The spinal column of an adult is a support for the entire body and can withstand heavy loads. If you lift the weight on outstretched arms, then the load increases to 400 kilograms. The largest falls on the lumbar region, because this is one of the most mobile parts of the trunk, and the center of balance is localized here. In this regard, all the factors described above provoke the development of a herniated lumbar disc, the symptoms of which are simply impossible to miss.
And a hernia occurs because, due to severe stress, the discs between the vertebrae, which act as a shock absorber, wear out earlier than in any other departments.
Lower discs differ from others in their unique structure. In their center there is a jelly-like egg held by the annulus fibrosus. But hernias are also found in other parts of the spine, and there are many reasons for this.
Causes of intervertebral hernias
There are many reasons for a herniated disc. diseaseoften a complication after pathologies such as scoliosis, osteochondrosis, lordosis and excessive kyphosis. A hernia can develop as a result of a spinal injury, a fall on the back or a strong blow.
The disease can manifest itself due to a power failure of the disks. They do not have a single blood vessel, and the state of the intervertebral cartilage discs is completely dependent on the deep muscles of the back. If they are little loaded, then the power of the disks decreases, they lose their strength.
Risk factors for a herniated disc include:
- age over 30 and tall;
- abrupt movements affecting the spine: falls, bumps and turns;
- female, because it is she who most often suffers from the disease;
- sedentary lifestyle;
- serious exercise;
- sitting in one position for a long time;
- long driving;
- smoking;
- poor posture;
- large body weight;
- hypothermia.
Patients who are at risk need to periodically change location, for example, if they sit at the computer for a long time or drive a car. Be sure to undergo an examination or do gymnastics to improve the nutrition of the back muscles.
Types of spinal hernias
Herniated discs are classified according to their location. Therefore, hernias of the cervical, thoracic, lumbar and sacral regions can occur. howstatistics shows, most often doctors after examination reveal these types of hernias:
- Central, or Shmol's hernia. This type is not acquired, since it does not arise due to the influence of external factors that affect the spine, but is considered a congenital ailment. With this form, there is no protrusion, but there is an indentation at the site of the lesion.
- Medial is a mystery for doctors, as it manifests itself for unknown reasons and goes away without treatment. It is accompanied by severe pain that goes from strong to weak.
- The dorsal view involves the protrusion of a hernia in the area of the spinal canal, which causes infringement of the nerve roots. At the initial stage, pain with this form is localized in the lumbar region, but over time it can also radiate to the leg.
- Sequestered disc herniation, the treatment of which requires an experienced approach, manifests itself as a result of a violation of the integrity of the disc, which leads to the release of the nucleus pulposus into the lumen of the canal. With this form, the patient's quality of life suffers significantly. This type appears most often in the neck and lower back.
Any type requires high-quality professional treatment, so at the first symptoms it is better to consult a specialist.
How does a hernia form?
Initially, there is a slight displacement of the intervertebral disc by a couple of millimeters, which is called prolapse. A displacement of 4 mm is referred to as protrusion. At the same time, the displacementpresent, but the nucleus pulposus does not extend beyond the annulus fibrosus. At this stage, the main symptom is irritation of the spinal root located in maximum proximity.
With further progression, the hernia leads to a crack in the fibrous capsule and prolapse of the nucleus pulposus. This condition in medicine is called extrusion. At this stage, a herniated disc can compress the spinal root and blood vessel, eventually causing radiculopathy, a radicular syndrome accompanied by neurological symptoms.
Then comes the stage when the prolapsed nucleus pulposus penetrates beyond the gap between the vertebrae, referred to as sequestration. It is this condition that ends with the rupture of the fibrous capsule and the complete expiration of the nucleus. At the stage of extrusion and sequestration, the hernia grows to such a size that there is a high probability of squeezing the spinal cord with the development of compression myelopathy.
Symptoms of a herniated disc
At the initial stage, it can be difficult to determine the disease, because it manifests itself in the form of pain. And it can just be a signal that the body is tired and needs rest. But if no measures are taken, then subsequently the symptoms of a herniated disc will not be missed. The following signs can tell about the disease:
- muscle atrophy in the affected area;
- pain in back muscles;
- headaches;
- migraines;
- problems with the intestinal microflora, which may result in upset or constipation;
- difficulty urinating;
- at the localization sitehernia manifests swelling;
- hypoxia appears in the spinal cord;
- difficulty walking, weak legs;
- drawing pain in the place where the hernia has formed;
- numbness in fingers, tingling sensation in limbs;
- pain when coughing, turning the torso and head;
- Sharp pain when moving, unable to endure.
If at least one of the symptoms of a herniated lumbar disc has appeared, treatment should be started urgently in order to prevent complications that can only be removed by surgery.
Complications of a herniated disc
There are several serious complications of herniated discs. They appear in patients who self-medicate and do not want to seek help from a doctor.
The radicular syndrome manifests itself at the moment when the hernia affects the spinal nerve. This complication can develop in stages: initially, a symptom of root irritation appears, patients feel a backache or feel like they were shocked. In the area of innervation of the root, paresthesias are observed. Loss of root function leads to the development of muscle weakness, lowering blood pressure and sensitivity in the affected area. After some time, flaccid paresis develops with muscle atrophy and trophic disorders.
Discogenic myalopathy is another complication that occurs when a hernial formation causes narrowing of the spinal canal and compression occursspinal substance. Initially, the motor function suffers, peripheral paresis develops in the affected area, later a violation of sensitivity and sensitive ataxia are added.
Another complication is vertebral artery syndrome, which occurs when a hernia in the neck compresses a nearby vertebral artery. The syndrome manifests itself in the form of dizziness, vestibular ataxia, tinnitus, fainting. It may even cause circulatory disorders in the brain.
In order to prevent complications, it is urgent to seek qualified help and undergo treatment for a herniated lumbar disc, the symptoms of which cannot be overlooked.
Diagnostic methods
To establish an accurate diagnosis and determine the form of the disease, the doctor recommends a comprehensive examination, because a hernia between the vertebrae can easily be confused with Bechterew's disease and other ailments. To make a diagnosis and identify in which particular department a hernia is present, the following methods are used:
- MRI;
- CT;
- Spine ultrasound;
- X-ray of the spine;
- lab research.
All these data will be able to accurately indicate whether this is a herniated disc l5 s1 or any other department. Hernia L5 S1 is called the formation in the lumbosacral region. The letter L stands for lumbar, or "lumbar" region, and S for sacrum, or "sacral". As a result, it turns out that a hernia formed between the 5th vertebrain the lower back and first in the sacrum.
Conservative treatment
It is very easy to treat an ailment detected at an early stage. The sooner the patient starts taking the drugs, the higher the chance of a complete cure and return to normal life. Conservative methods include manual massage, exercise therapy, spinal column traction, and acupuncture. In addition, the doctor prescribes a complex of medicines to relieve inflammation and pain:
- as painkillers, you can stop at "Ketonov", "Baralgin", "Nise";
- NSAIDs are selected to relieve the inflammatory process - Diclofenac, Ibuprofen, Nimesulide or Ketoprofen;
- muscle relaxants − "Mydocalm";
- narcotic and non-narcotic analgesics;
- sedatives;
- hormonal agent "Dexamethasone";
- novocaine blockades.
In the most difficult cases, the doctor may recommend surgery. In this case, the herniated disc is removed and the sensitivity in the muscles is restored.
Surgery
When conservative treatment of a herniated lumbar disc and any other does not give the desired results, and the patient can no longer tolerate the symptoms, the doctor can take drastic measures - surgery. Most often resort toendoscopic discectomy. The hernia is removed with a special tool. The main advantage of this technique is that no large incisions are needed, the patient recovers faster. To remove the protrusion, it is enough to make a small puncture. This technique has a number of undeniable advantages:
- no general anesthesia, only local anesthesia;
- no violations of the integrity of the bones and muscles of the spine;
- the patient can return to a full life not the next day.
Alternative methods include nucleoplasty, RF denervation and percutaneous vertebroplasty.
Useful exercises
During the treatment of a herniated lumbar disc, when pain and inflammation have already been relieved, it is useful for the patient to exercise daily. Special exercises will help increase the distance between the vertebrae and reduce the size of the hernia. You can perform such a complex:
- Lying on your back, lower your arms along the body, lift the body up and hold for a few seconds, come back. Do 10-15 sets.
- Continuing to lie on your back, arms are also extended along the body, pull the chin to the chest, and pull the socks up. During execution, the tension of the spine is felt. Repeat the exercise several times.
- Kneeling down, put your hands on the floor. Alternately, you need to stretch your arm forward and the opposite leg to the side.
- Remaining on all fours, arch your back up and down.
Regular exercise will strengthen your back muscles and relieve tension.
Preventive methods
If the patient knows that he belongs to the risk zone, then he needs to do everything possible to prevent the formation of a herniated disc l5 s1. To rule out a hernia, doctors recommend:
- Go to the pool regularly.
- Keep a he althy lifestyle.
- Do sports, even walking can solve the problem.
- When walking, always keep your back straight, do not slouch.
- Sleep on a special orthopedic mattress.
- Watch your weight, because extra pounds are a serious burden on the spine.
- Give up bad habits.
- Always balance weight on both hands.
- When working at the computer, lean back on the back of the chair, so you can reduce the tension from the spine.
- If the work involves constant sitting at the table, then every two hours it is better to stretch your back, just make turns even while sitting.
Consequences
If you do not receive timely qualified treatment, then a herniated disc of the lumbar and any other department can cause serious and irreversible consequences:
- Weakening of the back muscles in the area where the protrusion is present. The patient will not be able to expose himself to physical exertion, even climbingstairs and standing for a long time will cause him severe back pain.
- Local deterioration of muscle tone. The patient cannot endure even minor physical exertion, because the muscles are weakened.
- Muscle atrophy occurs, during which the figure of the problem side suffers. There is a smoothing of the gluteal fold, the volume of the legs is reduced.
- Sensitivity is impaired at the site of the protrusion and along the path of the nerve process.
- Failures in the thermoregulation system, the place where the hernia is localized, dries up or there is increased sweating.
- Paralysis is the most serious consequence that occurs if the patient does not seek timely help or does not follow the doctor's recommendations. As a result, paralysis leads to disability, it is difficult, and in some cases impossible, to return to a normal way of life.
Symptoms of a herniated disc of the lumbar or any other should make the patient take care of his he alth and go to the doctor. Early treatment guarantees a favorable prognosis.
