest ban.

Moderate exercise can:

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

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

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

How to live with a herniated lumbar spine

The lifestyle of the patient, with an intervertebral hernia, needs to be carefully reviewed and adjusted. He will have to seriously take care of his own health, as well as learn how to sleep, lie down, sit.

About what other restrictions there are on living with a hernia, you should check with your doctor.

• get rid of excess weight;
• switch to a healthy, vitamin-rich diet;
• limit strength training;
• sleep on an orthopedic mattress.

Nutrition for hernia

An important role in the process of overcoming the disease is played by a diet for hernia, because often its cause is metabolic failures.

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

Exacerbation of a hernia of the lumbar, what to do

The described disease is classified as severe by doctors, exacerbation of the 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 not uncommon.
With an increase in symptoms, you should immediately consult a doctor, the severity and duration of the exacerbation depend 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 the occurrence of relapses.

• rejection of bad habits;
• shoes with a hernia of the spine should be soft and comfortable;
• lifting weights should be carried out only with the back held straight from a sitting position, etc.

Treatment of a hernia of the lumbar spine

An 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.

Note that the answer to the question of whether such a pathology can be cured on its own will always be negative. With severe back pain, numbness of the limbs, you should contact a medical institution and clarify in it which doctor treats your ailment.

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

Methods for the treatment of intervertebral hernia, offered by modern medicine:

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

Is it possible to completely cure the burden of folk remedies? Alternative medicine is an 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 if your case is treated with them, which plants are better to give preference to.

Hernia treatment without surgery

In 70% of cases, the elimination of unpleasant symptoms occurs without invasive interventions. Modern drug therapy, epidural injections, physiotherapy, exercise therapy, etc. are used. If the above steps do not improve the condition, then surgical intervention is considered.

Blockade

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

Massage

The decision on 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, should be carried out taking into account the existing contraindications, compliance with the technique. When massaging the lower back, it is forbidden to put pressure directly on the damaged area.

exercise therapy

It is physiotherapy exercises that are 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. After 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 pain and worsen the condition of the interdiscal hernia.

Manual therapy

The technique, when performed correctly, reduces pain, relieves spasms, and expands the range of available actions. Its effectiveness in case of damage to the sacral spine depends on the skill level of the chiropractor. Otherwise, dangerous complications may appear, including paralysis of the limbs.

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

Acupuncture

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

electrophoresis

It relieves the main symptoms, it improves blood flow in the affected area, restores metabolic processes, and increases the effectiveness of drugs.

Physiotherapy

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

Hirudotherapy

This procedure perfectly relieves edema. However, the use of leeches for hernia is recommended 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 the existing problems.

Applicator Kuznetsov

This effective device, when used in combination with other methods of conservative therapy, shows excellent results. It helps to relieve tension, relax muscles, and has a slight 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 procedure of electrophoresis.

Drug treatment: pills for hernia

Hernia medications help relieve muscle spasms and soreness. Commonly used drugs belong to the groups of non-steroids (NSP), analgesics, cardiovascular drugs, muscle relaxants. The range of drugs that can be used is large. They are produced in a wide variety of forms (injections, droppers, warming ointments and tablets).

Which injections are suitable for each patient, the neurologist determines on an individual basis.

How to relieve pain in the lower back with a hernia

How to relieve pain in the sacral spine?

It's important to know! In no case should you apply ice directly to the 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 performed and non-steroidal anti-inflammatory drugs and drugs are taken. In the first 14-48 hours, cold helps relieve pain, reduce swelling and eliminate muscle spasm;
• the list of acceptable medications may include anti-inflammatory, analgesic drugs to alleviate acute pain. They are taken in the form of injections or tablets. How to anesthetize during an exacerbation with the greatest efficiency will tell the doctor;
• with slight pain, the effect of anesthesia can also be given by GNP drugs;
• heat therapy is indicated 48 hours after the exacerbation. By heating, blood flow increases, muscles relax. As with cold, heat should not be placed directly on the skin.

Removal of a hernia of the lumbar spine

Surgical treatment of a vertebral hernia is usually prescribed if non-surgical methods have proven ineffective.

Indications for surgery:

• continuous pain;
• weakening, loss of control over the 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 according to the classical method. The hernia was removed through a sufficiently large trepanation window, resulting in severe muscle damage, prolonged and not always successful recovery. At the same time, patients continued to experience pain after removal, and it is not uncommon for the disease to reappear.

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

• reconstruction with a laser that evaporates fluid from the nucleus that has come out, thereby eliminating compression of the nerve roots;
• percutaneous discectomy. 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 repair procedures carry some risks that you should ask your doctor about. Therefore, their implementation should be trusted only by an experienced specialist, and for the success of the postoperative period, it is necessary to follow all the recommendations after removal prescribed by the rehabilitation specialist.

Rehabilitation after surgery, as a rule, does not require specialized supervision. After removing the stitches, it is recommended to walk, gradually build up the muscle corset, by performing a set of exercises at home.

The lower parts of the spine carry a high load, so pathological conditions in this area are very common. One of the frequent manifestations are the symptoms of a hernia of the lumbar spine.

A herniated disc is an injury to the disc of the spine that occurs due to uneven and unexpected stress on the spine. This is one of the serious diseases of the spine, causing disability. Treatment of a hernia of the lumbar spine is a laborious and complex process. The sooner you start therapy, the higher the chances of recovery and a return to normal life.

How does a hernia appear?

The lumbar segment of the spine consists of 5 vertebrae, between which there are quite large distances (in comparison with other segments). In this space are the intervertebral discs that protect the bone tissue from stress and damage. But under the influence of certain factors, the disks are displaced, causing negative reactions.

The main cause of hernia in all parts of the spine is osteochondrosis. But other predisposing factors of this pathology are also distinguished: natural aging of the body, metabolic disorders, spinal injuries, developmental anomalies, impaired posture, sudden movements, excessive physical exertion, inflammatory diseases, etc.

The intervertebral disc consists of an internal nucleus pulposus and an external annulus fibrosus. Under the influence of various factors, cracks appear on the intervertebral disc, which lead to a rupture of the outer ring. This leads to protrusion of the inner core. This is the hernia.

A herniated disc of the lumbar spine does not manifest itself at first, but it constantly grows and gradually pinches the surrounding tissues, which leads to the appearance of characteristic signs.

Symptoms of intervertebral hernia of the spine are divided into 3 main groups: pain, vertebral and radicular.

Pain syndrome

Pain is the first symptom that manifests itself at all stages of the development of the disease and changes only in intensity, nature and localization.

Symptoms of Damage to a Specific Intervertebral Disc

Typological symptoms of a hernia of the lower spine often develop, by which it is possible to determine the localization of damage, for example:

• pathology between 1 and 2 lumbar vertebrae provokes pain in the intestines, disguised as appendicitis;
• hernia L2-L3 causes pain in the knee area and disruption of the urinary organs;
• damage to L3-L4 is characterized by a change in urination, pain and limitation of motor activity of the knees and feet;
• hernia L4-L5 causes sensory impairment and pain in the feet and toes, radiating to the buttocks or thighs, which often makes it difficult to just start moving.

The symptoms and treatment of a hernia of the spine are inextricably linked, because the time of the appointment of therapy also depends on the time of the onset of symptoms, which affects the entire future life of the patient.

Complications

The consequences of a hernia of the lumbar spine develop in the absence of adequate therapy. First of all, there is lumbodynia - backache. This condition lasts for several weeks and is characterized by sharp pain, the intensity of which increases with any movement.

Often, pathology causes disruption of the hip and knee joints, which further leads to loss of working capacity and disability. The presence of several diseases at the same time (for example, hernia and pathology of muscle tissue) provokes the rapid development of diseases, as well as the early onset of symptoms.

An intervertebral hernia develops as a result of protrusion of the nucleus pulposus of the intervertebral disc. This pathological condition is manifested by a number of signs that allow you to determine the disease, as well as its stage. The lumbar spine is the most vulnerable place for the appearance of intervertebral hernias. The disk located between the fourth and fifth vertebrae is especially susceptible to the development of the pathological process. In this case, pain can spread to the legs, in some cases the patient cannot walk on his own. Treatment of the disease includes both conservative and surgical methods. It also requires exercise therapy, a review of the diet, lifestyle.

Lumbar hernia is most common in people over 40 years of age. Due to the peculiarities of the anatomy of the spine during physical exertion, the lumbar region has the greatest load.

Due to evolution, the lumbar vertebrae have a powerful structure relative to other parts of the spine.

Hernias, as a rule, develop due to such reasons:

• osteochondrosis of the spine - is the most common cause of the development of atrophic-dystrophic processes in the vertebrae and fibrous discs between them;
• metabolic diseases of the connective tissue - can be caused by the pathology of some endocrine glands or hereditary genetic diseases;
• spinal injuries - after the restoration and repair of tissues after injury, complications may occur in the form of weakness of the fibrous junction or atrophy of the disc itself;
• great physical exertion and prolonged static positions with weight;
• hereditary anomalies in the development of the connective tissue of the spine.

In addition to the causes that are the main link in the development of the disease, there are a number of factors that accelerate its development:

• inactive lifestyle;
• obesity;
• decreased tone of the back muscles;
• anomalies in the development of the muscles of the back;
• anomalies in the development of the lower extremities and pelvis;
• high growth;
• weightlifting and gymnastics;
• frequent minor back injuries;
• hypovitaminosis and starvation;
• pathology of the vessels supplying blood to the vertebrae;
• inflammatory diseases of the skin and muscles of the back;
• violation of posture in any of the spine.

The combination of causes may be different, but in the final stage the pathogenesis of the disease will consist in the weakness of the fibrous tissue of the intervertebral disc and the exit of the nucleus pulposus beyond the boundaries of the latter. You also need to remember that the development of a hernia does not occur immediately, it develops first.

stages

In the development of the disease, three to five stages are distinguished. In the CIS countries, intervertebral hernias are usually classified according to changes in the disc itself and the symptoms that arise as a result of these changes.

The following stages are distinguished:

• First stage. Slight protrusion of the nucleus, but the integrity of the fibrous tissue is not violated. During this period, complaints, as a rule, do not arise.
• Second stage. Disk extrusion or extrusion beyond the edge of the intervertebral disc. At this stage, there is a slight discomfort during physical activity. The connective tissue of the disc is slightly damaged.
• Third stage or prolapse. During this period, there is a pronounced protrusion of the nucleus pulposus into the cavity of the spinal canal or to the other side. The clinic is bright, severe pain when moving or changing position. There are local and distant symptoms, the patient cannot perform significant physical work.
• Fourth or last stage. The hernia grows to such a size that it can compress the spinal cord or spinal nerves with nearby vessels. The clinic is typical for damage to the nerves and spinal cord, the nature of the pain and its intensity can be different, it all depends on the position of the patient. Sometimes the pathological process also passes to organs that have a dependent innervation on the segment of the spinal cord that is damaged.

The first two stages can be asymptomatic and respond well to conservative treatment, with the development of the last stage, treatment is more often surgical.

Main symptoms

The symptoms of a lumbar hernia are directly dependent on the size of the hernia and what structures are damaged. There are also a number of common symptoms that occur in almost all people with a herniated lumbar disc.

Symptoms of lumbar hernias:

• Pain syndrome that occurs due to compression of the spinal nerves, pain can also occur due to pressure of blood vessels with the subsequent development of ischemia of the structures of the spine. The pain is sharp, patients associate it with a change in position, bending or sudden lifting of weights. More often the pain occurs in the afternoon or after sleep. During a pain attack, a local and general increase in temperature may occur. The pain often radiates to the legs or pelvis.
• Goosebumps and numbness in the lower limbs. The symptom occurs due to compression of the structures of the spinal cord or arteries that supply it with blood. With a long absence of blood flow to the lumbar spinal cord, irreversible changes in the latter can develop. This phenomenon is dangerous because in the lumbar region there is a thickening of the spinal cord, in which the centers of conscious movements are localized.
• Development of atrophy of the muscles of the back and lower extremities. This condition occurs after damage to the posterior roots of the spinal cord.
• Violation of the pelvic innervation, which is manifested by frequent urge to defecate or urinate.
• Violation of the internal organs that are innervated by damaged nerves or their centers in the nuclei of the spinal cord.

Intervertebral hernia L4–L5

Lumbar hernia, which is localized in the fourth and fifth lumbar vertebrae, is more common than in the rest of the lumbar vertebrae, and is characterized by the following symptoms:

• increased pain during bowel movements or increased peristalsis;
• pain in the supine position;
• discomfort while walking and bending;
• violation of the autonomic innervation of the skin of the legs and pelvis.

A feature of hernias of the intervertebral disc of the lumbar spine is that they respond well to conservative treatment. With very large hernias, which are located between the fourth and fifth lumbar vertebrae, compression of the Adamkevich artery or other arteries may occur, which play an important role in the trophism of the tissues of the spinal cord.

Intervertebral hernia L5–S1

An intervertebral hernia of the lumbosacral spine is more common in people over the age of 40 years. A feature of this hernia is that it is located in the center of gravity of a person.

The hernia of the lumbar and sacral bulges in any direction. The clinical picture depends precisely on which side the hernia is located and which anatomical structures are under pressure. The main manifestations of a herniated disc in the lumbosacral region:

• pain radiating to the buttocks, back of the thigh;
• walking disorder;
• decreased libido;
• loss of conscious control of the legs;
• decreased reflexes of the lower extremities;
• violations of defecation and urination;
• pain when sitting;
• pain in the perineum and coccyx;
• decrease in the tone of the sphincters.

Many symptoms are similar in various diseases of the spine, spinal cord and nearby structures. It is possible to find out the exact cause of the occurrence of certain symptoms using radiation methods of examination. Early diagnosis favorably affects the further treatment of the disease.

Effective Treatments

A hernia of the lumbar spine has the following treatment methods:

• conservative treatment with tablets and injections;
• surgery;
• exercise therapy and massage;
• mode and nutrition;
• physiotherapy;
• lifestyle change.

For conservative treatment, the following drugs are used:

• non-steroidal anti-inflammatory drugs;
• muscle relaxants;
• vitamin preparations.

There are the following methods of surgical intervention on herniated intervertebral discs:

• direct open operation;
• neurosurgical minimally invasive intervention under x-ray control.

Exercise therapy includes exercises aimed at relaxing the muscles that compress the vertebrae. Massage is prescribed to improve local blood flow and relieve spasm from muscle tissue. Interesting to read -.

One of the methods of non-surgical treatment of hernias of the lumbar spine is the blockade of the inflamed nerve with analgesics. Doctors recommend exercising in the pool 2-3 times a week, wearing orthopedic shoes and sleeping on a good mattress (more information on that). You should also treat organs that suffer from diseases of the spinal cord.

Among other diseases of the back, a hernia of the lumbar intervertebral disc is distinguished: the treatment and symptoms of which, we will consider in our article in more detail. If the patient went to the doctor too late, it is difficult to rehabilitate the spine and return it to a state of integrity - as it was before the disease. It is important to distinguish between the causes of the pathology in order to protect yourself, and if it still does not work out, you will need up-to-date information about the treatment.

A hernia is a common occurrence. This is due to the heavy load on the lower back. It is worth noting that sometimes pain is not felt, and a person for a long time does not even suspect the presence of a pathology. This happens when the nerve is not under pressure, but such situations are incredibly rare.

Important! Lack of timely treatment causes disability - paralysis of the legs.

The reasons

There are enough reasons for the development of the disease. Often a hernia occurs as a result of a complication of osteochondrosis or scoliosis. But there are other factors as well:

• age - from 30 to 60 years;
• insufficient or excessive physical activity;
• incorrect posture;
• injuries, blows, falls;
• excess weight;
• bad habits - for example, smoking;
• jobs that require a sedentary lifestyle. Hernia is often found in programmers and drivers;
• hypothermia.

Important! Don't try to diagnose yourself. This is done exclusively by a qualified doctor. Try to identify what could be causing the hernia complications, but don't take action. Self-treatment is the main enemy in such a situation.

Symptoms

It is important to clearly identify the place that causes discomfort. Symptoms will vary depending on the affected area. The first signs of a herniated disc in the lumbar:

• pain in the lower back. Often she gives in the buttocks, legs;
• from time to time there is a sharp pain in the lower back, "lumbago";
• the legs go numb, “goosebumps” are often felt, a burning sensation is felt;
• difficult to turn and bend.

Ignoring these symptoms is a direct path to bladder dysfunction, diseases of internal organs, and muscle atrophy. What it is? The patient loses the ability to move - paralysis occurs. Sometimes the disease progresses quickly, but most often the person does not even pay attention to slight weakness in the legs. Every day they get tired more and more. Therefore, a doctor must be consulted immediately.

Important! Sometimes the pain is caused by pathologies of the internal organs. Diagnostics will show the exact cause. In order not to confuse the diagnosis, contact only trusted specialists.

Diagnostics

To find out why a particular symptom occurs, a specialist examines the nervous structures - find out if they are compressed, in what condition they are. Be prepared to answer the following questions from your doctor:

• when did you feel the first discomfort;
• whether you tried to apply something against pain, whether you were treated on your own;
• where, in your opinion, is the damaged area, which place hurts the most;
• whether you have a tendency to diseases of the spine (genetic predisposition);
• do you have bad habits, what lifestyle do you lead.

Based on the neurological examination and your answers, the diagnosis will be partly determined. However, this is not enough. For an accurate result, the following diagnostic methods are used:

• MRI - using a magnetic field, a specialist examines the affected area, assesses the condition of the nerve endings;
• CT scan. Shows the condition of the bones well;
• x-ray. A less popular method, poorly detects soft tissue pathologies.

Important! Do not try to withhold information about your health from your doctor. If you have any drug allergies, be sure to let us know. Most likely, the internal organs are also examined, but still notify the specialist about the presence of problems with them, if any.

Treatment

In many cases (up to 80%) patients do not need surgery. The natural healing process is the "drying" of the hernia. Therefore, most treatments are based on the expectation of a decrease in the size of the pathology, as well as on the removal of the most striking symptoms.

The following treatment methods can be distinguished:

• drug therapy;
• blockades performed under local anesthesia;
• surgical impact;
• alternative methods.

Medical therapy

Usually it all comes down to the use of several tools from this list (often they are combined with each other):

• conventional pain medications;
• non-steroidal anti-inflammatory drugs (NSAIDs). Medicines of this type practically do not differ from each other, but have an extensive list of contraindications;
• chondroprotectors.

Important! NSAIDs should not be used for more than 15-20 days. In addition, before use, be sure to consult a specialist. It is recommended to use such remedies only as a symptomatic relief, and not as the main drug.

blockades

Under X-ray and local anesthesia, hormones and painkillers are injected into the affected area - right into the area of ​​​​compression of the nerve roots. This method is recommended to be used only when ordinary drug therapy does not help.

Often, blockades eliminate pain within a few hours after the session. It also avoids surgery.

Surgical impact

If medicines and blockades with the help of x-rays do not help, the patient is prescribed an operation. A few more factors in favor of this decision:

• 6-7 weeks have passed, but no progress is visible, the pain does not decrease;
• nerve pathology is irreversible.

Only a few patients require such a procedure - about 10%. Modern technologies reduce discomfort after surgery, and a person can be discharged the next day. Despite all the advantages, there are also negative consequences of surgical exposure:

• due to the procedure, the spine partially loses flexibility, mobility;
• hernia may recur.

Not all patients get better after surgery. There is temporarily no pain, but the main cause of the pathology, osteochondrosis, is still not cured.

Alternative Methods

This type of treatment includes an extensive group of techniques that require only the absence of pronounced symptoms. These include:

• manual therapy - the effectiveness of this method has not been conclusively proven;
• traction of the spine - recognized as insufficiently effective;
• acupuncture - can reduce the balance of chronic pain in the spine, but will not cause significant changes in a positive direction;
• wearing a corset - weakens the muscles, and therefore is not effective enough;
• therapeutic exercises - used by many doctors. When used correctly, it guarantees a shift for the better;
• massage.

Important! When performing exercises, massage, swimming and other methods, there should be no discomfort.

Recovery and prevention

Removal of a hernia or its disappearance in a natural way, supported by medical treatment, is not at all a guarantee that the pathology will never occur again. Therefore, the basic principles of recovery are reduced to the complete rest of the patient. Over time, you can begin treatment with alternative methods - with the help of gymnastics, swimming, massage.

Preventive measures are also important during the recovery of the patient. They are quite light and require only constant execution.

1. Support for correct posture. The back must be kept straight. If there are difficulties with this, contact a specialist to get special exercises from him to strengthen the back muscles.
2. Healthy weight support. Extra pounds - a factor provoking the occurrence of a hernia. Therefore, it is necessary to revise the diet, including more healthy foods in it. Eliminate dyes, abundant use of spices.
3. Rejection of bad habits. Smoking is another cause of pathology. In addition, it is fraught with cancer. Therefore, take care of yourself and your body by removing cigarettes from life.
4. Regular exercise. They should not be exhausting, because this will provoke a recurrence of the hernia. Try to do at least a morning workout. Ideally, go to the fitness room so that the trainer prescribes an individual training program for you.

With a timely visit to a doctor, it is really possible to stop muscle atrophy, prevent disability and further health problems. A herniated disc is a serious ailment that cannot be ignored without consequences. It is possible to recover after treatment only with the unquestioning fulfillment of all the doctor's instructions.

A hernia of the lumbar spine is not only a painful pathology, but also dangerous. In the absence of timely treatment, signs of dysfunction of the lower extremities may develop, up to paralysis of the pelvic organs. The method of therapy is chosen depending on the stage of the pathological process. In the early stages of development, conservative methods of treatment are possible. With their ineffectiveness or with other indications, surgical intervention is performed.

Symptoms

A hernia of the lumbar spine can have different signs, which depend on the severity of the change in the intervertebral disc. There are 4 stages of the disease:

1. 1. Prolapse (lumbar protrusion). The disk is displaced by a minimum distance that does not exceed 2 mm. The nucleus does not extend beyond the body of the spine.
2. 2. The marginal disc is displaced by no more than 15 mm, the nucleus pulposus continues to be within the body of the spine.
3. 3. Extrusion, which is characterized by the exit of the nucleus beyond the limits of the vertebral bodies.
4. 4. Hanging of the nucleus pulposus in the form of a drop outward. This can lead to rupture of the fibrous ring and outflow of a liquid substance.

In the early stages of the formation of an intervertebral hernia, lower back pain appears, which disappears quite quickly. With the development of pathology, the symptoms become more complicated. Discomfort may be unbearable or mild. Usually, patients have several symptoms at once in the complex. The most common combinations:

1. 1. Soreness in the lower back with recoil to the legs.
2. 2. Pain in one of the buttocks and leg on one side of the body.
3. 3. Discomfort in the lower back or buttock, which is transmitted to the lower waist, then to the thigh, lower leg and foot.
4. 4. Tingling and pinching sensations all over the leg, numbness or weakness in the feet.
5. 5. Weakness and numbness when moving the leg or rotating the foot.
6. 6. Shooting soreness in the limb, which makes it difficult to walk and even to simply stand.

It is characteristic that when walking or lying down, the pain in the lower back weakens, and vice versa, it intensifies in a standing and sitting position. To eliminate unpleasant symptoms, you can use special exercises, medications and injections. But in some cases, pain can only be stopped surgically.

Most often, the hernia is localized in the lumbar segment L4-L5 and the lumbosacral region L5-S1. They have their own characteristic clinical signs.

The structure of the spine in the lumbar and lumbosacral region

Intervertebral hernia L4–L5

The lower back is the most complex part of the spinal column, and the L4-L5 vertebrae play one of the most important roles in supporting the upper body and ensuring body mobility in various directions. For this reason, this segment is subjected to serious loads, therefore it is subject to various lesions and destruction.

When a herniated disc occurs between these vertebrae, characteristic signs are noted:

• inability to move or extend the big toe;
• numbness and soreness in the upper part of the foot;
• weakening of the calf muscles, as a result of which the foot hangs down.

The last sign is checked quite simply. You have to wear high heels. With a paralytic foot, this is not feasible.

Intervertebral hernia L5–S1

The spinal segment L5–S1 forms the base. It is called the lumbosacral joint. With a herniated disc between the presented vertebrae, characteristic symptoms occur:

• absence of the Achilles reflex - there is no contraction of the gastrocnemius muscle and flexion of the sole when the hammer strikes the Achilles tendon;
• radiating pain to the foot, outer part of the foot or heel;
• inability to move, lift up the toes.

Any of the described symptoms require timely treatment by an orthopedist, neurosurgeon or vertebrologist. However, there are signs, in the event of which you should immediately call an ambulance:

1. 1. Severe pain, tingling or numbness that gets worse over time and does not go away under the influence of drugs.
2. 2. Problems with urination and defecation.
3. 3. The so-called saddle block - loss of sensation in the inner thighs, lower buttocks and perineum.

These signs are quite serious. In no case should they be ignored, since this can lead to the development of irreversible paralysis of the lower extremities.

Treatment

For the treatment of an intervertebral hernia of the lumbar spine, conservative or surgical methods can be applied. The choice of method depends on the stage of the pathological process, the presence of concomitant diseases and contraindications.

At the initial stages of the development of the disease, conservative measures can be taken, which include medicines, folk remedies, massage, physiotherapy and therapeutic exercises. The last 3 methods are used only after the elimination of acute pain syndrome. At the same time, physiotherapeutic procedures and massage should be carried out by specialists as prescribed by the attending physician, and health-improving physical education can be carried out independently.

The first few days the patient is shown bed rest. All movements must be slow. You can not perform actions that cause pain: lift heavy things, lean forward.

Medicines

Drug therapy is used to relieve pain and the pathological process in the intervertebral disc. It must be carried out with the appointment of the attending physician.

Three therapies can be used to treat a hernia:

• etiotropic;
• symptomatic;
• pathogenetic.

Etiotropic therapy

Etiotropic therapy - treatment aimed at eliminating the causes of the disease. To achieve these goals, non-steroidal anti-inflammatory drugs, chondroprotectors and homeopathic medicines are used.

NSAIDs are one of the most popular drugs in the treatment of intervertebral hernia, because they have analgesic, anti-inflammatory and antipyretic effects. From this group are distinguished:

1. 1. Diclofenac. The drug is available in several forms: tablets, intramuscular solutions, gels, ointments, suppositories. It is not recommended for long-term use, as it can damage the lining of the stomach and intestines.
2. 2. Movalis. It is made in the form of an intramuscular solution, tablets, suspensions and suppositories. The active substance of the drug is meloxicam. Movalis is contraindicated for people suffering from heart disease, asthma, diabetes.

Chondroprotectors have a slow action. They consist of glucosamine and chondroitin sulfate, which have an antiseptic effect and prevent the degradation of intervertebral discs. The following drugs are distinguished from this group:

1. 1. Teraflex. Effective for the treatment of intervertebral hernia in the early stages of its development. The drug is produced in the form of capsules, which contain glucosamine, ibuprofen and chondroitin. This combination allows you to eliminate inflammation and relieve soreness. The composition also contains peppermint oil, which enhances the flow of blood to the affected vertebral segment. Contraindication to use is pregnancy or intolerance to one of the components of the drug.
2. 2. Aflutop. Available in the form of a solution for injection. The preparation contains a concentrate, which consists of particles of small fish - whiting, anchovy, sprat. The drug helps to maintain the normal metabolism of cartilage tissue, preventing the development of a lumbar hernia. Side effects from the drug may occur during pregnancy or allergies to fish. Usually patients with intervertebral hernia are prescribed a course of 20 injections, which is repeated if necessary after 6 months.
3. 3. Artra. This drug has a composition similar in action to Teraflex. It is produced in the form of tablets with a sweetish taste and a specific smell.

To eliminate the causes of the disease, homeopathic remedies have proven to be harmless. They do not cause side effects, do not affect the internal organs and digestive processes. The action of homeopathy is based on a point effect on the cause of the intervertebral hernia, while the composition of the preparations is natural. Allocate the following drugs in the form of ointments:

1. 1. Target-T. It contains natural plant ingredients, sulfur, citric acid and salt. This ointment is recommended to be applied 2-4 times a day for rubbing on the problem area in the lower back or used for massage. Zeel-T has practically no contraindications, it is allowed for pregnant women and children.
2. 2. Traumel-S. The basis of the ointment is calendula and echinacea, which have anti-inflammatory and immunomodulatory effects, help relieve pain. Traumeel-S is usually prescribed for complex treatment with tablets and intramuscular injections.

Symptomatic therapy

The goal of symptomatic therapy is to relieve attacks of pain and other symptoms of the disease. Analgesics are used to eliminate neuralgic reactions. The following drugs are distinguished:

1. 1. Mydocalm. Produced in the form of tablets and solution for injection. The active substance of the drug is tolperisone, which helps to reduce muscle hypertonicity, which allows the patient to actively move. Mydocalm is suitable for long-term use, does not cause addiction and side effects. The drug is well tolerated, does not have a sedative effect.
2. 2. Tylenol. Based on paracetamol. It has a non-narcotic, analgesic effect. It does not have a negative effect on the digestive system and other organs. Tylenol is available in tablet form, in the form of injections and suppositories.

Symptomatic therapy should be carried out with drugs that will protect the stomach from possible side effects of analgesics. Simultaneously with them, it is recommended to use Phosphalugel, Gastal or Almagel. They have an antiseptic and enveloping effect.

If insomnia occurs against the background of an intervertebral hernia, the doctor prescribes antidepressants and sleeping pills. To normalize sleep, you can use the drug Sertraline, which does not cause dependence. It should be taken once a day in the morning or evening. Dosage - 50 mg. However, this drug can cause allergic reactions, nausea, loss of appetite, dry mouth.

Pathogenetic therapy

Such therapy is carried out to block the processes that provoked the pathology in the intervertebral disc. To do this, use drugs that relieve puffiness, have a vasodilating effect, and normalize the hormonal background.

Patients may be prescribed glucocorticoids. They are effective for acute pain. From this group, a drug called Milgamma is isolated, which contains vitamins of group B. The latter affect metabolism at the cellular level, restore nerve tissue. For example, vitamin B6 is involved in the formation of hemoglobin, and B12 - in the removal of anemia. Milgamma improves blood circulation and is a powerful analgesic.

Folk remedies

For the treatment of a herniated disc, traditional medicine can be used:

• ointments;
• rubbing;
• lotions;
• cakes;
• compresses.

Before using them, you should consult with your doctor. In no case should you replace the means of traditional medicine prescribed by a specialist with medical treatment.

There are the following popular methods:

1. 1. Compress horse fat. Means based on horse fat are highly effective in relieving pain. To prepare, you need to mix together 2 teaspoons of iodine and 2 egg yolks. The resulting mixture should be diluted with 1 cup of horse fat, then mix thoroughly until a homogeneous mass is obtained. The finished product must be applied to a double layer of gauze and applied to the place where the hernia is located. The compress must be fixed with a bandage and not removed during the day. After 24 hours, the bandage with horse fat should be replaced with a new one. Treatment continues for 10 days.
2. 2. Clay compress. It has a warming effect. To prepare a healing agent, you need to take ordinary red clay, moisten it and make a small cake. After that, it is necessary to warm the mass to 40 degrees, wrap it in gauze and attach it to the sore spot. The compress should be covered with plastic wrap and fixed with a bandage that does not need to be removed until the clay cake crumbles.
3. 3. Rubbing with honey and mummy. You need to take 1 g of mummy and dilute it with 1 teaspoon of warm water, then mix it with 100 g of honey. A section of the spine with a hernia must be prepared with fir oil. After preliminary rubbing, the resulting mixture can be applied.
4. 4. Decoction of aspen bark. You need to take 1 teaspoon of bark, fill with 200 ml of boiling water. The drink is recommended for drinking 4 times a day after meals, 50 ml.
5. 5. Infusion of drupes. It is necessary to take 30 g of a stone drupe leaf, fill with 250 ml of boiling water, cover the container with a lid and insist for 4 hours. The resulting drink should be consumed 3 times a day before meals, 50 ml.
6. 6. Kalanchoe applications. It is necessary to remove the film from the surface of the leaf of this plant, fix the leaf in the lumbar region. The procedure should be performed before going to bed, and the application should be removed in the morning.
7. 7. Garlic compresses. It is necessary to take a few cloves of garlic, chop them with a knife or meat grinder, pour alcohol and remove to infuse in a dark, cool place. The product must be kept for at least 10 days, after which it will be possible to moisten a napkin in it and apply it to the affected area. The garlic mixture should be kept on the skin for no more than 1 hour.

Physiotherapy

Physiotherapy exercises are used in the acute stage of the disease and during rehabilitation. The difference lies in the choice of loads.

In the first case, exercises that are gentle on the spinal column are selected. During the recovery period, the muscle structure is trained and the mobility of the spine is increased.

Exercise in the acute stage

In the acute stage of the disease, it is necessary to combine relaxation and absolute rest of the muscle groups located in the affected area of ​​the spinal column, with the tension of other muscles of the body and the movement of the limbs. Since in the first days the patient is shown bed rest, therapeutic exercises are carried out in a supine position.

To relieve pain in neurological disorders in the sacro-lumbar region, it is necessary to take the correct position. You need to be located on your back or on your side, bending your knees. These postures allow you to increase the size of the intervertebral foramen, improve blood circulation, and reduce the irritability of the nerve roots. Due to the convergence of the points of fixation of the iliopsoas muscles, their tension and compression of the vertebrae at this level decreases.

They offer several unloading positions:

1. 1. Lie on your back, place your legs on a special stand so that the knee and hip joints are bent at an angle of 90 degrees.
2. 2. Lie on your stomach. Place a soft roller under it with a diameter of up to 6-8 cm.

With signs of instability in the lumbar vertebrae, a semi-rigid corset is used

After the pain subsides, isometric exercises are used, and then active movements in the hands of the feet. To relax the muscles in the acute period of the disease, post-isometric muscle relaxation can be applied. Various techniques are recommended for this, but they should all be slow, smooth. For example, the patient needs to bend the legs at the knees and hip joint by 80-90 degrees. The exercise is performed with an assistant, who should continue to bend the lower limbs slightly, and the patient should prevent this. The duration of the voltage should be up to 7 seconds.

The main sets of exercises:

Exercises for hernia of the lumbar and lumbosacral should be carried out 2 times a day for 3-5 minutes. Each of these should be done 3-5 times, all actions should exclude flexion of the spine. If the pain decreases, then exercise therapy can be gradually expanded, and the duration of classes can be increased to 10 minutes.

Exercise during convalescence

As exercise is added to exercise therapy, which contribute to the training of the muscles of the back and abdomen. Gradually move on to activities that increase the tone of sore muscles, facilitate the transition from bed rest to walking.

It is forbidden to use exercises that unnecessarily strain the iliopsoas muscles. During the recovery period, it is contraindicated to bend forward and to the sides with a large amplitude, perform rotational movements of the body, deep squats.

All movements should help strengthen the muscles of the back and lower back, reduce and eliminate root blockage. These goals can be achieved by training the extensor muscles of the back.

Operation

Conservative methods are used for 4-8 weeks. If during this time it is not possible to achieve positive results, then the treatment tactics are changed. Surgery may also be considered. It is carried out with serious neurological symptoms associated with dysfunctions of the pelvic organs and the sensitivity of the extremities.

With a hernia of the lumbar spine, the following operations can be performed:

1. 1. Microdiscectomy. Its essence is to remove part of the intervertebral disc. But after such a surgical intervention in half of the cases, a relapse of the disease occurs.
2. 2. Laminectomy. The technique is based on the removal of bone processes that put pressure on the disc located at the level of the affected area. This type of operation is very difficult and dangerous, as it can provoke a violation of the supporting function of the spine.

There is also another method. A titanium implant can be placed in the intervertebral space.

Regardless of the technique used, the operation on the intervertebral disc allows you to eliminate the direct cause of the disease.