Intervertebral hernia of the lumbosacral region. The main symptoms of an intervertebral hernia of the lumbar

Intervertebral hernia is a degenerative disease of the intervertebral disc, characterized by a violation of its integrity and structure.

The lumbar spine consists of five vertebrae, between which there are intervertebral discs that play the role of a kind of shock absorbers. Normally, the intervertebral disc consists of a pulpous nucleus of a liquid consistency, around it it is closed into a fibrous ring, and the disc is covered from above and below by the endplates.

With excessive axial load on the spine, there is significant pressure on the intervertebral discs in the lumbar region.

Most often, these problems occur when:

• weight lifting;
• excessive weight;
• long walk.

Because of this, microtraumas are formed in the intervertebral discs, damage that has the ability to self-heal if the processes of tissue regeneration proceed at a good level.

Photo: computed tomography for a hernia of the lumbar spine

With age, the ability to regenerate decreases, and with a sharp movement, lifting a load or injury, the fibrous ring breaks, followed by protrusion of the nucleus pulposus of the disc to the back or side, squeezing the roots of the spinal cord.

Such a bulge is called an intervertebral hernia. In this regard, there are various symptoms, such as pain in the projection area of ​​the damaged disc, extending to the buttock and spreading along the back and outer side of the leg on the side of the lesion. But pain is not the worst symptom!

It is dangerous when pain sensations go away and weakness appears in the lower extremities, sensitivity disturbance, tingling, defecation, urination, and potency decrease. This suggests that irreversible changes have begun in the compressed roots.

Treatment Methods

There are two main methods of treating a herniated disc in the lumbar spine:

• conservative (includes medications, physiotherapy, massage);
• surgical.

Some separately distinguish alternative methods of treatment. In this section, we will look at each of the treatments in more detail.

Folk remedies

Treatment of an intervertebral hernia of the lumbar with folk remedies can to some extent be attributed to the methods of conservative therapy. Its purpose is to relieve swelling of the roots of the spinal cord and remove pain.

• The most widely used bee products.
• Also popular are compresses from marsh cinquefoil grass, which has good anti-inflammatory properties, relieves swelling and pain.
• Compresses from horse fat and rubbing with fir oil have similar properties.

But such methods of treatment are only temporarily able to relieve the pain syndrome, but not eliminate the main problem.

Honey is used for massage and rubbing in the affected area, bee venom relieves inflammation, and royal jelly strengthens the overall protective reserves of the body.

Removal operation

An operation on a herniated disc is the treatment method that eliminates the cause itself. The indication for it is a serious neurological symptomatology associated with dysfunctions of the pelvic organs and weakness and decreased sensitivity in the extremities.

The operation consists in removing the hernia and part of the affected disc, replacing this part with an implant and installing a special fixation system on the vertebrae for a stabilizing effect.

Now, when performing surgical interventions, doctors are trying to use innovative technologies that can significantly reduce the rehabilitation period, the scars after them are invisible, since the size of the incision is minimal.

Another method is endoscopic hernia removal.. The incision for such an operation is only 2 - 2.5 cm, the risk of relapses and complications is very small, and patients can get up and walk almost immediately after the operation. However, the method is new and not fully developed, in addition, there are restrictions on the localization of the hernia and its size.

The standard of modern treatment is microdiscectomy. It is performed using special optical equipment under multiple magnification, the incision is only 3-4 cm.

Photo: transfacet hernia removal

Treatment without surgery

Most often, the treatment of an intervertebral hernia of the lumbar without surgery is performed. After it, improvement occurs in 70-80% of patients. Methods of conservative treatment set themselves such tasks as removing swelling of the roots, pain, neurological symptoms, and preventing or reducing the frequency of relapses.

In addition to drug therapy, methods such as:

• physiotherapy;
• massage;
• physiotherapy.

They are aimed at strengthening the muscles of the back. Traction methods of treatment using skeletal traction are also used.

The spine, as it were, is stretched, the compression of the roots by the affected disc is removed. But all these methods require lifestyle changes, limiting sudden movements and lifting weights up to 2-3 kg.

Conservative therapy includes the appointment of anti-inflammatory and analgesic drugs, muscle relaxants, and therapeutic blockades.

Laser

Laser vaporization is one of the modern methods of treatment of intervertebral hernias. It consists in heating the disc with a laser, thus water is removed from it, edema and the volume of the hernial protrusion are removed, pain and neurological symptoms disappear.

The terms of rehabilitation are no more than a month. In addition, this technique has a number of contraindications:

• history of spinal surgery
• spondylolisthesis
• narrowing of the spinal canal
• spondyloarthritis
• extrusion of the disc with compression of the nerve roots.

But it is important to remember that by themselves degenerative changes in the intervertebral disc do not go anywhere, therefore, the risk of relapse is not excluded.

Rehabilitation

Rehabilitation after surgery to remove an intervertebral hernia requires a serious approach. The patient cannot sit for 3 months and needs to wear a corset, at first it is worn constantly, then 3 hours a day is enough. Another important method in rehabilitation is exercise therapy.

Photo: physiotherapy exercises after removal of the intervertebral hernia

Gymnastics starts from 1 day after the operation. It includes flexion-extension movements in the knees, circular rotation in the ankle joints, pulling the legs to the stomach. Throughout life, you also need to remember about therapeutic exercises, daily push-ups, shallow squats; cycling, swimming will also strengthen your back muscles.

Frequently asked Questions

How painful is it to treat a lumbar hernia?

Operative treatment is always carried out under anesthesia, so any pain is excluded. Pain may occur only in the postoperative period, but this is completely normal.

How long does the treatment last?

To relieve pain in a conservative way, sometimes a few days are enough, but sometimes it takes months. Surgical treatment includes only the time of the operation and subsequent rehabilitation, it takes up to 3 months.

Is it possible to do without surgery?

If the hernia is not accompanied by a violation of sensitivity and weakness in the lower extremities, a disorder of defecation, urination, potency, then you can do without surgery. Otherwise, an operation is necessary.

Is hernia treatment effective with conservative methods?

If with the help of conservative therapy it is possible to achieve relief of symptoms and prevent or reduce the frequency of relapses, then it can be considered effective. But the root cause of the disease will not be eliminated.

Lumbosacral disc herniation occupies a leading position among disorders of the musculoskeletal system. This pathology requires timely diagnosis and the appointment of competent therapy. Advanced forms of the disease can have very dangerous consequences in the form of paresis or paralysis.

Causes of pain in the lumbosacral spine

With discomfort in the lumbar region, many are familiar firsthand. In this case, a person may experience pain of a different nature. Is it transient (acute) or chronic. The first passes faster than the cause that provoked it. The second lasts even after the cessation of the action of irritating factors. The causes of each of the above syndromes can be the following conditions:

The appearance of acute pain is provoked by:

• muscle injury;
• vertebral fractures;
• radiculopathy;
• rupture of the ligament;
• lumbosacral hernia;
• epidural abscess.

Chronic pain occurs due to:

• deforming spondylosis;
• oncology;
• osteomyelitis;
• myositis (inflammation) of the spinal muscles.

Hernia of the lumbosacral spine

Intervertebral fibrocartilaginous formations consist of a nucleus, rings surrounding it with collagen fibers and hyaline connective tissue. Due to this structure, they provide strength and cushioning of the spine. This greatly reduces the risk of damage due to injuries, heavy physical exertion, sprains. It happens that under the influence of negative factors, the development of pathologies of the disk space occurs.

Intervertebral hernia of the lumbosacral spine is formed when the annular collagen fibers are torn. There is a protrusion of the pulpous nucleus. The result is a hernia that compresses the nerve roots and leads to inflammation of the adjacent tissues. In the absence of proper treatment, the patient consistently develops such stages of the formation of a lumbosacral hernia of the spine:

1. Protrusion. At this stage, there is a small protrusion (3 mm).
2. Prolapse. The size of the lumbar hernia is about 1.5 cm.
3. Sequestration. The stage is characterized by pinched nerve roots and constant severe pain.

Symptoms

The first signs of the development of degenerative changes in the intervertebral space are often ignored by patients. The dull, aching nature of recurrent syndromes is simply "experienced" by them from day to day. Due to such a careless attitude to the problem over time, patients experience a progressive displacement of the pulp nucleus outside the disk space. The following symptoms of a hernia of the lumbosacral spine are distinguished:

• muscle atrophy;
• pain syndrome when lifting the leg (a specific sign of a hernia of the intervertebral space);
• shootings extending to the lower limbs;
• numbness;
• lumbar pain;
• decrease in reflex activity;
• the development of sciatica, as a consequence of a hernia;
• dryness of the skin.

Risk factors

Degenerative changes in the intervertebral discs, manifested by a lumbosacral hernia, can occur due to many reasons. Modern lifestyle often provokes the development of dysfunction of the musculoskeletal system. An increase in physical activity, a balanced diet, and a reduction in possible stressful situations will help to avoid the negative impact. The main risk factors for the formation of an intervertebral hernia of the lumbosacral spine include:

• heavy physical labor;
• work involving a long stay of the body in a static position;
• neglect of the principles of physical activity;
• bad addictions and habits;
• excess weight, additionally loading the lower spine.

Treatment of intervertebral hernia of the lumbar

In the stage of protrusion of the fibrous ring, therapeutic measures to eliminate the protrusion in the lower spine are limited to bed rest, the appointment of anti-inflammatory and other drugs. Advanced forms of pathology require the use of measures for the medical removal of swelling of adjacent tissues, the release of intervertebral discs and the elimination of compression of the nerve roots. In addition to these, there are the following methods on how to treat a lumbosacral hernia:

1. through conservative therapy involving the use of medications:
   • synthetic hormonal drugs injected into the epidural space of the spine (methylprednisolone);
   • opioid analgesics;
   • NSAIDs (Indomethacin, Movalis), used at the beginning of the formation of a lumbosacral hernia;
   • blockade injections of novocaine or lidocaine into the lower spine;
   • drugs to improve blood circulation (Actovegin, Trental);
   • injections with B vitamins to accelerate the recovery of tissues adjacent to the hernia area;
   • external agents with non-steroidal components.
2. through surgery:
   • Endoscopic discectomy - resection of the damaged disc space. The “breakage” is removed along with the hernia through a small incision in the skin.
   • Laminectomy - extraction of the vertebral arch.
   • Ligamentectomy - scraping of the disc.
   • Chemonucleolysis - drying of the resulting hernia.
   • Spinal fusion - transplantation of a new bone disc from the patient's pelvic bone.
   • Laser disc decompression - laser evaporation of an existing hernia.

Therapeutic exercises for the lumbar spine

The recovery period is of paramount importance in the entire process of treatment of intervertebral hernia. Therapeutic physical culture (LFK) helps the body adapt to the changes that have occurred and gradually develop a new set of conditioned reflex motor reactions. The lower spine is at high risk of recurrent hernia. In view of this, it is important to follow the basic rules of physical activity.

Therapeutic exercises for a hernia of the lower spine include measures aimed at stretching the bearing part of the skeleton, for example, swimming. Engage in these types of activities regularly:

• To perform the exercise, get on all fours with support on your knees and elbows. Next, you need to simultaneously raise the right arm and left leg, fix the body for 5 s. Take the starting position, and perform the approach on the other side.
• Take a horizontal position with straightened arms and legs bent at the knees. Raise the pelvis with emphasis on the back and fix the position for 3 s.
• Lie on your stomach and put your hands under your chin. Gently raise the body without lifting the lower body from the floor surface. You need to hold this position for 5 s.

During the rehabilitation period, it is strongly recommended to adhere to moderate physical activity. After 2-3 months after the extraction of the lumbosacral hernia, the patient can start exercise therapy, take short walks. You can speed up the processes of adaptation and healing with the help of spa treatment, including baths with radon, turpentine, sulfides.

You can significantly reduce the risk of recurrence of an intervertebral hernia if you follow such recommendations as:

• maintaining an active lifestyle without heavy loads on the spine;
• the use of preventive means of protection against injuries of the bearing part of the skeleton;
• visiting the pool;
• reduction of excess body weight;
• conducting regular classes;
• maintaining constant control over the correct posture;
• preventing the body from being in a static uncomfortable position;
• taking frequent walks in the fresh air.

Video: Exercises for the lumbosacral spine

It is one of the most common dysfunctions of the musculoskeletal system.

This problem occurs when the pulpous core of the spinal disc is actually squeezed out of the annulus fibrosus.

Such a violation leads to the fact that the tissues of the damaged intervertebral disc begin to put pressure on the nerve roots of the spinal column.

Because of this, the patient experiences severe pain. Since this type of disease is very common, it is worth knowing the main symptoms and being ready to start treatment in a timely manner, because a hernia of the spine can lead to a limitation (or even deprivation) of the patient's working capacity.

What is a lumbar disc herniation?

Intervertebral hernia of the lumbar spine - This is a disease in which the central part of the spinal disc is squeezed out by two adjacent vertebrae outside the intervertebral space.

If the problem is not diagnosed at this stage, then further deformation will aggravate the situation and the nucleus of the intervertebral disc will come out(the integrity of the capsule is broken). This process will mark the formation of a hernia.

Disease classification

A hernia has a fairly extensive number of "variations", a competent and complete description of your specific case can only be given by a specialist after conducting research.

It is well known that a hernia of the lumbar spine is subdivided into two main types:

1. L4-L5- in medical practice, each section of the spinal column is designated by a certain letter of the Latin alphabet (the letter L was allocated for the spine). This type of disease means that compression of the nerve roots occurs in the space between the 4th and 5th vertebrae in the lumbar spine;
2. L5-S1- with this type of disease, pinching of nerve endings occurs between the 5th vertebra in the lumbar region and 1 vertebra in the sacral spine.

In addition to this classification, one can distinguish by the nature of the tissues that protrude beyond the spinal column. From this point of view, there are:

• Pulpous hernia- a hernia of this type consists of a pulpous nucleus, which is “squeezed out” due to a violation of the integrity of the fibrous ring. This type occurs in the vast majority of patients (approximately 86% of cases);
• cartilaginous hernia- a hernia of this type consists of fragments of deformed intervertebral cartilage. This type occurs after a long-term inflammatory process, which is often caused by various injuries of the spine. This type occurs in about 13% of cases;
• Bone hernia- this type can be called a hernia only conditionally, since the main cause of its appearance is osteochondrosis (or another long-term degenerative-dystrophic process), which leads to the growth of bone tissue and the appearance of osteophytes (bone "thorns"). Osteophytes compress the nerve endings of the spinal cord and narrow its canal, which leads to the formation of a hernia. Typically, this type of disease occurs in only 1% of patients, most of whom are elderly.

The prevalence and significance of the disease

Intervertebral hernia of the lumbar spine occupies one of the leading places in terms of prevalence among all diseases of the musculoskeletal system.

This means that this type of spinal dysfunction requires not only timely diagnosis and treatment, but also prevention, because otherwise (at advanced stages) the development of the disease may threaten to deprive the patient of working capacity (from partial limitation to complete deprivation).

That's why don't be shy about this issue., at the first symptoms, you should consult a specialist and start treatment.

Reasons for the development of the disease

The list of risk factors is quite extensive when it comes to the formation of a hernia in the lumbar region. The specific cause (or a combination of them) will be named by a specialist after a series of examinations.

The most common causes of a herniated disc are::

All this is only a small part of those factors that can lead to changes in the tissues of the intervertebral discs and displacement of the nucleus.

Symptoms and methods of diagnosing the disease

Usually, the first signs that signal us about the presence of disorders in the lumbar spine are ignored. Aching, dull pain in this area is simply "experienced" by the patient. Therefore, in the early stages, degenerative changes usually go unnoticed and develop into a full-fledged intervertebral hernia.

When the hernia has already formed, new symptoms appear, which is already difficult not to notice or endure. This is first of all:

• pain syndrome in the lumbar region when lifting the leg;
• amyotrophy;
• frequent "lumbago" (sharp pain in the lower back, arising from awkward movement, weight lifting, hypothermia, etc.);
• numbness;
• the appearance of sciatica;
• reduction or limitation of reflex activity;
• dry skin in the affected area.

Such symptoms are quickly fixed in the life of the patient, without giving him the slightest rest. Therefore, at the first manifestations of the disease, it is worthwhile to undergo a diagnosis.

In order to find a disc that has undergone deformation, a specialist will carry out a number of activities, including:

• X-ray diagnostics(in two projections);
• MRI(will help clarify the details of the development of the disease);
• tendon reflex test(such a simple method will allow you to find out how badly the nerve endings are damaged, as well as to identify the level of sensitivity of the lower extremities and their mobility).

Only after carrying out the main diagnostic measures, the specialist will prescribe you a treatment course that will help to cope with the developed disease.

Video: "What is a vertebral hernia?"

Treatment of intervertebral hernia of the lumbar

When the main list of diagnostic actions is left behind, it's time to start treatment.

But keep in mind that the course of the disease is divided into three main periods:

The division into periods allows specialists to apply the correct hernia treatment strategy.

Treatment of the disease in the acute period

And did you know that…

Next fact

This period is the most painful and dangerous in terms of motor activity.. Here you need to be very careful not to hurt yourself even more. The main thing at this stage is a minimum of movements and bed rest.

In this case, you should lie on a small pillow, put a small roller under your back. The doctor should give you the correct position on your back, since it is he who knows which particular discs are damaged.

At this stage of the disease are usually applied painkillers. It is preferable that they are introduced into the body by injection (at the initial stage).

Diclofenac, Movalis, Rofika are widely used. When the pain subsides a little, you can replace the injections with tablet forms of the same drugs or add others (Ibuprofen, Meloxicam, etc.);

At this stage of the disease, any manipulation of this kind is prohibited.

In the acute period of the disease, you can only move your toes. All other movements are prohibited.

Treatment of the disease in the subacute period

When the crisis has passed a little, you can move on to the next treatment course. Subacute period requires the patient to remain in bed and careful monitoring of their well-being. Any movement that causes pain should be avoided.

Medical treatment

In the subacute period, the same types of medications are used as in the acute period.. The only difference is that the dose of drugs is reduced or the form of administration is changed (for example, injections are replaced by tablets). All changes should only be made by your healthcare provider based on the symptoms you are experiencing at this stage.

The following procedures are very good for the body:

• thermal procedures;
• acupressure;
• acupuncture (here you need to be careful and find a competent specialist);
• underwater massage.

Used as an additional hirudotherapy(treatment with medicinal leeches). But here it is important to find a competent specialist and consult with your doctor.

This technique is insidious and can cause complications. The same applies to manual therapy and massage courses - both methods require a competent approach and professional performance.

Physiotherapy

Physiotherapy exercises in the subacute period should be performed with great care. All exercises should not cause pain. If you feel that you have pain, immediately stop exercising and go to rest.

Exercises to perform:

Important! Be sure to check with your doctor before you start exercising.

1. Lie on your back, straighten your arms and legs. Relax all muscles. Slowly raise your arms up, stretch slightly, and then slowly lower your arms;
2. Lie on your back, relax your body. Bend the left leg at the knee, then slightly shake it to the left and right, relax the muscles. Repeat with the opposite leg;
3. Lie on your stomach, put your hands under your chin. Bend your knees and alternately touch your buttocks with your heels. After that, relax all the muscles and rest a little;
4. Lie on your back. Begin to bend-unbend the leg at the knee and move it in different directions;
5. Take the same starting position as in exercise 4. Bend your leg at the knee and pull it with your hands to your chest. Repeat for each leg;

Treatment during the recovery period

At this stage, medication and physiotherapy remain the same.. The difference is that the dose of medications is significantly reduced, some groups of drugs can be completely excluded from the course by your doctor. Physiotherapy procedures remain the same.

Physiotherapy

The recovery period is characterized by an increase in the volume of physical activity. It is important to consult with your doctor when expanding the gymnastic complex.

Exercises to perform:

1. Starting position - lying on your stomach. The doctor bends and unbends the leg at the hip, fixing it for 6-8 seconds in an extended state;
2. Starting position - lying on your stomach. Alternately take the left, then the right leg away from the body;
3. Starting position - lying on your stomach. Raise the straightened leg at a slight angle (over time, the angle of elevation needs to be increased);
4. Starting position - lying on your side on the healthy side. Bend the sore leg at the knee and take it away from the body;

Surgical intervention

The decision to remove a hernia is made by your doctor based on certain symptoms that can seriously threaten your health..

Among these symptoms are narrowing of the spinal canal (despite the entire medical complex), numbness of the extremities, severe weakness in the muscles, dysfunction of the pelvic organs, squeezing of the “horse tail” (the end of the spinal cord, consisting of a bundle of nerve endings, pinching or irritation of which causes unbearable pain in the perineum and lower extremities).

Surgical intervention in this case is the release of the spinal cord from the hernia compressing it.

There are several ways to do this:

• endoscopy;
• Endoprosthetics;
• Percutaneous discectomy;

Each of these methods is applied under certain characteristic conditions of the course of the disease.

Folk recipes

In order to make conservative treatment even more effective, some folk methods can be used that can help relieve unwanted symptoms of the disease.

Disease prevention and recovery prognosis

In order to prevent the formation of a hernia, First of all, you need to watch your own weight.. In most cases, it is excess weight that causes a hernia, since our spine cannot withstand such a strong load.

Besides watch your diet and lifestyle, eliminate smoking, minimize alcohol consumption, exclude strong physical exertion, go in for sports (running, swimming, walking, cycling), pick up a hard mattress for sleep, adjust the daily routine.

If you notice the first symptoms of the disease, then immediately consult a doctor. He will prescribe you a treatment course that can avoid surgery or serious complications. Timely treatment will help to defeat the disease in the early stages.

Conclusion

Since the intervertebral hernia of the lumbar spine is one of the most common diseases of the musculoskeletal system today, you should know as much as possible about it, in order to prevent the disease in time or choose the right treatment:

• The initial symptoms of the disease may be completely ignored by the patient, since they are not pronounced. Symptoms will become more pronounced when the hernia is finally formed. At the first signs, we advise you to contact a specialist and undergo an examination;
• In medical practice, the intervertebral hernia of the lumbar spine has three main periods of the course of the disease: acute, subacute and recovery. For each of these periods, there is a set of therapeutic measures, so only your doctor can prescribe certain procedures, based on the symptoms that bother you at a particular moment;
• The acute period of the disease is characterized by severe pain and limitation of motor functions., therefore, you need to observe bed rest and give your body maximum rest until the end of the crisis;
• In addition to conservative methods of treatment, some folk recipes can be used.. But it is worth consulting with your doctor, as well as taking into account the individual characteristics of your body before using these or other non-traditional methods;
• Any disease is much easier to prevent than to treat, so check out the preventive techniques that will help you avoid the appearance of a hernia.

Rheumatologist, Orthopedist

He is engaged in the management of patients with traumatological and orthopedic profiles, reading radiographs and interpreting the results of analyzes, as well as conducting conservative and surgical methods of treatment.

Intervertebral hernia is very often localized in the lumbar spine. Women over the age of 30 are most susceptible to this disease. The cause of the pathology is a rupture of the disc, which occurs under the influence of a large load or due to a violation of its nutrition. Left untreated, the disease can lead to disability.

The lumbar region is the most mobile part of the spine. It bears the greatest weight load, as it is responsible for the center of balance of the body. This makes him the most vulnerable and injured. Lack of physical activity also negatively affects his condition and leads to a violation of his nutrition.

The lumbar region includes five vertebrae connected by discs. Thanks to them, there is a distribution of gravity on the spine. The structure of the discs is a semi-liquid core surrounded by an annulus fibrosus.

Strong loads lead to damage to the fibrous ring and its rupture. As a result, the semi-liquid core enters the spinal canal, which is accompanied by pinched nerve endings. Microcracks are formed, which increase under the action of the load.

Symptoms of the disease

The manifestation of symptoms depends on the stage of the disease. Initially, a hernia does not cause much discomfort, and people rarely seek medical help, considering it a manifestation of normal fatigue and pain from physical exertion. When the disease progresses, it is no longer possible to ignore it, since the symptoms are quite pronounced:

1. Discomfort when turning and tilting.
2. Prolonged drawing pains in the back.
3. Severe pain radiating to the buttock.
4. Feeling of tingling and goosebumps.
5. Temporary numbness and burning of the legs.
6. Problems in the work of the intestines and bladder.
7. Paralysis.

These symptoms appear during the development of the disease and often depend on the individual characteristics of the organism. Some people may suffer for years in the initial form of the disease, which does not progress, and is expressed only by dull aching pains. Some, for example, after injuries in car accidents, cannot get out of bed after a few months.

Most often, hernias occur in the lumbosacral segment L5-S1 and lumbar L4-L5. In the presence of a hernia in the L4–L5 department, the following can be added to the main symptoms of the disease:

1. Difficulty moving the big toe.
2. Weakening of the calf muscles, which is the cause of the hanging foot.
3. Soreness and numbness of the foot in the upper part.

With a hernia in the L5–S1 section, there is no possibility of moving and raising the fingers, pain radiates to the foot or heel, there is no Achilles reflex.

By the nature of the pain, it is enough for a specialist to simply establish their cause, but an accurate diagnosis is possible only after a complete examination, which includes x-rays and computed tomography. These methods allow you to visualize a damaged disk.

Pain development

At the initial stage, a person feels a dull aching pain. In the supine position, the pain disappears, and increases with walking. Pain can subside and appear abruptly, and is present throughout the disease.

This is the initial stage, which can last for several years. Most people ignore the pain and refuse to visit a specialist, which leads to the further development of the disease.

The pain begins to intensify, give to the thigh and cause numbness of the limbs. A person feels discomfort when bending over, raising the legs and pressing on the lower back. Shooting pains begin to appear, which can radiate to the leg, foot or buttock. Discomfort increases with any movement. Relief can be felt only in the supine position. Sitting or standing up makes the pain worse.

Important! For diseases of the lower back, the characters are shooting pains, the duration of which can be up to several weeks.

It is difficult for a person to move, sit and stand - in any position he feels severe pain. But not only the lower back hurts - the pain gives to the buttock, foot and ankle. In the absence of treatment, internal organs begin to suffer, and especially the genitourinary system. This happens due to a violation of blood circulation in the pelvis.

Compression of the nerve roots leads to:

1. Weakness in the muscles of the legs and thighs. It is difficult for the patient to move, jump and squat.
2. Crawling sensation in the leg area.
3. Feet are constantly cold.
4. Sweating at the site of compression of the root.

If the hernia bulges backward, it can compress the spinal cord, resulting in severe paralysis. There is a decrease in body temperature, swelling and dryness of the skin occur.

Causes of pathology

There are many reasons for this pathology. It can be the result of osteochondrosis or scoliosis, and also develop after a serious injury. Hernias occur due to the lack of nutrition of the intervertebral discs, which is produced through the muscles of the back. With the refusal of physical activity, the muscles atrophy, which leads to a lack of nutrition of the discs and an increased risk of injury.

Factors provoking the disease:

1. Weight lifting.
2. Great physical activity.
3. Falls.
4. Excess weight.
5. Passive lifestyle.
6. Wrong posture.
7. Infections and viruses.
8. Natural aging.
9. Smoking.

Important! Women are more likely to suffer from the disease, and with growth above 170 cm, the risk of a hernia is much higher.

Hernias occur due to sudden lifting of gravity. If at a younger age men do not notice aching pains after hard physical work, then after a while it becomes difficult for them to unbend, lifting loads. Women who carry heavy bags in one hand are also susceptible to this disease, and the weight should be distributed evenly.

Very often, hernias occur after a fall and injury, but in most cases they do not appear immediately, but after a couple of years. A person begins to feel a sharp pain that radiates to one of the legs, and can rarely determine what caused such an ailment. The localization of pain depends on the location of the spinal injury.

Important! If several parts of the spine are damaged, both the right and left legs will hurt.

Excess weight is a strong load on the spine. Obesity is often accompanied by diseases of the spine and vascular system, which increases the risk of hernia formation. Smoking also has a negative effect on blood circulation. Some infectious and inflammatory diseases can also lead to the development of hernias due to the destruction of the lining of the intervertebral discs.

Effects

The disease is dangerous for both sexes. Women develop gynecological diseases due to circulatory disorders in the reproductive organs. Problems with urination and menstruation may occur. All organs of the small pelvis suffer, but this does not appear immediately.

Important! In men, if left untreated, impotence and other diseases of the genitourinary system may develop.

Very often this disease is accompanied by intestinal disorders. I suffer from frequent constipation, pain radiating to the anus, and bloating. Due to high pressure in the affected area, a curvature of the spine develops. It becomes impossible to bend the back - hunchback and stoop may appear. Due to compression of the nerve roots, a decrease in sensitivity in the affected areas is possible. A person's legs, fingers, or hips begin to go numb.

Sometimes the disease is accompanied by the appearance of backache, which cause severe pain. At this time, a person cannot get out of bed, and with any change in position, the pain increases. The most dangerous consequence is limited mobility and paralysis. Due to severe pain, a person can neither lie down nor sit. The knee jerk may disappear and the mobility of the thumb may be impaired. If treatment is ignored, disability is possible.

Video - Intervertebral hernia of the lumbar spine symptoms, exercises

Effective Treatments

At the moment, there are two ways to treat pathology - surgical and conservative method. As practice shows, most patients do not require surgery, but rather conservative methods of treatment. They are aimed at eliminating pain in the lumbar region. In the acute course of the disease, you need to observe bed rest and take painkillers.

Usually, pain relief occurs within a month. After this, the disease is not yet completely cured and it is necessary to strengthen the damaged discs. Next month, in no case should you lift weights and engage in heavy physical work.

The most popular drugs

After removing the pain syndrome, great importance is given to therapeutic exercises and special physical exercises. The patient is faced with the task of strengthening the ligamentous apparatus and muscles. A person needs to independently monitor the health of his back and refuse to lift weights.

An operation is an extreme method that is resorted to if it is not possible to reduce pain for a long time or a hernia has provoked a malfunction of the internal organs. To remove a hernia, a minimally invasive operation is performed, which takes place under general anesthesia and lasts about half an hour. Thanks to the use of microinstruments, the tissues surrounding the spine are practically not injured, and the body is restored in the shortest possible time.

The operation only in 10% of cases does not bring the proper result, and after a while new hernias may appear. This happens due to a weakened muscle corset. In this case, it is necessary to pay great attention to therapeutic exercises and strengthen the back. After that, it is recommended to repeat the operation again, which usually has a positive result.

Prevention

First of all, you need to give up a sedentary lifestyle. It is recommended to walk every day and exercise for the spine. Swimming and yoga are helpful. After prolonged work in a sitting position, it is necessary to do physical exercises.

Before lifting weights, you need to bend your knees and keep your back straight. In no case should you make too sharp turns and movements. Regular heavy physical activity, accompanied by lifting heavy loads, is the risk of spinal pathologies at an early age.

Important! Loads should be moderate if a person wants to maintain his health.

Nutrition plays a huge role. It is worth giving up fried, smoked and fatty foods. They lead not only to excess weight, but also to problems of the vascular system. It will be helpful to eat foods rich in protein. You need to choose lean meats, and use stewing, steaming or boiling as a heat treatment. The diet must include vegetables and fruits.

Pain in the back and limbs should not be left without proper attention. Because in about half of the patients, back pain is provoked by the intervertebral hernia. However, often the disease is discovered by chance during a computed tomography. The disease occurs with a frequency of 100 cases per 100,000 population. Intervertebral hernias are more often found at the age of 30-40 years.

The reasons

The spine is the main support of the body. The vertebral column is made up of vertebrae connected to each other by intervertebral discs. The function of the latter is to provide shock absorption when walking, running, as well as the flexibility of the entire spine. The intervertebral disc consists of an outer shell - the annulus fibrosus, as well as the nucleus pulposus, located in the center of the disc. Normally, the fibrous ring is quite dense and able to withstand physical exertion. But the properties of the connective tissue membrane can change.

With compression of the motor fibers of the spinal roots, weakness of the leg muscles is observed, as well as a decrease in reflexes. When the sensitive fibers of the spinal roots are compressed, there is a decrease in skin sensitivity, tingling, a feeling of crawling along the back of the leg, from the buttock to the heel. These symptoms are considered as manifestations of sciatica.

Vegetative disorders may be observed: the skin of the lower back and legs turns pale, red or white spots may appear on it, and increased sweating is recorded.

In addition, with compression of the roots innervated by the pelvic organs, the patient complains of urination and defecation disorders, as well as a violation of potency.

With compression or damage to the spinal cord, paresis or paralysis in the lower extremities may occur.

With this type of intervertebral hernia, a person is disturbed by constant aching pains in the neck, which is the earliest sign of the disease. With compression of the nerve roots and vertebral artery, headaches occur. Moreover, the pain can be diffuse or concentrated in the neck and temples. There are also symptoms such as dizziness, tinnitus. Due to inadequate oxygen supply to neurons, constant weakness and rapid fatigue develop. In addition, there may be an increase in blood pressure.

With compression of the sensitive fibers of the spinal roots in the neck, occiput, hands, there are sensations of numbness, tingling, crawling, and a decrease in skin sensitivity. With compression of the motor fibers of the spinal roots, weakness of the muscles of the hand is observed. Vegetative disorders are characteristic: the skin of the neck, hands turns pale, there is increased sweating.

With severe compression of the hernia of the spinal cord, paralysis may develop.

With this type of disease, a person is concerned about back pain, mainly between the shoulder blades. However, the pain can radiate to the chest, lumbar region, neck, upper limbs. Pain sensations noticeably increase when coughing, sneezing, laughing, turning the body. It is noteworthy that the pain is often shingles in nature.

Sometimes the pain spreads to the abdomen, which can mimic the pathology of the abdominal organs. When the spinal cord is compressed below the injury site, paresis and paralysis occur.

In the presence of characteristic symptoms and complaints of a person, a neuropathologist examines. The doctor determines muscle tone, skin sensitivity, as well as the state of reflexes. To confirm the diagnosis, the patient should undergo instrumental studies.

The most accessible method is radiography of the spinal column in frontal and lateral projections. On the pictures, the intervertebral discs are not visualized, and therefore the hernia cannot be determined. But with the help of radiography, it is possible to identify the cause of the development of the disease: vertebral injuries, signs of osteochondrosis, congenital anomalies.

The most effective research is magnetic resonance. This method allows you to assess the condition of soft tissues. With the help of the obtained images, you can study the condition of the intervertebral discs, as well as the presence of a hernia.

Not all herniated discs need active treatment. So patients with protrusion of the intervertebral disc up to three millimeters and no symptoms need only observation.

In the presence of severe pain, it will not be possible to avoid taking medications. For this purpose, drugs belonging to the group of NSAIDs (diclofenac, meloxicam, ketorol) are used. With intervertebral hernias with a pronounced inflammatory process, they resort to the use of ointments containing glucocorticosteroids (flucinar, triacort, esperon, dermovate).

A fairly common and effective procedure is a therapeutic blockade. This is the introduction of anesthetics (lidocaine, novocaine) into the epidural space. The purpose of the procedure is to eliminate pain and muscle spasm. The patient experiences relief after a couple of minutes. The effect of the blockade can last for several weeks.

Additionally, the doctor may prescribe B vitamins (neurovitan, milgamma), which provide regeneration of destroyed nerve fibers, as well as improve the conduction of a nerve impulse. Chondroprotectors (structum, alfutol) are prescribed for the repair of cartilaginous tissue of the discs.

If, despite conservative therapy, the pain does not leave the person and worries more and more every day, then it is necessary to consider the option of surgical treatment. Immediate surgical intervention requires compression of the cauda equina.

Operations are carried out in an open way, as well as endoscopically. During the operation, the doctor removes the hernia and restores the integrity of the fibrous ring. If the intervertebral disc is severely damaged, surgery is performed to replace it with an implant.