The word "foraminal" means the area where the nerve endings of the spinal cord are located. They start in the spinal column itself. If in this space there was a deformation of the intervertebral disc, which resulted in a hernia, then this type of disease is called a foraminal hernia.
That is, it is one of the types of hernias. It can be found not so often - from four to ten percent among all vertebral pathologies. Also, this view has its subspecies: back and side.
Because of what does this pathology develop?
Foraminal hernia usually occurs if a person overexerts himself physically, loads the region of the spinal column too much. Sports in the gym can also provoke the appearance of a hernia, when the main burden falls on the spine. Also one of the reasons for the deteriorationcondition is any activity that requires lifting weights.
Foraminal hernia also occurs with existing spinal injuries. Absolutely any part of the spinal column can suffer, but most often the neck and thoracic back section fall under the distribution. Especially often, foraminal hernias appear on the vertebral sections L2-5 (in some variation) and L5 - S1, since these are the places that experience the greatest stress.
All bones in different parts of the human body have their own names in the form of a letter from the Latin alphabet and a serial number. When a doctor is determined with a diagnosis, he uses just such a designation, since with its help you can clearly understand exactly where the protrusion occurred. For example, if the hernia is in L4 and L5, then the disc is damaged precisely between the fourth and fifth lumbar vertebrae. When the doctor says that a foraminal hernia has formed in L3 and L4, he means damage to the intervertebral disc between the third and fourth lumbar vertebrae. But the designation L5 and S1 means the presence of a hernia between the fifth lumbar vertebra and the first sacral vertebra.
What else can lead to the development of a foraminal disc herniation? Various diseases and disorders in the body. For example, problems with the musculoskeletal system, weak muscles of the spinal corset, various infections that affect the cartilaginous body, and so on.
Distinction by species
In medicine, there is a special classification of such a pathology. Such hernias are usually divided into severalspecies:
- A hernia that occurs at the very vertebral entrance is called medial.
- Pathology located inside the intervertebral foramen is designated as intraforaminal.
- If the hernia is located at the spinal outlet, then it is called lateral.
- In the case of a pathology outside the opening of the spine, this is an extraforaminal hernia.
Plus the variety is divided into three sections of the spine: cervical, thoracic and lumbar.
Difference in pathology directions
Foraminal hernia of the spine can be subdivided into three other types, which are classified by the direction in which it protrudes. In this case, there are three varieties:
- Dorsal foraminal hernia, where the cartilage is directed to the left side to the canal with the spinal cord. It is quite possible that with such a development, the nerve root from the left side will be infringed. Left-sided foraminal hernia is most often found in the cervical and lumbar region of the spinal column. If the damage to the nerve endings is severe, then the consequence will be paralysis (complete or partial).
- There is also a dorsal foraminal right-sided hernia, which protrudes, respectively, to the right, all to the same canal with the spinal cord. The consequences are the same as with the above pathology.
And the third option is a paramedian-foraminal hernia. This is one of the most dangerous types of pathology of the spinal column, since when it occurs, deformed cartilage tissueprotrudes directly into the canal where the spinal cord is located. Next, there is compression of the spinal canal from both sides. Most often, such hernias occur due to severe scoliosis, severe osteochondrosis, or dysplasia. Paramedian-foraminal disc herniation can provoke severe neurological abnormalities in a person and ultimately lead to disability
General symptoms
Common symptoms of all types of hernias is aching pain in the place where the protrusion of cartilage has occurred. The first stages are usually not very noticeable - they are sluggish, but when you repeat strong loads on the back, sharp pains appear, after a while the back returns to a state of rest and relaxation.
Further, the primary symptoms worsen, and the pain syndrome is accompanied by a malfunction of the internal organs, such as the lungs or even the heart. There is a limitation in the mobility of the musculoskeletal system, which flows into the chronic stage.
Symptoms of a hernia in the area C6-7
Most often, additional symptoms are added to the general symptoms, depending on which particular disk was damaged. For example, in the presence of a right-sided foraminal hernia inside the C6 and C7 discs, the muscle tone of the right hand weakens, the hand and fingers become numb, but sometimes the entire limb becomes numb. There is also constant pain at the site of the formation of the pathology. A person begins to suffer from migraines, his hearing, memory and vision deteriorate.
Symptoms of hernia in area L4-5
When L4 and L5 discs are deformed, in addition to the general symptoms described above, a person begins to feel constant weakness in the legs, and if it is also a left-sided foraminal disc herniation, then it is the left leg that suffers the most and may even completely lose sensitivity. Periodic lumbar pain develops into permanent. There are also tingling sensations in the legs. In the internal cavity of the body, there is a malfunction of the organs located in the lower part of the abdominal cavity and in the pelvis.
Most often, foraminal hernias occur in the region of the L5-S1 and L3-4 discs. Here the symptoms are more pronounced with severe pain and severe forms of neuralgic abnormalities. It is difficult to treat such pathologies, since the initial symptoms are not noticeable, but in a neglected form - improvements come after a very long treatment.
How to diagnose a foraminal hernia?
If the patient goes to the hospital, then the examination will be carried out by a vertebrologist who makes a preliminary diagnosis based on complaints and reflex responses of the patient's body. Accurate information will be known only after tomography (computer or magnetic resonance imaging).
Smart modern equipment makes an accurate analysis of the state of cartilage tissue and finds places affected by pathology, in particular - nerve endings and other vessels. It is important to determine to what extent the degenerative change of the damaged joints has occurred. In fact, success in treatment can be achievedonly thanks to the correct diagnosis.
What are the treatments?
There are two options in total:
- therapeutic therapy with the introduction of gymnastics, yoga, exercise therapy and more;
- operation.
The latter method is usually suitable for advanced stages, when the difficult situation of the body does not accept therapeutic procedures that make life easier for the patient.
Conservative therapy. Stages
Therapy can only be used in the initial stages of pathology development. It includes a comprehensive solution to the problem:
- First of all, the patient should get rid of pain, as well as cure inflammation in the neurotissue resulting from compression. For this, medical treatment is used. Usually, doctors prescribe Ketorol or Nalgesin as anti-inflammatory drugs, since they do not contain steroids. As painkillers, most people take "Analgin" or "Spasmalgon", and among the muscle relaxants "Ditilin" and "Mydocalm" are popular.
- The second part of therapy is treatment with physiotherapy. This includes both massage and manual techniques. In addition, electrophoresis, magnetotherapy and, of course, therapeutic baths are recommended.
The third step will be to consolidate the result by strengthening the muscles of the spinal corset. This is where therapeutic exercises and wearing a bandage come into play. Yoga, as well as walking andswimming, without using the breaststroke technique, will prevent a possible relapse. Acupuncture helps to strengthen muscles to reduce the load on the diseased area, and spinal traction reduces the protrusion of cartilage tissue
Operation
When the patient does not feel any improvement when performing the above described therapy, harsh methods come into play - operations. Ineffective drug treatment, at times, can further trigger the disease, so it is important to immediately determine the extent of the lesion. Usually, surgery is prescribed if the disc protrudes more than nine millimeters towards the spinal cord, as well as in the presence of severe pain syndromes and loss of limb mobility.
Surgical intervention can be performed in several variations:
- When the surgeon removes the entire disc with the lesion.
- Instead of a herniated disc, an implant is placed.
- Removal of some parts of the vertebrae that put pressure on the nerve roots.
The rehabilitation period after such operations for all patients may be different, it all depends on the general he alth of the patient and his individual development of the body. Usually, if a person fulfills all further prescriptions of a doctor, then he joins his former active life in about a year and a half, and sometimes two years.
Prevention
According to the advice of rheumatologists, in order to avoid new formations and deformities, a person should monitor the physical activity that he gives to his body. And as during rehabilitation,and after it throughout life. Of course, he will need to give up all existing bad habits and start monitoring his diet, at least switch to he althy food in a complete diet.
In order for the body to recover faster, the patient must nourish it with vitamins and minerals. Of course, you should not completely limit yourself in physical activity, but sports should be in moderation. Be sure to perform exercises to strengthen the muscular corset of the back, because this is the only way to relieve the load on the cartilage. And do not forget about yoga - a panacea for the treatment and maintenance of a he althy back.
