Hernias of the spine are often the cause of severe back pain. Their formation is typical for people of mature age (35-50 years). And to eliminate a hernia, non-surgical techniques and surgical intervention can be used. The final decision always remains with the doctor, and it depends on the general condition of the patient and the initial causes of the pathology.
What is a vertebral hernia
All vertebrae are separated from each other by special discs - a kind of gaskets that protect the bone from injury during movement. In addition, they provide good flexibility to the entire spine. The discs are composed of two parts - the annulus fibrosus and the nucleus pulposus. What is a vertebral hernia? This is a deformity that is formed due to damage to the disc and its bulging. As a result of this change, the nerve endings of the spinal cord are clamped, and a hernia appears.
Pathology entails discomfort, malfunction of internal organs and decreased sensitivity of the limbs. Most often, a lumbar vertebral hernia is diagnosed, but in the neck and chest itoccurs much less frequently. For the formation of a deformity, strong physical exertion is not at all necessary - sometimes inaccurate movement is quite enough, especially if a person already has predisposing factors.
But if you know what a vertebral hernia is, you can identify it in time and start treatment. But it is the timeliness in such a situation that is the key to success.
Reasons for appearance
Most often, the following factors lead to the development of a hernia:
- osteochondrosis;
- kyphosis;
- scoliosis;
- lordosis;
- hard fall or impact;
- injury of the spine.
Although in fact, pathology can develop for other, less obvious reasons:
- Sedentary lifestyle. Regular driving, prolonged work in front of the monitor, poor posture - all this can sooner or later lead to the appearance of a hernia.
- Extra pounds.
- Severe hypothermia.
- Smoking for several years.
- Gender-wise, hernia is much more common among the fair sex.
- Reduced physical activity. The discs get the nutrition they need from the deep back muscles. If they are not subjected to regular stress, there is a loss of tone and strength.
- Age over 30 and over 170 cm tall.
- Increased physical activity. Sudden careless movements and excessive loads can cause injury to the fibrous membrane of the discs.
Symptoms of spinal hernia
Treatment depends on how the person is feeling and what specific signs of the problem are bothering them. Sometimes it is not necessary to resort to surgery for recovery, many patients manage to cope with the disease with the help of conservative therapy.
The main symptom of spinal hernia is pain, which can vary depending on the location of the injury. In addition, the clinical picture is often complemented by:
- excessive sweating;
- muscle tone;
- decrease in the sensitivity of the legs and arms.
Other symptoms of the disease depend on the type of pathology.
Lumbar hernia
In this case, a person feels burning, sharp pains, which are explained by the strong pressure of the hernia on the nerve receptors nearby. Usually sensations extend to the back of the body. The main symptoms of lumbar vertebral hernia:
- numbness of toes;
- pain in the foot, lower leg, thigh or buttock;
- malfunctions in the activity of the pelvic organs;
- a feeling of tingling or tingling in the lower extremities;
- low back pain lasting longer than three months;
- loss of sensation in the groin area.
Hernia of the thoracic spine
This pathology is considered the most difficult to recognize. And all because sheoften disguised as heart and digestive ailments. In this case, pain covers the chest, but may slightly descend into the upper abdomen.
Pathology has other characteristic manifestations:
- goosebumps, numbness or tingling in the abdomen, chest, back or arms;
- complete or partial paralysis below the affected area;
- strong weakness in arms;
- disturbances in the work of the rectum, bladder and reproductive organs.
The clinical picture can be expressed in different ways, depending on the level of impact of the protruding disc on the spinal cord or nerve endings. The method of treatment of a hernia of the vertebral section is determined after a complete diagnosis and detection of the intensity of damage. With an injury to the upper region of the spine, complete paralysis is not ruled out, in which the motor function remains only at the head. But such cases are extremely rare.
Cervical herniation
Injuries in this area occur in approximately 20% of all cases, making this pathology the second most common. The main danger lies in the close relationship of this department with vital internal organs. That is why untimely treatment can lead to the development of serious problems.
When a hernia is formed in the cervical region, signs may cover the entire upper body. Patients typically experience:
- loss of feeling in hands;
- noise inears;
- sudden pressure surges;
- severe dizziness;
- migraines;
- systematically occurring pain in the neck and shoulders, which gradually become permanent;
- difficulty moving neck and shoulders;
- significant increase in pain when bending over, turning or even coughing.
Syndromes of vertebral hernia
Without appropriate treatment, discomfort and other symptoms of pathology gradually progress. Because of this, a person may develop spinal hernia syndromes, which further worsen a person’s well-being.
Radicular syndrome. Due to prolonged compression, the roots of the spinal cord gradually die off. As a result, tissue nutrition and the ability to move deteriorate. First, the muscles of the legs weaken, which makes it difficult to climb stairs and squats, then they atrophy, even complete paralysis is not ruled out. The susceptibility of the skin decreases, it is likely that the process of sweating is disturbed. Over time, the activity of the pelvic organs becomes difficult.
Spinal Syndrome. Against the background of constant soreness, spasms of the back muscles occur, which leads to an increase in discomfort. They interfere with the full straightening of the back, limit the mobility of the lower back, spoil the posture, causing a misalignment. The consequences depend on the size of the hernia and its location. If the pathology covers the spinal cord, diseases of the organs and systems associated with it will be diagnosed over time.
Diagnosis
A doctor may suspect a herniated disc during a physical examination. In doing so, he must check:
- reflexes;
- range of motion;
- sensitivity;
- soreness;
- muscle strength;
- walking quality.
Recognize the deformation of the disk makes it possible tomography - magnetic resonance and computer. Moreover, MRI is more preferable, since it demonstrates the state of soft tissues much more informatively. Such a study allows not only to identify a hernia, but also to assess the level of narrowing of the spinal canal.
If MRI is contraindicated for any reason, patients should undergo contrast myelography. Intervertebral hernia often has a clinical picture similar to manifestations of other pathologies. Differential diagnosis may require gastroscopy, ECG, or radiography.
Conservative treatment
In some situations, it is quite possible to do without surgical intervention. A positive result can come after a course of drug therapy and some exercises. The doctor always chooses the tactics of treating a hernia of the vertebral region, based on the degree of the disease and the severity of the symptoms.
You need to understand that without therapy, the pathology will progress quite quickly, which sooner or later will lead to the need to lie on the operating table.
Medicated treatment
The optimal scheme is selected on an individual basis, sometimes this requires consultation of several narrow specialists. Receptionmedicines can be supplemented with therapeutic exercises or special procedures. Sometimes even monotherapy is effective, but still complex treatment is considered more preferable. Doctors usually prescribe several categories of drugs at once:
- Non-steroidal anti-inflammatory drugs. Available in the form of tablets and ointments - Ibuprofen, Diclofenac, Indomethacin. They allow you to quickly get rid of pain, but negatively affect the functioning of the digestive tract, so they are recommended to be taken in parallel with special protectors. Most often, doctors prescribe Almagel and Omeprazole.
- Novocaine blockade. Relieves even severe pain, the effect of such treatment lasts 20 days. But such therapy is rarely used in the fight against vertebral hernia due to the high risk of ligament atrophy.
- Chondoprotectors. They are effective at an early stage of the disease, they do an excellent job with the restoration of cartilage tissues. Ideal for the treatment of vertebral hernia of the lumbar. Most often, doctors prescribe "Struktum" and "Teraflex".
- Muscle relaxants. Helps relax muscles and relieve spasms. The most commonly used are Mydocalm and Sirdalud.
- Corticosteroids. Stop inflammatory processes. But such drugs should not be used for too long, as they can lead to a number of side effects. Doctors advise Metyprednison and Decadron.
Physiotherapyprocedures
Such sessions are not used independently - they serve as an auxiliary component of the main treatment of vertebral hernia. Symptoms of the disease recede literally after several procedures. Physiotherapy sessions equally effectively cope with discomfort in different parts of the spine. Treatment of a vertebral hernia without surgery is not complete without such therapy.
Physiotherapy treatments:
- stimulate metabolic processes;
- improve blood microcirculation;
- accelerate the processes of regeneration of damaged areas of the body;
- eliminate pain;
- cope with stiffness.
For the treatment of vertebral hernia, doctors recommend different methods:
- Electrophoresis. During this procedure, direct current is used, which helps to deliver the medicines used directly to the pathology.
- Phonophoresis. It has the same effect as electrophoresis, only ultrasound is used in the process.
- Electrical stimulation. Helps relax muscles and stabilize lymph flow. The procedure is performed using alternating current.
- Magnetotherapy. Allows you to enhance the effect of other procedures and medicines. Never used as a standalone treatment.
- Laser therapy. Allows you to get rid of pain and inflammation, significantly improves regeneration.
Therapeutic gymnastics
What is a vertebral hernia? This is a deformation of the discs located between the vertebrae, accompanied by pain. Ifthe patient has no pain or has managed to eliminate it with the help of medicines, he can improve his condition with the help of physiotherapy exercises.
Hernia treatment involves regular exercise without increased stress on the spine. The result does not come immediately, the dynamics will need to be periodically monitored using MRI examinations.
Most often, therapeutic exercises are recommended for the treatment of lumbar vertebral hernia. But it is also suitable for improving the condition of problems with the thoracic and cervical region.
All exercises are done in the prone position, as smoothly and slowly as possible. Doctors recommend doing 10-12 repetitions. If, in the process, the patient is overtaken by pain or movements are difficult for him, the gymnastics should be stopped.
- Twisting the body. Stand with your feet shoulder-width apart, cross your arms over your chest. Gently and, most importantly, smoothly turn the body, first in one direction and then in the other direction. At the same time, the body must be motionless below the waist.
- Tilts in the prone position. Take the same position as in the previous exercise. Gently tilt your torso first to the right and then to the left. It is advisable to stretch as far as you can at all, but in such a way that there is no discomfort.
- Twists of the hips. Straighten your legs, press your palms to the floor, slightly spread them to the sides. As you rotate your hips, keep your legs in the starting position.
- Sliding feet. Take the same position as last time, put your feet together. movethem in one direction or the other, making efforts with the lateral and lumbar muscles.
Such gymnastics is very effective for lumbar vertebral hernia.
Surgery
Surgery is the last measure resorted to in the absence of the effect of conservative treatment. Surgery may be required for those who delay drug therapy or patients who discover the disease too late.
If the condition is rapidly deteriorating, then the removal of the vertebral hernia in an operative way will be the only solution to the problem. True, it should be understood that surgical intervention:
- may have negative consequences;
- may require reoperation;
- needs full rehabilitation.
After spinal hernia surgery, the patient should be as attentive as possible to his he alth and listen to all the instructions of the attending physician. During this period, the further prognosis and the chances of a full recovery depend on the person.
Varieties of operation
How to treat a vertebral hernia if medicines and physiotherapy do not help? To do this, doctors offer several ways:
- Discectomy. It involves partial or complete removal of a deformed disc. It is performed through an incision 8 cm long under general anesthesia. True, this technique is now considered obsolete due to the long rehabilitation and the need to take antibiotics for 10 days.
- Endoscopy. It is carried out through an incision 5 cm long using miniature devices. This method is considered more preferable due to the absence of muscle damage, which speeds up the healing process. The intervention is carried out quite quickly, the patient is discharged the very next day. Recovery takes approximately 3 weeks. However, the procedure has disadvantages: a high risk of recurrence and the need for spinal anesthesia.
- Microdiscectomy. It is performed through a 4 cm long incision under a microscope under general anesthesia. It is used most often because the nerves are released without collateral damage to the muscles. Allows you to fix multiple issues at once. In the hospital, the patient stays no longer than 3 days.
- Nucleoplasty. An improved technique involving the use of local anesthesia. The operation is performed using a laser, plasma or radio frequency beams through needles with a diameter of 2-3 mm. During the procedure, the pressure exerted on the nerve is reduced, the pain is completely stopped. The patient can be discharged within a few hours. True, in this way it is possible to remove a hernia no larger than 7 mm.
Rehab
The quality and speed of recovery actually largely depend on the patient himself and the correctness of the rehabilitation. After surgical removal of a spinal hernia, a person needs an integrated approach, the components of which are selected individually.
Most often doctors recommend patientsseveral stages of rehabilitation that allow you to achieve a positive result as quickly as possible:
- Medications. They are prescribed to eliminate pain, prevent various complications and accelerate the process of tissue regeneration.
- Physiotherapy treatments. Increase the effectiveness of other methods and tools.
- Therapeutic gymnastics. Allows you to restore the activity of the muscles and significantly improve the mobility of the vertebrae.
- Sanatorium rehabilitation. Includes a whole range of beneficial treatments, such as therapeutic applications, massages and mud baths.
Now you know whether it is possible to manage a vertebral hernia with conservative treatment and how to properly deal with unpleasant symptoms. The main thing to remember is that only timely therapy and full compliance with all doctor's instructions can guarantee you recovery and a favorable prognosis for the future.
