What is an intervertebral hernia. Spinal hernia: symptoms, diagnosis, treatment and rehabilitation. Types of spinal hernias

A hernia of the spine is a rather dangerous disease. Ignoring it can lead to complete paralysis. With timely diagnosis, the pathology lends itself well to conservative treatment. Patients should review their physical activity and diet. After treatment, preventive measures must be followed to exclude relapse.

A spinal hernia often forms in the lumbar or cervical spine, less often in the thoracic region. Timely diagnosis and specialist assistance increase the effectiveness of treatment. In severe cases, doctors prescribe surgery. Degenerative changes are often irreversible. However, proper treatment can relieve pain and other discomforting symptoms and stop disc displacement and destruction.

What is a hernia of the spine

Pathology is associated with the displacement of the intervertebral discs. It provokes numbness, pain and weakness. The anatomical task of the discs is to absorb the load on the spinal column during movement. Any deformations in it cause discomfort in a person.

The intervertebral disc consists of a fibrous ring, the outer side of which consists of collagen fibers, and the inner side of the nucleus pulposus. The ring limits the nucleus, but if this function is disturbed, it is displaced and an intervertebral hernia is formed. Pathology develops gradually. Prolonged disc degeneration occurs, associated with fluid loss and increased fragility. A hernia is formed in several stages:

Protrusion - a protrusion appears, the inner fibers of the ring are damaged, but the rupture has not yet occurred. The gelatinous body is kept within certain limits, which makes it possible to cure the disease in conservative ways.

Entrusion - the outer fibers of the ring are damaged, which allows the nucleus pulposus to go beyond the boundaries of the disc.

Disease catalysts include:

• physical damage, microtrauma;
• infections;
• improper metabolism;
• obesity;
• engaging in heavy physical labor;
• pregnancy;
• congenital malformations of the spine;
• low physical activity;
• lordosis, scoliosis, osteochondrosis.

Note!

Statistics show that men are diagnosed with pathology much more often than women.

Doctors use the classification of spinal hernias according to their localization:

• cervical - 4% of all cases of the disease;
• chest - 31%;
• lumbar - 65%.

Symptoms of pathology

A hernia of the spine occurs when there is pressure inside the disc. The neurological disease manifests itself when the fibrous ring is stretched due to the breaking load, which causes compression of the nerve branches and blood vessels. Up to this point, the symptomatology is often attributed to another disease. In the later stages, the pain syndrome is constantly present and does not depend on physical stress.

Primary signs of a spinal hernia:

• Acute pain in the spine that disappears at rest.
• Unnatural swelling and muscle tension.
• Kyphosis or scoliosis of the spine.
• Burning, tingling, "goose bumps" - paresthesia, turning into paresis.

Many patients experience hormonal imbalance - impotence or cessation of menstruation.

Patients complain of sharp and severe pain. It is associated with the compression of the nerve root by a dropped disc, which is responsible for the work of some organ. Pathology causes malfunctioning of the organ. Symptoms depend on the location of the pathology:

Cervical

Decreased performance, sleep disturbance, neurasthenia, headaches, fatigue, vision problems, hypertension, epilepsy, inflammation of the tonsils, nausea, numbness of the fingers, pain in the extremities, tinnitus, loss of taste, increased intracranial and blood pressure.

Chest

Thyroid dysfunction, discomfort in the shoulders and shoulder blades, pain and burning sensation in the chest, the sensitivity of the skin decreases when nerve endings are damaged.

Lumbar

Diarrhea, hemorrhoids, cystitis, pelvic inflammatory disease, numbness of the lower extremities, muscle atrophy, bladder stones, unnatural sweating or dry feet.

People with an unfavorable heredity, whose family members have degenerative diseases of the spine, should pay more attention to prevention.

When symptomatic neurology of a hernia of the spine appears, it is required to consult a surgeon or neurologist who will diagnose and determine the treatment.

Diagnosis of the disease

Before starting treatment, it is required to determine the investigative causes of the appearance of the pathology using laboratory diagnostics. Only a specialist can determine the presence of swelling using X-ray and MRI.

During a visual examination of the patient, a curvature of posture will be noticeable, the sensitivity of some areas is lost.

The doctor must feel the spine to determine the degree of pain and localization of the pathology, to reveal an unnatural tension in muscle tone. When flexing and extending, determine the limitation of mobility, the range of motion.

MRI allows you to determine:

• the size
• localization.

With a hernia, a protrusion appears in the interdisk space of the nucleus:

• protrusion - up to 3 mm;
• prolapse - 3-5 mm;
• developed hernia - 6 mm.

With instrumental research, the direction of protrusion can be distinguished.

Additional studies are prescribed depending on individual characteristics.

Treatment

The correct therapy can be prescribed only after a complete examination, taking into account the stage of the disease and the type of pathology. For example, in the absence of complications, an action to stop large disc damage is sufficient.

There are three stages of treatment:

• anesthesia with medication and complete rest;
• massage and complex therapy;
• rehabilitation, recovery.

Treatment begins with over-the-counter drugs, and in the absence of a result, they switch to strong analgesics (codeine). At the initial stage, it is recommended to provide peace and maintain bed rest, take painkillers, exercise exercise therapy, undergo physiotherapy. If after 3 months the condition worsens (neurological deficit syndrome, potency decreases, limbs grow numb, pain syndrome increases), then surgical intervention is prescribed - an extreme measure of treatment due to the increased risk of complications.

Video

Professor I.M. Danilov will tell you in detail about the correct treatment of a hernia of the spine.

Non-surgical methods

After a complete examination, the initial stage of a hernia can be treated at home with the help of medicines (pain relievers, blockers), therapeutic exercises, physiotherapy.

The following methods show good efficiency:

Manual therapy - a specialist performs special manipulations to eliminate pathology. The duration of the course is 2-10 sessions.

Hirudotherapy

Treatment with leeches. The saliva of the worms contains an enzyme that provokes the resorption of the fallen out fragment and improves blood circulation.

Cryotherapy

The problem area is exposed to liquid nitrogen to increase blood circulation.

Osteopathy

With light movements and pressure, the doctor eliminates pathological changes.

Acupuncture

Impact on active points to irritate nerve endings. The effect is similar to massage, when the masseur touches these points tactilely.

Physiotherapy allows you to relieve pain without taking medication, as well as speed up the recovery process. Patients are recommended:

• manual therapy;
• massage;
• Exercise therapy;
• UHF;
• electrophoresis;
• phonopharesis;
• reflexology.

Each method has its own indications and limitations. The exact complex will be selected correctly only by the attending physician.

Drug treatment

First of all, conservative therapy is necessary to eliminate painful neurological reflexes. Patients are prescribed anti-inflammatory nonsteroidal drugs:

• diclofenac;
• indomethacin;
• ibuprofen.

Note!

In the presence of chronic pathologies of the gastrointestinal tract, the choice of anti-inflammatory therapy is approached more carefully.

At the first signs of improvement, they switch to a comprehensive therapeutic and prophylactic effect. Subsequently, the patient must undergo a preventive examination by a neurologist or therapist every month.

Miorelaxans, such as Midocalm and Sirdalud, are prescribed to relieve spasms. It is worth remembering the side effects:

• absent-mindedness, decreased performance;
• nausea;
• lowering blood pressure;
• loss of sensitivity;
• urinary and intestinal disorders;
• psychological problems.

To protect the gastric mucosa, drugs are used that cover the stomach with a protective film:

Almagel.

• almag;
• almagel;
• gastal;
• phosphalugel.

When treating a hernia, chondroprotectors are used to restore cartilage tissue:

• structure;
• teraflex;
• alflutop.

The course of treatment with chondroprotectors should be more than 3 months.

To improve blood circulation in the problem area, appoint:

• trental
• pentoxifylline.

Patients must take vitamins of group B, D, A, E to restore damaged tissues, reduce pain.

Use a deep penetration transdermal ointment. It is made just before use, as it contains a lot of organic matter, which completely excludes factory production. The ointment should be applied with light movements, kneading is completely excluded, so as not to cause great damage.

Among the pharmacy ointments are:

• non-steroidal anti-inflammatory (Fastum gel, Ketonal, Nurofen, Voltaren);
• combined effects - pain relief and removal of puffiness (Dexpanthenol, Dolobene);
• irritating effects (Nikoflex, Kapsikam);
• chondroprotectors (Chondroxide, Arthrocyte).

When prescribing the ointment, the likelihood of an allergic reaction to the components should be taken into account.

Blockade

If pain relievers are ineffective, then X-ray-controlled blockade is done. A needle with a hormonal solution is injected into the focus of the pinching of the nerve roots. Local administration provides maximum efficiency. The injection can be done at the exit site of the nerve processes, between the spinal processes or in the intervertebral region. A contrast agent is often used to determine the pathway of the drug.

The procedure is performed under local anesthesia and X-ray control. Practice shows that in 50% of cases, patients recover.

Manual therapy

Manual therapy is preferred over massage. With the help of shifting and stretching, the pinched nerve is released. Manual therapy can be used as a pain reliever without taking various medications.

Manual therapy should be performed only in specialized clinics. It can only be used for hernias of a certain size and location.

Manual therapy does not cure pathology, but only removes symptoms for a while. Patients should in the future exclude the convergence of the vertebrae and increased pressure on the disc.

Folk remedies

Folk remedies should be used with caution. It is possible to reduce symptoms with the help of beekeeping products, herbal infusions, horse fat.

Note!

General rules of use folk remedies: avoid heating the surface and exclude heating substances.

In the east, it is believed that the daily consumption of prunes, figs and dried apricots strengthens the spine and increases the healing effect of other conservative agents.

A compress of honey and potatoes will help reduce pain. Raw potatoes are grated and mixed with honey. Apply to the area of \u200b\u200bpain, cover with a film, wrap. Withstand 2-3 hours.

You can also make a 1 cm thick flat cake from honey and flour, which is applied overnight and tied with plastic wrap.

The local effect is exerted by a compress from Kalanchoe and burdock leaf, fir. But all funds should be used only after consultation with your doctor.

Small shavings of horse fat are covered with plastic wrap and covered with natural fabric. The compress is tightly secured with a bandage and worn throughout the day. Instead of horse fat, you can take badger or dog fat. Patients note a decrease in pain already 2 hours after application. Horse fat accelerates the synthesis of ceramides, which increases the protective functions of the body. Additionally, it has regenerating, moisturizing properties and contains the necessary Omega-3.

Note!

In cases where conservative methods of treating a hernia do not help, you can turn to neurosurgeons, you need to be careful with the choice. Of everything that inspires confidence in Russia, one can single out the SL Clinic in Moscow, and see the section on removal of spinal hernias, as well as examples of the work of these surgeons: https://spinelife.ru/workexemples/, impressively true ?. But still it is worth remembering that surgery is the last resort in the treatment of diseases of the spine and it is worth resorting to it only when conservative therapy does not give results.

Surgery

• severe pain for a long time;
• severe neurological disorders;
• impotence, urinary incontinence.

There are several types of surgical intervention, the exact type is determined by the attending physician.

Discectomy

The nucleus pulposus is removed through an open incision. In severe cases, the disc must be removed and replaced with a titanium implant. The long recovery period and the risk of infection with pathogenic microflora forces doctors to resort to this method in rare cases.

After the operation, it is important to follow preventive measures, as the disease may recur. Patients should regularly do muscle strengthening exercises, undergo physiotherapy courses and take vitamin and mineral complexes. In the presence of excess weight, they switch to a special diet with a restriction on fats and "fast" carbohydrates, increasing the intake of fiber, fruits and vegetables, low-fat dairy products.

Endoscopic surgery

A camera and an instrument are introduced through the puncture. The method is considered gentle, since the muscles are almost not damaged. The hernia is removed and the disc is corrected. Positive dynamics is observed in 80% of patients.

Microsurgical laser surgery

Laser treatment, like surgery, is considered an extreme measure. But unlike the latter, it is considered more gentle. The patient is punctured to insert a needle with a light guide. Next, a laser is used to relieve pressure in the disc. Soft tissues have a high permeability to directed radiation, which makes it possible to treat pathology with a laser without disturbing the cover. When elevated temperature the damaged areas are evaporated. Hernia symptoms disappear immediately as the pressure on the nerve endings decreases.

Duration of the procedure - 10-40 minutes using local anesthesia. After a couple of days, the person is transferred to inpatient treatment. The technique is used in the absence of disc destruction, mainly in patients under 40 years of age. With age, the disc dries up, which makes the use of a laser impractical.

Physical exercise

Patients are advised to follow a rest and exercise control regimen. It is necessary to exclude an increase in tension in the spinal column: perform jumps, lift weights. A person must control movements, excluding sudden movements, strong bends, twists.

Exercise therapy

Exercises should be selected by a doctor and a trainer with medical education. During classes, the load on the spinal column should be completely excluded, which completely excludes exercises in an upright position.

Simple and effective exercises:

• Walk around the room on all fours, keeping your back and arms straight.
• In the same position, simultaneously extend the arm and leg from opposite sides. If possible, fix the position for a couple of seconds to strengthen the ligaments.
• Hanging on the bar.
• Lie on your back and pull your knees to your chest.

Yoga

At the initial stage of the disease, yoga is not prohibited. The only limitation is not doing the exercises in bed. If pain and discomfort appear, classes are recommended to be stopped.

Permitted Exercises:

• To stretch the ligaments and muscles of the back, lie on your back, pull your knees to your chin and roll to the sides.
• Lie on your back, bending your knees and clasping your shins with your hands. Try to straighten your spine as much as possible.
• Get on all fours and bend like a cat. You need to look at the ceiling, and then at the floor.
• Lie on your back with one leg bent and try to reach the knee with your forehead. Change your leg.

Training on simulators

A properly selected simulator and the supervision of a qualified instructor will be an effective tool. It is allowed to practice only during the period of remission and according to an individually compiled program.

It is important to control breathing: during an increase in tension, inhale strongly, and then exhale slowly. This will avoid the negative effects of increased load. After each approach, take a short break. In total, the duration of the lesson is 3 hours, but active action only 1 hour.

There are different simulators depending on how the load is generated. Weighing is achieved through body weight or block system. For example, horizontal bars and parallel bars provide a load due to body weight and can only be used by people with good physical fitness.

Rules for using the simulators:

• use pain-relieving exercises if pain is present;
• eliminate axial loads;
• avoid shock loads;
• do not perform barbell presses;
• kettlebell lifting is prohibited.

Sport

A spinal hernia is a limitation in some sports. All exercises in a sitting or standing position are completely excluded.

Prohibited species are:

• race walking;
• Weightlifting;
• active sports, in which there is running or a long stay in a standing position (football, skiing, basketball);
• body-building;
• partial restriction on jumping athletics.

Gymnastics

The gymnastic complex for treatment can be performed according to several methods: Bubnovsky, Pilyuiko, Dikul. The task of the complex is to strengthen the muscle corset to avoid pinching the nerves.

Gymnastics is necessary for patients due to reduced mobility. It is required to speed up the metabolism and blood circulation, activate the muscles, which will allow the vertebrae to take a natural position and dissolve the hernia. The course should be selected on an individual basis, taking into account the physiological characteristics of the patient and the location of the pathology.

Rehabilitation

After a full course of treatment or surgery, the patient must undergo a rehabilitation period. Patients should follow all the doctor's recommendations to exclude the occurrence of complications and relapse. In most cases, patients are advised to wear a special corset, undergo a number of physiotherapy procedures, and control body weight.

Corset

Orthopedic aids reduce stress on the spine. The corset should be flexible but have a tight base. It is especially necessary for people who do not monitor their posture during the day. The corset allows you to fix the spine.

Some models have shoulder straps. The front part covers the area from the pelvis to the chest, the back - from the shoulders to the buttocks. The increased pressure is transferred from the spine to the abdominal cavity.

When choosing a model, pay attention that the corset does not compress the spine. It is impossible to wear it constantly, so the back muscles will degrade. The exact time is determined by the attending physician.

Spinal traction

The traction can be dry or underwater. In the first case, special simulators or a weighted load are used. In this case, the patient can be in a vertical and horizontal position. Underwater spinal stretching is considered to be more gentle: in water, body weight is significantly reduced, which makes the procedure less painful.

During the procedure, there is a risk of pinching a large hernia. The method has contraindications:

• sharp pain;
• oncology;
• kidney stone disease;
• cardiovascular diseases;
• osteoporosis.

After stretching, it is mandatory to wear a corset and perform a number of exercise therapy exercises. This is to prevent the vertebrae from returning to their original place.

Food

Diet is important for overweight patients. Obesity provokes pathology and aggravates the course of the disease. A healthy weight will be a prerequisite for successful treatment. To lose weight, it is necessary to introduce a restriction on the calorie content of foods, consume more fiber.

• smoked meats,
• alcohol,
• spicy dishes,
• pickled foods.

Getting a disability

Many patients are interested in getting a disability, as the disease affects the standard of living and working capacity. The group is given in the following cases:

• the appearance of complications after surgery;
• long course of the disease;
• late diagnosis.

Often people with herniated discs do not even try to get a disability, although they are legally entitled to it. Without fail, a group is given with complete or partial loss of independent movement and working capacity.

1 First group issued if a person cannot do without outside help in everyday life - he cannot move himself, paralysis is diagnosed.

2 Second group can be obtained with intense pain syndrome, impaired motor ability, or after surgery for disability.

3 Third group it is prescribed for patients with increased muscle tension and intense pain, with frequent exacerbations of the disease due to work.

Hernia during pregnancy

It was previously mentioned that pregnancy can cause a hernia of the spine. The fetus increases the load on the spine, the normal distribution of the load is disturbed. When pathology appears during this period, treatment must be started.

The main difficulty is the restriction on taking medications and exercise therapy, so as not to harm the child. Doctors recommend sparing treatment based on folk remedies.

During childbirth, the physician should take into account the mother's illness and be extremely careful. After the birth of a child, the advanced form of the disease is recommended to be eliminated by surgical intervention.

Army with a hernia of the spine

An intervertebral hernia is considered a contraindication to military service. Pathology is often accompanied by complications that lead to complete disrepair. The disease is especially dangerous in the later stages.

For a postponement, a doctor's opinion is necessary after a man's treatment for back pain. Be sure to attach the results of the above surveys.

With a mild form of a hernia, a delay of 6-12 months is laid, since it is amenable to conservative treatment. The reasons for inadequacy can be:

• atrophy, muscle paresis;
• hernia more than 8 mm;
• decreased sensitivity in the absence of natural tendon reflexes;
• congenital pathologies of the spinal column;
• intensive development of the disease;
• change in the dural sac;
• indications for surgical intervention if the patient refuses the operation or there are a number of contraindications to it.

A neglected form of a hernia of the spine leads to severe complications. The main danger is damage to nerve endings and the spinal cord, which can lead to paralysis, loss of skin sensitivity, and disruption of normal limb mobility. Treatment without preliminary diagnosis will aggravate the situation and lead to irreversible consequences.

Questions - Answers

The hernia is very large in the sacral region, I did an MRI and made a blockade, but I still yearn for myself. What to do?

You did not describe the results of the MRI (what kind of hernia) and the symptoms: do you have pain, movement disorders, loss of sensitivity in the leg, etc. This is important for deciding treatment tactics. If there are movement or sensory impairments, it is necessary to discuss the issue of surgery with a neurosurgeon. If there are no absolute indications for surgery, you need to contact an osteopath who will help you cope with pain and choose the right exercises for your back muscles.

What effect does thebantine have on spine treatment?

Tebantin is an anticonvulsant drug, but it is also used for back pain due to compression of nerves and roots. In this case, it acts as a pain reliever by altering the signal transmission in the nerve endings. It does not affect the cause of pain and inflammation. Therefore, if you want not only to anesthetize (remove symptoms), but to work with the cause of the disease, you must use other methods (osteopathy and, if necessary, surgery).

(Total 23 471, today 5)

Tom 03.03.2018 at 10:37

I had a hernia of the spine. I already thought that I would remain semi-paralyzed forever. I tried everything: neuropathologists - ours and Russian, injections, acupuncture, chiropractors, massages, healers, I was in the hospital. I relied on doctors and massages for half a year. It got worse. Barely walked, pestered pain - was saved by anesthetic injections. Having exhausted all means and having lost hope for anyone else, she began to study the nature of her sore. I came across a doctor's book on this part - everything was well explained there. What causes a hernia, what happens to the vertebrae and discs. I realized that the root of the pain is the squeezing of the discs between the vertebrae, and they need to be pulled. It turns out that in this case a vacuum effect arises in the discs, the squeezed out hernia is pulled back and they are restored. And I went (crawled) to the sports field of the nearest school. And she began to hang on the crossbar. At first it was possible only for a few seconds - the hands could not stand it. I had to hang, slowly, slowly pulling my knees up. On the third day I felt relief, the pain began to go away. A few days later I started to do jogging carefully. In general, the crossbar proved to be the most effective tool. Since then, I have a lot of respect for this sports equipment. And plus yoga, later. My back didn't bother me anymore. P.S. Maybe my experience will be useful to you.

Azat 03.03.2018 at 10:46

People! Don't just do the operation! .. There is a special home. Simulator to hang upside down, stretching the vertebrae. Order as soon as possible. My wife uses it all the time, she also had a very neglected and bad spinal hernia. And the vertebrae protruded like a dinosaur hump (no longer, pah-pah-pah). Kazakh folk chiropractors straighten very well with horse fat (grease for several days, it stinks terribly, but the bones soften, then a special massage, she went through all this as well), but the fat is also special from a certain place - Kazakh healers know ... Then it is necessary to do set of exercises of the Chinese qigong. This is also important.

Mukhtar 03.03.2018 at 11:38

The method of Professor Bubnovsky helped me. 2014 year. MRI showed a 5 mm hernia. 2015 bought inversion boots for the horizontal bar. I also ordered an inversion table. Hanging upside down and doing the exercises. The effect is excellent. Now I lift weights. Manual massage helps.


Alya 09/08/2018 at 21:22

I myself know firsthand the discomfort and pain caused by intervertebral hernias. I have 2 in the lumbar region. I suffered for 5 years until I found ways to get rid of the pain. I was helped by acupuncture, manual therapy and massage. all this was done at the Paramita clinic. Plus, yoga exercises have become mandatory for me, I do it almost every day, at first I worked with a trainer, the girl also medical education in the field of rehabilitation. So do not give up, everything is in your power, fight for your health and try to avoid surgery to the last, there are ways to cope with this ailment without surgery. I wish you all good health!

Date of publication of the article: 01/29/2015

Date the article was updated: 23.10.2018

This article provides a detailed overview of the signs of a lumbar disc herniation. Symptoms of the intervertebral hernia lumbarmost common:

Pain in the lower back or buttocks.

Pain that radiates to the leg.

Numbness, weakness, tingling or tingling sensation in the leg.

Pain in the lower back is sharp and burning in nature, rather than dull. They are caused by the protrusion of the disc affecting nearby nerve roots.

The main symptoms of a hernia of the lower back

Symptoms in some patients with a hernia of the lumbar spine are constant, very pronounced, deliver tangible, and sometimes just unbearable discomfort. Other patients report that symptoms appear from time to time and are relatively tolerable.

Most often, there is not one, but several symptoms in the complex. Here are the 6 most common combinations:

Pain in the lumbar spine combined with pain in the leg (the latter is felt more strongly).

Pain in only one buttock and in one leg on one side of the body (pain on both the right and left is rare).

The pain occurs in the lower back or buttock and goes along the sciatic nerve to the area below the waist, then to the thigh, lower leg and foot.

There may be tingling or pinching, numbness or weakness in the feet, as well as throughout the leg.

Feeling weak and numb when moving the leg or rotating the foot.

"Shooting" pain in the leg that can make it difficult to stand or walk.

In the supine position or when walking, the pain in the lumbar spine weakens, in the standing and sitting position it intensifies.

Unpleasant sensations can go away or weaken on their own or with the help of therapy (medications, injections, exercises, etc.). Sometimes it is possible to stop the symptoms of a hernia in the lumbar spine only with the help of surgery.

Attention! The most common localizations of herniated discs are the lumbar segment L4 – L5 (more than 50% of cases) and the lumbosacral segment L5 – S1 (more than 80% of cases). Let's talk about the symptoms of damage to these segments in more detail.

Symptoms of intervertebral hernia L4 – L5 (lumbar spine)

X-ray: Lumbar hernia L4 – L5

The loin is the most difficult of all parts of the spinal column. The L4 – L5 vertebrae close the lumbar region and, together with the intervertebral discs, joints, nerves and soft tissues, perform a huge variety of important functions, including supporting the upper torso and realizing body movements in various directions.

But due to the very high load, the L4 – L5 segment is especially susceptible to various lesions and destruction (that is, degenerative changes - osteochondrosis). In most patients, a lumbar hernia develops in this segment.

In addition to general symptoms, L4 – L5 herniated discs may present with the following:

• inability to move or stretch the big toe;
• drooping (paralytic) foot caused by weakening of the calf muscles;
• numbness or pain in the top of the foot

On a note. It is quite simple to check for the symptom of a dangling foot: just walk on high-heeled shoes. This cannot be done with a paralytic foot.

Symptoms of the L5 – S1 intervertebral hernia (lumbosacral dress)

X-ray: Lumbar hernia L5 – S1

The base of the spine is formed by a unique segment of the vertebrae L5 – S1, also known as the lumbosacral joint. If the outer part of the intervertebral disc located in this segment protrudes, a hernia is formed. Typical symptoms of the pathology of this department (in addition to the main ones):

• absence of the Achilles reflex: when hitting the Achilles tendon with a hammer, there is no contraction of the gastrocnemius muscle and bending of the sole;
• inability to move, raise toes up;
• irradiation of pain to the foot, heel, or outer part of the foot.

What are the signs that you should immediately call an ambulance?

For any symptoms of intervertebral hernia, the patient should consult a doctor: neurosurgeon, orthopedic surgeon or vertebrologist.

In some cases, you should immediately call an ambulance:

• Pain, numbness, or tingling becomes so severe that it literally “drives you crazy” and is not relieved with medication.
• Have trouble urinating or having a bowel movement.
• The effect of "saddle blockade" begins from time to time or constantly: the sensitivity of the inner thighs, perineum and lower part of the buttocks is lost (the area "as in contact with the saddle").
• Asymmetric paralysis of the feet, pain syndrome, numbness or loss of sensation in the leg area, dysfunction of the pelvic organs and the absence of Achilles reflexes develop. Together, all these are signs of the development of a rather serious disease - cauda equina syndrome.

In no case can the listed phenomena be ignored, since this can lead to the development of irreversible paralysis of the lower extremities.

Owner and responsible for the site and content: Afinogenov Alexey.

The vertebral column consists of a row of vertebrae with discs located between them. Thanks to the latter, the shock absorption and mobility of the spine is provided. The structure of the intervertebral discs itself includes the inner nucleus and the outer ring. When the latter is ruptured, some part of the nucleus is released into the spinal canal. This leads to the formation of formations known as hernias.

The presence of a hernia is not yet a 100% indication for its treatment. If the formation does not put pressure on the nerve roots and does not provoke the occurrence of other complications, there may be no need for medical intervention.

Along with this, in accordance with the average statistical data, in more than 80% of cases, intervertebral hernias cause very severe pain and a number of other adverse manifestations. In such circumstances, it will not be possible to do without conservative or even surgical treatment.

Under any circumstances, all sorts of unfavorable changes in well-being should be the reason for seeking medical attention. A hernia left unattended can give a number of complications, provoking the occurrence of irreversible pathologies of nervous structures with subsequent weakening or even paralysis of the limbs, dysfunction internal organs etc.

When should you see a doctor?

First of all, you need to make an appointment with a doctor if you have pain in the back. These can appear for various reasons and quite often indicate more about overwork than pathology, but it does not hurt to play it safe.

Particularly alarming should be pain that radiates to the lower extremities, intensifying during movement (even worse - at rest), coughing, etc.

In such circumstances, the doctor will prescribe the necessary diagnostic measures in order to develop the most effective treatment program for a particular patient based on their results.

The following symptoms and signs should be the reason for an immediate trip to the doctor:

• loss of control over the processes of urination and defecation;
• feeling of numbness in the perineal region, weakness in the lower extremities and impaired sensitivity of those;
• difficulties of independent movement.

If your legs become numb and it is difficult to move, go to the doctor immediately

If you have any of the above signs, you must visit a doctor within the next 24 hours. Otherwise, the consequences may be irreversible.

The procedure for diagnosing an intervertebral hernia

To confirm / deny the presence of an intervertebral hernia, the doctor listens to your complaints and conducts an initial examination. Further, the appropriate diagnostic measures will be assigned in combination or selectively. About them in the table.

Table. Methods for diagnosing intervertebral hernias

Basic treatment methods

The treatment of intervertebral hernia is a complex approach. After assessing the patient's condition, the doctor will understand whether conservative methods are sufficient for this particular case, or whether it is necessary to resort to surgical intervention.

Medications

As a rule, they resort to the complex use of non-steroidal anti-inflammatory drugs, painkillers, and muscle relaxants to relieve muscle tension.

Specific drugs and schemes for their use are selected by the doctor individually for the patient - it depends on the intensity of the severity of adverse sensations and the general condition of the patient.

Medicinal blockade

If surgery at this stage is not advisable, and conventional medications do not help relieve pain, your doctor may recommend a special epidural block. To carry out this, hormone-based drugs are usually used.

The procedure is quite complicated in its implementation. For its successful implementation, the doctor must have the appropriate qualifications and the necessary experience. To minimize the risks, the blockade is done under ultrasound control.

The procedure is as follows: with the help of a special needle, the doctor injects the necessary drugs into the places of localization of pathology. Local anesthesia is usually carried out beforehand. In total, the procedure takes up to 10-30 minutes. Already after 2-3 hours (provided that there are no complications and uncharacteristic reactions), the patient is allowed to go home.

The blockade is characterized by very fast action, good duration and high efficiency.

Operation

If you cannot get rid of pain either with the help of drugs or by means of blockade, and the hernia, at the same time, puts pressure on the nerve roots, which can potentially provoke many serious complications, the doctor will prescribe an operation. Statistics show that, on average, every tenth patient with intervertebral hernia needs surgical intervention.

The most common surgical method is microdiscectomy. In the course of its implementation, special micro-instruments and a neurosurgical operating microscope are used. This approach allows you to get rid of a hernia without causing significant damage to the surrounding tissues, which is especially important if we take into account the close location of the hernia and nerve structures.

The above operation does not require a long subsequent recovery course. If everything is in order with the patient, he will be allowed to go home a couple of days after the surgery.

Alternative treatment

There are a number of alternative methods that are often used in combination with the main methods of treatment, increasing their effectiveness, speed and efficiency. You can find out about the accompanying options for influencing intervertebral hernias in the table. study the link.

Table. Alternative treatments for herniated discs

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Video - Intervertebral hernia how to treat

Herniated disc is a fairly common disease that is inherent in middle-aged people, although young people also have this pathology. The whole danger of pathology lies in the immediate proximity to the spinal cord, therefore, any back pain cannot be ignored. Below we will tell you what a hernia is, what to fear, what the threat of inaction, what are the first symptoms of the disease and what to do if you have a confirmed diagnosis of herniated disc.

Brief description of the disease

Intervertebral discs help the spine to move and provide additional cushioning during exercise. All of these discs consist of the outer annulus fibrosus and the nucleus pulposus, which is in the middle. The concept of intervertebral hernia means rupture of the annulus fibrosus and the exit of a part of the nucleus outside. The nucleus begins to press on the spinal canal and infringe on the nerve roots and spinal cord. Due to this, local inflammation begins to develop and the person feels pain.

If there is a gap, but there is no inflammation and infringement, then you may not even suspect that you have a similar problem. As a rule, an unrestrained hernia does not require special treatment.

Most often, there are hernias of the cervical and vertebral regions. In the chest area, pathology appears extremely rarely. The hernia can be of different sizes.

Therefore, in medicine, there is a division of the disease into subspecies. The protrusion of the nucleus by 2-3 mm is called prolapse. In this case, the fibrous ring remains intact. In case of protrusion, the protrusion can have dimensions from 4 mm to 15 mm. If the hernia falls outside the nucleus and looks like a drop, then we are talking about extrusion. In addition, experts distinguish 4 stages of this disease:

• At stage 1, cracks form in the intervertebral discs and the hernia can protrude by 2-3 mm. Due to this, local blood circulation is disturbed, local edema and hypoxia of the spinal cord root occur. Patients feel sharp pain in different parts of the spine, especially with certain movements that involve the affected area.
• At stage 2, the protrusion reaches 4-15 mm in size. The pain becomes dull and aching. There is a feeling of numbness in the limbs.
• Stage 3 is characterized by atrophic processes of the nerve root and the formation of osteophytes, from which the disc is no longer able to perform its shock-absorbing functions.
• At stage 4, atrophy of the surrounding tissues occurs. There is practically no pain and the mobility of the vertebra is close to zero.

The main symptoms

First of all, the intervertebral hernia is manifested by pain. Unpleasant sensations make themselves felt at the time of a sharp change in position (jumping, bending, turning), while coughing or laughing. When an exacerbation of the disease occurs, the back muscles quickly get tired, so fatigue appears by the end of the day. Also, patients often complain of impaired sensitivity.

It is worth noting that the pain manifests itself not only in the very place where the hernia is localized, but also spreads to the arms and legs. Moreover, if your hernia is located on the left side, then the left leg will hurt more. Sometimes leg pain occurs before the lower back begins to hurt, so it is important to notice such signs of a herniated disc.

Indicators that a hernia is potentially dangerous and nerve roots are strangled are:

• weak sensitivity in the legs;
• change in gait;
• feeling of numbness in the perineal area;
• violations of the processes of defecation and urination.

If any of the symptoms described above are detected, you should seek the help of a qualified doctor as soon as possible to make a diagnosis and start treatment as soon as possible.

Causes and risk factors

The causes of herniated discs lie in the anatomical structure of the intervertebral discs. The point is that they do not have their own blood vessels. Nutrition occurs by absorbing the necessary substances from neighboring tissues during movement. Due to the fact that, due to the modern lifestyle in many people, the spine remains motionless throughout the day, the nutrition process is disrupted and the disc tissues become more fragile.

The same destructive effect is given by excessive physical work... If we exceed the limit of permissible flexion and extension per day, lift weights or spend a lot of time in unnatural positions, the discs wear out faster.

Sometimes a rupture of the annulus fibrosus also provokes a single load, for example, when an untrained person sharply lifts a heavy bag.

Speaking of risk factors, mention should be made of the anatomical characteristics of an individual organism, age and certain professions. Hernia often attacks overweight and tall people. Disks begin to age after 20 years, so often the first symptoms of the disease appear at 35-40 years. Bad habits also have a detrimental effect on the condition of the spine, especially smoking.

Diagnostic methods

First of all, the patient needs to make an appointment with a neurologist. The doctor will conduct a general examination and draw up a preliminary history of existing complaints. For an accurate diagnosis, it is necessary to undergo instrumental studies. The most accurate results are obtained by MRI (magnetic resonance imaging). On the final image, the doctor will be able to see how many mm the hernia protrudes from the disc, where the rupture occurred, whether there is swelling and other details.

Computed tomography (CT) is used as an additional study. With this device, you can better see the condition of the bones of the spine. In modern medicine, doctors no longer use X-ray photographs to diagnose a hernia, since soft tissues are not visible on them. To determine the degree of damage to the nerve roots, the method of electroneuromyography is used.

Treatment and prevention methods

There are various ways to deal with herniated vertebrae. The main thing is not to self-medicate and listen to the recommendations of professional doctors. The most radical measure applicable to the treatment of this disease is surgery. Surgical intervention ends in about 5-10% of hernias. Such a small percentage is due to the fact that the operation carries many risks and adverse consequences. This option is resorted to only in the most neglected and hopeless cases, when the hernia becomes life-threatening.

The decision to do or not to do an operation should only be made by experienced specialists after other methods of struggle have proved ineffective. In the remaining 90-95% of cases, hernias can be treated with safe, conservative methods.

Since the intervertebral hernia causes pain to patients and interferes with their usual lifestyle, doctors first of all try to relieve the exacerbation of the disease and remove painful sensations.

For this, various drugs are used, which are available in the form of ointments, injections, tablets. As medicines, non-steroidal anti-inflammatory drugs and muscle relaxants are used. To restore the elasticity and elasticity of the intervertebral discs, doctors prescribe drugs with hyaluronic acid. In this case, you should limit your movements as much as possible for 1-3 days so that your back relaxes, but you should not abuse bed rest either.

If the hernia is at stages 2-3, the protrusion fluctuates between 5 mm and 15 mm and the pain is severe, the patient may be advised to undergo an epidural block. This procedure is performed under x-rays. The doctor injects a special composition of hormones and anesthetic substances directly to the place where there is an exacerbation and inflammation. Such manipulation can be carried out no more than 1-3 times. The relief is temporary, but often it is the blockade that is the trigger on the road to recovery in the case of severe and lingering pain.

When the exacerbation subsides and the period of remission begins, it's time to think about a set of physical exercises. Physiotherapy gives excellent results if done wisely. Charging should be smooth, without sudden movements and jumps. The main task of exercise therapy is to stretch the spine and establish blood flow. To do all the exercises correctly, look on the network for photo instructions and videos with a detailed description of all movements.

As a rule, in such training videos, instructors show how everything should ideally look. But if you feel that a certain exercise is causing pain, skip it. Do not try to do everything with force as shown in the video. It should be noted that the best video can only be an individual lesson with a trainer.

Hernia prevention involves maintaining a healthy lifestyle. Quit smoking completely. Don't overdo alcohol. If you are overweight, fight it. Eat right, in your daily diet should be foods rich in vitamins A, B, C, D and E, phosphorus, calcium, magnesium. And, of course, pay special attention to physical activity, go to the gym, go swimming, do exercises at home from video, walk more.

Herniated disc is not an independent pathology. The cause of hernias is osteochondrosis. In the early stages of osteochondrosis, the disease does not manifest itself in any way. With such a latent course, there is a great chance that intervertebral hernias will appear.

With osteochondrosis, the flexibility and elasticity of the intervertebral discs are disturbed, and they harden. After that, the discs change their shape, become more flattened. There are small protrusions of the intervertebral discs - protrusions. What is a hernia?

The last stage in the development of osteochondrosis is a herniated disc, in which fluid leaks from the discs into the spinal cord canal.

Spinal hernias have 2 stages of progression. At the first stage, pain occurs at the site of localization, aggravated by lifting weights or prolonged sitting. At the second stage, the vertebral hernia begins to manifest itself more specifically, the pain does not appear locally, but radiates to the limb.

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Intervertebral hernias have a number of reasons for their appearance. With any of them, the spine changes its structure, dystrophic processes occur. The rate at which the hernia progresses may depend on the cause.

Consequences of osteochondrosis

In a large number of people, osteochondrosis appears at a young age. With an illiterate or untimely treatment of pathology, the patient's condition may noticeably worsen. The intervertebral discs change their structure, lose their elasticity, become more flattened. – protrusion. When the tissues of the disc are destroyed, a liquid nucleus begins to flow out of it, a herniated disc of the spine occurs. Factors that aggravate osteochondrosis, resulting in a herniated intervertebral disc:

• Smoking. The smoker's body suffers from a lack of nutrients, the spine loses strength, changes its structure. Lack of oxygen in the blood leads to accelerated aging of the intervertebral discs.
• Overweight. When a person is obese, the load on the spine increases greatly, the discs wear out and flatten faster.
• Passive lifestyle. When a person sits, the load on the spine increases, he becomes inactive, the intervertebral discs flatten, the cartilage tissue is destroyed.
• Unbalanced diet. Lack of calcium and many other vitamins leads to weakening of the vertebrae, hardening of the intervertebral discs, loss of their elasticity.

Spine injury

Spinal hernias can also appear as a result of mechanical impact on the back. Vibration loads are especially dangerous.The fibrous ring may not withstand such a sharp jump in load and burst. In many people, the intervertebral discs are already slightly worn out, flattened under the influence of stress. Making sudden movements with the rotation of the body, a person increases the risk of injury and increases the chance of a spinal hernia.

Heavy sports

Another reason why an intervertebral hernia appears is weight training if safety rules are not followed. Exercises such as squats, full range deadlifts, snatch, and clean and jerk exercises are prime examples. When performing exercises, you must choose the right weights, use a safety belt.

During strength exercises, there is a vertical load on the spinal column. Overstrain wears out the intervertebral discs and at some point a back hernia may appear.

Separately, we can single out an exercise with movements - jerks, during which the risk of increased injury increases many times due to a sharp compression and stretching of the spinal column. If a herniated disc occurs, the causes are of particular importance. The degree of destruction of the intervertebral disc sometimes depends on this.

Symptoms and degrees of hernia

Symptoms of intervertebral hernia may depend on the degree of progression of the pathology, on the patient's lifestyle and on the location of the hernia. But there are also the main symptoms that are manifested in most owners of an intervertebral hernia. In some people, signs of intervertebral hernia are absent for a long time, manifesting itself already at later stages of progression. If a person has a spinal hernia, symptoms and treatment will be closely interrelated, so it is important to tell the doctor about all manifestations.

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Typical signs of a spinal hernia:

• Muscle spasm near injured intervertebral discs. A person cannot voluntarily relax such muscles.
• Arises sharp pain when flexing and extending the back.
• When walking, a lingering, aching pain appears. In some cases, the pain does not allow walking normally, the person begins to limp severely.
• Poor sensitivity in some areas of the spine or limbs.

Hernias can be of three types: lumbar spine, thoracic and cervical spine. Lumbar and cervical herniated discs are most common. The thoracic region undergoes pathological changes very rarely and mainly in women.

When symptoms of a hernia of the spine appear, the manifestations may be more individual character, depending on the location:

• Poor sensitivity of the lower extremities, impaired coordination of movements;
• Pain in the lower extremities (legs, individual fingers);
• Groin pain;
• The lower back hurts very often. The blood supply to this part of the spine is disrupted, the muscles harden and spasm. The loin becomes more constrained.

Symptoms of a hernia in the thoracic spine:

• The thoracic region is subject to constant pain;
• Some parts of the chest become less sensitive;
• and in the area between them;
• There are pains in the region of the heart.

Symptoms of a hernia in the cervical spine:

• Painful sensations radiating to the upper limbs.
• Decreased hand sensitivity;
• Frequent dizziness and migraines;
• Decreased vitality, insomnia, impaired brain activity and cerebral circulation.
• Weakness and lethargy;
• Sharp changes in intravascular pressure.

How is the diagnosis carried out?

It is precisely to say that a person has an intervertebral hernia, only a qualified specialist can. After contacting a doctor, an individual examination is carried out, a patient is interviewed in order to obtain information about all the symptoms. To begin the correct treatment for a hernia of the spine, an accurate diagnosis is required. When a person has a herniated disc, symptoms and treatment are directly related. Despite the fact that the hernia appears and outward signs, examinations are needed to make an accurate diagnosis.

So that the doctor can diagnose intervertebral hernias, the patient is sent for such procedures: X-ray, MRI, ultrasound. Using MRI (magnetic resonance imaging), the doctor determines the size of the hernia and the stage of progression.

Depending on the severity of the disease:

• Prolapse - a hernia protrudes into the intervertebral space by a few millimeters;
• Protrusion - the intervertebral disc protrudes in the intervertebral space up to one and a half centimeters;
• - the liquid component of the intervertebral disc flows into the spinal canal.

Depending on the state of progression, there are such degrees of development of the disease:

• 1 degree. The intervertebral disc loses its elasticity, cracks begin to appear with a slight protrusion.
• 2nd degree. Protrusions are formed, the pain begins to radiate (give) to the arms and legs.
• 3 degree. Calcium salts are deposited in the intervertebral discs, which makes them harder.
• 4 degree. Nerve endings near the damaged intervertebral disc die off. Ossification of the cartilage tissue occurs.

What to do to get rid of a herniated disc?

If a person has an intervertebral hernia, treatment is a mandatory measure. Spinal hernia treatment is a difficult and time-consuming process. An integrated approach is required for efficiency. To maintain your health, you need to contact only highly qualified specialists. They carry out complex diagnostics and treatment of intervertebral hernia, starting with a blood test and ending with the day of discharge from the clinic.

Herniated disc treatment is carried out with an emphasis on avoiding surgery.

Knowing how the body distributes its forces, to which parts of the body the greatest amount of blood flows, the doctor prescribes a course of treatment. The most narrowly specialized doctor is a vertebrologist.

Drug treatment

Treatment of a vertebral hernia with drugs must fulfill several goals at once:

1. Eliminate the causes of the disease;
2. Influence the damaged intervertebral disc in order to restore cartilage tissue. For this, chondroprotectors are used.
3. To minimize pain syndrome in the patient, restore the quality of life.

Only a doctor is responsible for prescribing drugs that make up the medical treatment of intervertebral hernias. Purchasing such drugs on your own can harm you, therefore it is strictly prohibited.

To inform readers, the most effective chondroprotectors used to treat disc herniation are:

• Artron;
• Chondroxide;
• Mukosat;
• Teraflex;
• Structum;
• Don.

The most effective anti-inflammatory drugs used for the treatment of spinal hernia:

• Diclofenac;
• Voltaren;
• Fenistil;
• Indomethacin;
• Ibuprofen;
• Ketoprofen.

How to treat herniated disc with drugs? The most important thing is to follow your doctor's instructions. He has a better understanding of what a herniated disc is and will help you restore lost health.

How to treat a hernia of the spine with massage?

If an intervertebral hernia appears, how to treat it with massage and exercise? With the help, a person can prevent the occurrence of complications and slow down the development of degenerative processes in the back.

Massage will help get rid of pain and relieve the presence of herniated discs.

The masseur selects a set of exercises that will help to relax tight muscles, relieve spasms. The pain will diminish, but massage and any other method of treatment will not completely cure the disease. In men and women leading a sedentary lifestyle, pinching of the nerves of the spine may appear, symptoms: sharp pain with any movement. A set of stretching and relaxing exercises will help alleviate this manifestation.

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Traditional methods of treatment

Many people wonder how to cure a hernia of the spine using folk remedies? The answer is no way. A complete cure is not achievable with the help of drug treatment. But folk methods help to eliminate the recurring pain syndrome. There are many recipes to ease the manifestation of hernial pain.

With the help of ointments, rubbing, decoctions and infusions, it is possible to get rid of the manifestations of a spinal hernia for a long time. To treat a spinal hernia at home, you can use medicinal herbal baths. With correct and full course application, they will help to get rid of a hernia of the spine for a long time.

Operative intervention

Surgery is the most recent treatment. Doctors try to prevent surgery, this is an extreme measure. When an intervertebral hernia is treated for a very long time, the therapy is constantly changing, but nothing helps, then you can already resort to surgery. - a huge risk. A person may remain disabled due to the careless movement of the surgeon.

How to get rid of a hernia surgically? The surgeon can perform one of three operations, depending on the severity of the disease:

• If the hernia has not progressed much, plastic changes can be made in the annulus fibrosus, thereby restoring the integrity of the intervertebral disc
• If the severity is higher, a spinal hernia can be cured by removing a part of the damaged disc that interferes with the functioning of the spine.
• In the most advanced cases, the surgeon performs a complete removal of the destroyed disc, replacing it with an implant, which allows simulating the functions of a conventional vertebral disc.

Is it possible to completely cure a hernia with an operation? Recovery is relative, a person will no longer be able to live like people who have never had a hernia. Hernia symptoms may appear in the future with exertion, but in a milder form.

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Sports for hernias

Is it possible to play sports with hernias? Some men and women have a craving for heavy strength sports, such loads must be avoided. There are sports that can strengthen muscular system without stress on the spine. You can go swimming, walking, cycling. This will be an excellent solution for spinal hernia repair.

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Prevention

To prevent spinal hernia, it is necessary to lead an active lifestyle, and not sit all day at the computer monitor. You can go in for sports to develop the respiratory, cardiovascular and musculoskeletal systems. The main thing is not to overdo it: do not overload the spine with weights, avoid injuries in sports and in everyday life, then your back will remain healthy, and life will be a joy.