Often the hernia affects not only the lower back (L1 and other discs), but also part thoracic(T12). There are several reasons for the appearance of this neoplasm:
- improper metabolism;
- all kinds of injuries;
- excessive physical exercise;
- excess body weight;
- muscle weakness;
- infections;
- Availability bad habits;
- age-related changes in the body;
- hereditary predisposition;
- lack of movement.
All of these conditions lead to cartilage and bone tissue quickly wearing out and aging. As a result, a hernia of the T12, L1, etc. vertebrae is formed.
Stages of development and signs of the disease
Intervertebral hernias go through several stages of their development:
- . The disc moves to the side a small distance, approximately 2 mm.
- . The core changes its usual position and moves.
- Hernia. The nucleus pulposus comes out.
The first stages of herniated discs T12, L1 and others are characterized by mild pain. As the tumor grows, the symptoms become more pronounced.
Signs of damage to the L1, L2, L3 vertebrae include the following conditions: 
- pain in the sacral area;
- weakness in the legs;
- pain when walking;
- disturbances in the functioning of the pelvic organs;
- feeling of numbness in the lower extremities.
At first, the pain affects only the damaged part spinal column. The patient has difficulty walking, playing sports, or carrying heavy objects. If you do not move, the pain disappears.
At the next stage, the pain affects the muscles of the lower back and even the legs. If at first it was dull and aching, now it becomes sharp.
Conservative treatment measures and surgery
Herniated discs L1, L2 are treated in several ways. First of all this conservative treatment by using medicines. The main goal of such therapy is to relieve pain and prevent the development of complications.
In most cases, the doctor prescribes the use. They relieve swelling and stiffness of movement. help relieve pain.
Attention! All medications for this disease, they are prescribed only by a doctor! Self-medication may worsen the condition.
During the treatment process, it is important that bed rest. You cannot lean forward, carry heavy objects, or play sports.
As soon as the pain goes away, you can begin the second part of the therapy - this is. They must be carried out under the supervision of the attending physician, otherwise they will have the opposite effect. In some cases it is shown.
If using conservative methods failed to cure disc herniation of Th12, L1 and other parts lumbar region spine, is prescribed. It comes in several types.
- . This is the removal of the damaged part of the disk. An ineffective method of treatment, since in 50% of cases the hernia appears again.
- Laminectomy. The surgeon removes the bone spurs that are pressing on the damaged area of the disc. This operation has certain risks, so before performing it, the doctor must carefully weigh the pros and cons.
- Another method of surgical treatment of hernial formations, for example, Schmorl's hernia of the L1 body, involves installation.
Surgical treatment helps eliminate both the symptoms of the disease and the cause of its occurrence.
After the operation, a rehabilitation period begins. Sitting is not recommended for about three months. In addition, you should wear an orthopedic corset. At first it is worn all day, then several hours every day.
Herniation of the L1-2 disc and other areas of the lumbar spine is quite serious illness. It is accompanied by severe pain, a feeling of numbness and stiffness of movement. This pathology can be cured with the help of medications, correct mode or, in difficult cases, surgery.
Denial of responsibility
The information in the articles is for general information purposes only and should not be used for self-diagnosis of health problems or medicinal purposes. This article is not a replacement for medical consultation see a doctor (neurologist, therapist). Please consult your doctor first to know the exact cause of your health problem.
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Head of the Department of Anesthesiology and intensive care, work experience 8 years. Higher education majoring in General Medicine.
Hernia intervertebral disc is a pathological protrusion of the nucleus pulposus (the jelly-like central part of the intervertebral disc), resulting from a rupture of the fibrous ring surrounding it.
Treatment algorithm for intervertebral hernia of the lumbar spine:
elimination pain syndrome,
normalization motor activity,
prevention further development diseases.
To achieve these goals, traditional conservative methods and innovative non-surgical treatment methods are used.
Conservative methods are:
- medicines,
- manual therapy
- physiotherapy,
- physiotherapy,
- acupuncture,
- massage,
- wearing a soft corset.
Read more about the methods of therapy and their use later in the article.
Treatment effectiveness lumbar hernia at home has not been proven, but some procedures can alleviate the patient’s condition.
If conservative therapy does not bring the desired results, the doctor (vertebrologist or neurologist) can offer the patient modern minimally invasive or radical surgical intervention. According to world statistics, such cases are no more than 10%: in the remaining 90% of cases, a vertebral hernia can be cured without surgery.
A herniated disc can be treated without surgery
Drug therapy
NSAIDs and painkillers are the gold standard
Nonsteroidal anti-inflammatory drugs (NSAIDs) and painkillers are the gold standard in drug treatment intervertebral hernias. They suppress the action of the enzyme that is formed at the site of inflammation and is responsible for the formation of the pain impulse.
Classic (non-selective) NSAIDs reduce the sensitivity of nerve endings and the intensity of the inflammatory process, and improve blood flow. To quickly relieve pain, patients with a hernia of the lumbar spine are prescribed ibuprofen, diclofenac, lornoxicam, indomethacin, etc.
Doctors also widely use the selective NSAID meloxicam (Movalis), which patients tolerate better than others.
Selective NSAIDs act only at the site of inflammation and have virtually no effect or effect on side effects to other organs. Non-selective agents lack these benefits.
When choosing medication The doctor takes into account the patient’s age, the presence of concomitant pathologies, and assesses the risk of developing gastrointestinal complications. The size of a single dose and duration of administration depend on the intensity of the pain syndrome.
Muscle relaxants
Muscle relaxants are a group of drugs that reduce the tone of tight, spasmodic muscles. In combination with NSAIDs, they have a good therapeutic effect.
Examples of drugs in this group: mydocalm, diazepam, sirdalud, tizanidine, tetrazepam.
Products that improve microcirculation of blood and lymph
Drugs that improve microcirculation are mandatory for use in patients with hernias of the lumbar spine. They help improve blood flow in the damaged area and reduce swelling.
Local remedies: ointments, gels, compresses
For severe pain, pain-relieving ointments, gels and compresses with novocaine and dimexide are used.
Novocaine blockade with the addition of corticosteroids brings significant relief from pinched spinal segments.
Manual therapy
Manual therapy is a special “therapeutic system” based on manual work chiropractor. The specialist acts on the affected areas of the body, works with muscle tone in the area of the damaged vertebra - and thus eliminates muscle spasm and displacement of the vertebrae.
This technique is prescribed if a hernia of the lumbar spine is combined with vertebral subluxation.
Physiotherapy
Therapeutic exercises are prescribed only after the symptoms of nerve compression have been eliminated and in the absence of pain in the affected leg (with lumbar hernias, the pain usually spreads to the leg).
For each patient, the exercise therapy instructor develops an individual set of exercises, including smooth turns, bends and rotations of the torso.
An approximate set of exercises for a patient with lumbar hernia.
Click on photo to enlarge
Acupuncture
Acupuncture is additional method therapy, which in combination with other treatment methods accelerates the healing process.
When irritated biologically active points The spasm of the paravertebral muscles that occurs due to a change in the position of the damaged disc is eliminated, and local blood circulation is restored.
Massotherapy
Massage stimulates microcirculation of blood, lymph, and relieves muscle spasms.
The procedure includes four main elements: rubbing, kneading, vibration and stroking.
Today, periosteal deep massage (or, in other words, myofascial therapy) is especially in demand. This is an effect on altered painful points and areas, which leads to irritation of highly sensitive receptors of the periosteum. For a hernia of the lumbar spine, the sacrum, the area of the pubic symphysis, the ischium and the ilium are massaged.
For hernias of the lumbar spine, hydromassage is very effective (water is supplied in jets high pressure). This procedure:
- stimulates the immune system,
- reduces muscle spasm,
- eliminates blood stagnation in blood vessels,
- normalizes blood circulation.
When using hydromassage, the functions of the musculoskeletal system are restored much faster and more efficiently.
Innovative methods for treating intervertebral hernias
Spinal Cord Stimulation (SCS)
This technique uses a neurostimulator that produces weak electrical impulses. The device transmits impulses directly to nerve endings spinal cord by microelectrodes implanted into the epidural space.
The epidural space is located between the hard meninges spinal cord and periosteum of the vertebrae.
Neurostimulator and electrodes implanted into the epidural space to stimulate the spine
Percutaneous laser decompression
This is a gentle treatment method that uses a microlaser to reduce intervertebral hernia and reduce pressure on surrounding tissues.
In parallel, the laser, which is applied to the spinal canal, restores collagen fibers cartilage tissue and tightens small cracks on the surface of the articular cartilage.
Chemonucliolysis
Chemonucliolysis is an effective innovative method for treating lumbar disc hernias. An enzymatic preparation that dissolves the nucleus pulposus - chymopapain - is injected into the damaged intervertebral disc. After the core has liquefied, it is sucked out, resulting in intervertebral hernia decreases significantly.
A prerequisite for carrying out this fairly simple and low-traumatic procedure is the preservation of the disc membrane.
Treatment of lumbar hernia at home
Two recipes:
(if the table is not completely visible, scroll to the right)
| Name and ingredients | How to prepare the product | How to use |
|---|---|---|
|
Honey compress. You will need:
|
Pass the leaves through a meat grinder and squeeze through cheesecloth. Add vodka and honey to the resulting juice. Mix everything thoroughly and let the product brew for one day. |
To eliminate lower back pain, soak medicinal composition gauze or bandage folded in 10 layers and apply to the affected vertebra for an hour. Repeat the procedure daily until the product runs out. |
|
Comfrey tincture. Ingredients:
|
Grind the roots in a meat grinder and pour vodka over them. After 2 weeks, add a dimexide solution to the resulting tincture (10 ml of solution per 90 ml of water). |
Rub the tincture into the lower back. For rubbing traditional healers It is recommended to use a piece of felt, which has a massage and warming effect. |
Conclusion
If you experience pain in the lumbar spine, do not delay your visit to the doctor, aggravating the development of the disease. A competent vertebrologist will help you find out the cause of your discomfort and prescribe effective treatment.
Remember: A hernia of the lumbar spine is a complex but treatable disease that can be eliminated without surgery, which can lead to a number of complications.
Owner and responsible for the site and content: Afinogenov Alexey.
The musculoskeletal system is the basis of the human body. Any damage has consequences. Feeling pain in the lower back, sacral region spine extending to the legs, it is worth considering whether it is a symptom of the formation of intervertebral pathology in the lumbar region. Having discovered signs of an intervertebral hernia, it is necessary to undergo diagnostics in order to prescribe a course of treatment in a timely manner.
The way to cure the consequences of deformation of the fibrous ring with drugs, folk remedies or exercises will be determined by the doctor. In the absence of symptoms, you should not forget about preventing the disease, doing exercises, and doing medical treatment.
physical education, gymnastics.
Intervertebral hernia of the lumbar region - causes
Intervertebral hernia can form in the spine:
- neck;
- chest;
- lumbar;
- sacral
Pathology in the lumbar region is more common than other types.
Causes of intervertebral disc deformation:
- upon reaching the age of 30 years, tall(from 170 cm) the spine experiences heavy load;
- spinal injury;
- sudden movements;
- sedentary lifestyle, sedentary work;
- curvature of posture;
- excess weight;
- bad habits;
- hypothermia.
It is believed that intervertebral formation occurs more often in women than in the stronger sex.
How does a lumbar hernia develop and why is it dangerous?
In the spine, intervertebral discs are the connecting material. Intervertebral discs consist of an annulus fibrosus and a nucleus pulposus inside it. In the lumbar region, the intervertebral discs are higher than in other regions. This is the main factor in the prevalence of lumbar disc herniation.
The annulus fibrosus can crack for a certain reason, which will lead to leakage of fluid from the nucleus, pinching the nerve endings of the spinal cord. The intervertebral disc becomes deformed and a lumbar intervertebral hernia is formed. If dysplasia and displacement of the intervertebral disc occurs in a nearby vertebra, this disease is called Schmorl's disease.
This may be a consequence of a lower back injury. Sedentary work leads to curvature of posture, which negatively affects the spine, increasing the load on the intervertebral discs of the lumbar region.
Without load, the intervertebral disc does not receive nutrition and its strength is lost. An overly active lifestyle puts a lot of stress on the intervertebral discs, which leads to their wear, deformation, and, as a consequence, the formation of pathology.
As a result of the development of a tumor on the spine, pressure occurs on the pelvic organs, which can lead to improper functioning. Bad influence affects nerve endings and the spinal cord, which can lead to irreversible consequences such as muscle weakness or paralysis. As a result of the consequences of changes in the intervertebral disc, radiculitis develops.
Hernia of the lumbar spine symptoms
When an intervertebral hernia forms, a person will encounter symptoms:
- pain in the lower back (lower back), which gets worse with movement;
- pain may spread to the buttocks;
- feeling of pain in the sides and back of the legs;
- disappearance of knee reflexes;
- feeling of numbness in the legs;
- malfunctions of the pelvic organs.
Schmorl pathology has no symptoms; the mobility of the spine in this region decreases.
Diagnostics
To diagnose problems with the annulus fibrosus in the spine, you should consult a specialist who will prescribe an examination method according to the symptoms. The main methods for examining intervertebral hernia are MRI and ultrasound.
There is a pulse diagnostic method that will determine the health status of all body systems.
The doctor may suggest determining the exact location of the herniated disc in the lumbar region using stress testing.
Having passed neurological test, the patient learns what disorders of the body have become
a consequence of fluid leakage from the fibrous ring.
How to treat a herniated lumbar spine
Hernia of the lumbar spine, which is treated various methods, is the most common type of formation on the spine. Treatment methods for formations in the lumbar or sacral region are aimed at relieving pain in the lower back and reducing inflammation. If symptoms begin to occur periodically, work is not impaired internal organs In humans, annulus fibrosus deformity can be treated without surgery using:
- acupuncture;
- manual therapy;
- massage;
- Ju therapy;
- reflexology;
- Bubnovsky kinesiotherapy, back exercises on a special simulator;
- folk remedies.
A course of treatment without surgery may consist of a complex of various techniques.
When a herniated disc in the lumbar region affects the functioning of organs in the pelvic area, it must be treated with surgery.
Intervertebral hernia in the lower back treatment period of exacerbation - what to do
During the period of exacerbation of the consequences of deformation of the fibrous rings, it is necessary to consult a doctor for diagnostics, monitoring changes in the spine, and changing the course of treatment.
The main goal when exacerbating an intervertebral hernia in the lower back is to avoid activities that may cause or intensify pain. For a person during an exacerbation, rest is necessary; when the pain in the spine begins to recede, one must gradually begin to move.
To relieve pain, you can use painkillers.
Drink plenty of fluids to help reduce inflammation.
Warm or cold compresses can provide an analgesic effect, relieve spasms, and improve blood circulation.
Treating a hernia at home
A person whose form of the disease allows him to do without surgery is wondering how to treat a lumbar disc herniation at home. Folk remedies will help cure without surgery.
The result of deformation of the fibrous ring can be treated with the help of St. John's wort, birch, and comfrey oil. Oils are used to rub the spine before the massage procedure.
A positive effect has a Kalanchoe leaf, from which the film was removed and attached with a plaster overnight to the place on the back where the formation is supposed to be located in the spine.
A folk remedy made from 4 tablespoons of honey and 5 g of mumiyo diluted in water can be used to rub the back in the area of a damaged intervertebral disc.
If you chop 300 g of garlic, pour in 150 g of alcohol and leave in a dark place for 10 days, you will get a tincture for the treatment of intervertebral hernia. You can make a compress from it
for 40 minutes, covering with film and a warm scarf.
Known application folk remedies for the treatment of disease in combination with a bath:
- combine a glass of boiling water, salicylic alcohol 100 g, baby soap 10 g;
- add 3 tablespoons of the mixture to the bath;
- The water temperature in the bathroom should be 37 degrees.
Exercises for the lumbar spine for hernia
Gymnastics, physical therapy, exercises on the horizontal bar, and daily exercises will help cure the pathology without surgery.
Gymnastics for a herniated disc in the lumbar region, or for a hernia in the sacral region, should be prescribed by a physical therapy specialist. The doctor will prescribe correct exercises in the amount necessary to cure the disease without undesirable consequences.
Exercise therapy, yoga, massage, exercises, swimming, Bubnovsky exercises are in effective ways to cure pathology in the lumbar or sacral region.
It is useful to perform the exercise while lying on your back and lifting the body a short distance from the floor, with your arms along your body.
A physiotherapy specialist can suggest an exercise for stretching the spine in a similar starting position, bringing the chin closer to the chest and pulling the socks towards you.
Exercise in the knee-elbow position: simultaneously extend your arm and leg diagonally.
An exercise in which a person, standing in a knee-elbow position, arches and bends his back will be effective in nourishing the intervertebral discs.
Pelvic lifts are useful while lying on your back, legs bent at the knees at an angle of 90 degrees.
Nutrition for intervertebral hernia
Medicines, a set of exercises, and physiotherapy and massage in combination with proper nutrition. The diet of a person who has noted symptoms of formations as a result of deformation of the fibrous ring should include foods enriched with calcium, manganese, phosphorus, magnesium,
The diet should include:
- fish;
- eggs;
- legumes;
- carrots, cucumbers, potatoes, celery, spinach;
- oranges;
- wheat, bran, nuts, raisins, honey, seeds;
- herbal teas.
There should be no coffee, strong tea, or alcohol in the diet.
Drugs
Used to treat the disease various drugs Most medications are painkillers. In case of severe pain, opiates and narcotic painkillers (codeine, morphine) are prescribed.
To relieve back pain and inflammation, the doctor may prescribe non-steroidal anti-inflammatory drugs (Ibuprofen, Naproxen, Diclofenac).
Muscle relaxants are prescribed to relieve muscle spasm, which is a consequence of the formation of a hernia.
Corticosteroids will reduce the swelling.
Antidepressants are pain relievers that protect the spinal cord and increase the effect of endorphins.
Injections for a hernia of the lumbar spine are prescribed for anti-inflammatory purposes. Novocaine injections and epidural blockade are used to reduce inflammation. Among the well-known injection suspensions, Diprospan is used to relieve swelling, stop the development of pathology, and dilate blood vessels.
A doctor may prescribe an ointment for a herniated lumbar spine. Ointments can be analgesic (Diclofenac, Ketoprofen, Movalis), irritating (Voltaren, Comfrey ointment), for massage, homeopathic (TselT, Traumeel).
Prevention for spinal hernia
In order to avoid the need to treat an intervertebral hernia in the lumbar or sacral region, it is worth thinking about prevention before it appears.
Dosed physical activity will help ease the load on the spine, relieve tension from the intervertebral discs, and improve their nutrition. If you exercise, physical therapy, yoga, swimming, perform a complex special exercises on the horizontal bar, you can create a muscle corset that will allow you to fix the fibrous rings, preventing the intervertebral discs from popping out.
You can practice at home. It is necessary to exercise regularly, focusing on the sensations in the lower back and sacral region. Too much huge pressure won't bring positive result, can lead to serious consequences.
Losing weight will help partially relieve the load from the lumbar and sacral regions and the spine as a whole. Changing your work style, moving from a sedentary to a more active lifestyle, tracking your posture will help positive influence for the back. Changing the pillow and mattress to orthopedic ones will help improve posture and rest the spine from the daily stress.
Giving up bad habits and tracking your diet will improve the condition of the body as a whole, which will have a positive effect on the spine and intervertebral discs.
If a person has undergone a course of treatment, then he must carry out disease prevention so that pathology in the lumbar or sacral region does not form again. We must not forget that lifting weights with outstretched arms or from the floor in a squat has a negative effect on the fibrous rings.
It is one of the most common dysfunctions of the musculoskeletal system.
This problem occurs when the core pulp of the spinal disc is actually squeezed out of the annulus fibrosus.
Such a violation leads to the fact that the tissues of the damaged intervertebral disc begin to put pressure on the nerve roots of the spinal column.
Because of this, the patient experiences severe pain. Because the this type The disease is very common, it is worth knowing the main symptoms and being ready to start treatment in a timely manner, because a herniated disc can lead to a limitation (or even complete deprivation) of the patient’s ability to work.
What is a lumbar disc herniation?
Intervertebral hernia of the lumbar spine - This is a disease in which the central part of the vertebral disc is squeezed out of the intervertebral space by two adjacent vertebrae.
If the problem is not diagnosed at this stage, then further deformation will lead to aggravation of the situation and the release of the core of the intervertebral disc to the outside(the integrity of the capsule is compromised). This process will mark the formation of a hernia.
Classification of the disease
The hernia has a fairly wide number of “variations”, competent and Full description Only a specialist can give you specific advice on your case after conducting research.
It is well known that a hernia of the lumbar spine is divided into into two main types:
- L4-L5- V medical practice Each part of the spinal column is designated a certain letter Latin alphabet (the letter L was allocated for the spine). This type of disease means that compression of the nerve roots occurs in the space between the 4th and 5th vertebrae in the lumbar spine;
- L5-S1- with this type of disease, pinching of nerve endings occurs between the 5th vertebra in the lumbar region and 1st vertebra in the sacral region of the spinal column.
In addition to this classification, we can give a division by the nature of the tissues that protrude beyond the spinal column. From this point of view, there are:
- Pulpous hernia- a hernia of this type consists of a nucleus pulposus, which is “squeezed out” due to a violation of the integrity of the fibrous ring. This type occurs in the vast majority of patients (approximately 86% of cases);
- Cartilaginous hernia- a hernia of this type consists of fragments of deformed intervertebral cartilage. This type occurs after a long-term inflammatory process, which is often caused by various injuries spine. This type occurs in approximately 13% of cases;
- Bone hernia- this type can be called a hernia only conditionally, since the main reason for its appearance is osteochondrosis (or other long-term degenerative-dystrophic process), which leads to the growth bone tissue and the appearance of osteophytes (bone “spikes”). Osteophytes compress the nerve endings of the spinal cord and narrow its canal, which leads to the formation of a hernia. Typically, this type of disease occurs in only 1% of patients, most of whom are elderly.
Prevalence and significance of the disease
Intervertebral hernia of the lumbar spine occupies one of the leading places in terms of prevalence among all diseases of the musculoskeletal system.
This means that this type of spinal dysfunction requires not only timely diagnosis and treatment, but also prevention, since otherwise (in advanced stages) the development of the disease may threaten to deprive the patient of his ability to work (from partial limitation to complete deprivation).
That's why Don't be careless about this problem, at the first symptoms you should contact a specialist and begin treatment.
Causes of the disease
The list of risk factors is quite extensive when it comes to the formation of a hernia in the lumbar region. Specific reason(or a combination of them) will be given to you by a specialist after conducting a series of examinations.
The most common causes of intervertebral herniation are:
All this is just small part those factors that can lead to changes in tissues intervertebral discs and core displacement.
Symptoms and methods of diagnosing the disease
Usually the first signs that signal us about the presence of disorders in the lumbar spine are ignored. Aching, Blunt pain in this area it is simply “experienced” by the patient. Therefore on early stages degenerative changes usually go unnoticed and develop into a full-fledged intervertebral hernia.
When a hernia has already formed, new symptoms appear, which are already difficult not to notice or endure. This is first of all:
- pain in the lumbar region when lifting the leg;
- amyotrophy;
- frequent “lumbago” ( sharp pains in the lower back, resulting from awkward movement, heavy lifting, hypothermia, etc.);
- numbness;
- the appearance of radiculitis;
- reduction or limitation of reflex activity;
- dryness skin in the damaged area.
Such symptoms quickly become entrenched in the patient’s life, without giving him the slightest rest. Therefore, at the first manifestations of the disease, it is worth getting diagnosed.
In order to find a disc that has undergone deformation, a specialist will carry out a number of measures, including:
- X-ray diagnostics(in two projections);
- MRI(will help clarify the details of the development of the disease);
- tendon reflex test(this simple method will allow you to find out how badly the nerve endings are damaged, as well as identify the level of sensitivity lower limbs and their mobility).
Only after the main diagnostic measures, the specialist will prescribe for you treatment course, which will help cope with the developed disease.
Video: "What is a vertebral hernia?"
Treatment of lumbar disc herniation
When the main list of diagnostic steps is left behind, it’s time to start treatment.
But you need to take into account that the course of the disease is divided into three main periods:
| Acute period | -- | Characterized by acute pain in the lumbar region, stiffness when moving, impaired sensitivity in the lower extremities. |
| Subacute period | Occurs 4-6 days after acute period. | The pain syndrome subsides somewhat, sensitivity in the legs is slightly restored. |
| Recovery period | Occurs 2-3 weeks after the start of treatment; not all patients can go through this stage. | This period is characterized by the absence of pain and minor sensory disturbances. |
Dividing into periods allows specialists to apply the correct strategy for treating a hernia.
Treatment of the disease in the acute period
Did you know that...
Next fact
This period is the most painful and dangerous in terms of physical activity.. Here you need to be very careful not to harm yourself even more. The main thing at this stage is a minimum of movements and bed rest.
You should lie on a small pillow and place a small cushion under your back. Correct position on your back should be given to you by a doctor, since he is the one who knows which specific discs are damaged.
At this stage, the disease is usually used painkillers. It is preferable that they be introduced into the body by injection (at the initial stage).
Diclofenac, Movalis, Rofica are widely used. When the pain subsides a little, you can replace the injections with tablet forms of the same drugs or add others (Ibuprofen, Meloxicam, etc.);
At this stage of the disease, any manipulations of this kind are prohibited.
During the acute period of the disease, you can only move your toes. Other movements are prohibited.
Treatment of the disease in the subacute period
When the crisis has passed a little, you can move on to the next treatment course. Subacute period requires the patient to remain in semi-bed rest and carefully monitoring your well-being. Any movements that cause pain should be avoided.
Drug treatment
In the subacute period, the same types of medications are used as in the acute period. The only difference is that the dose of drugs is reduced or the form of administration is changed (for example, injections are replaced with tablets). All changes should be made only by your attending physician based on the symptoms you are experiencing at this stage.
The following procedures have a very good effect on the body::
- thermal procedures;
- acupressure;
- acupuncture (here you need to be careful and find a competent specialist);
- underwater massage.
As additional means applies hirudotherapy(treatment medical leeches). But here it is important to find a competent specialist and consult with your doctor.
This technique is insidious and can cause complications. The same applies to manual therapy and massage courses - both methods require a competent approach and professional execution.
Physiotherapy
Physical therapy in the subacute period should be performed with great caution. All exercises should not be painful. If you feel pain, immediately stop doing the exercises and go to rest.
Exercises to perform:
Important! Be sure to consult with your physician before starting exercise.
- Lie on your back, straighten your arms and legs. Relax all your muscles. Slowly raise your arms up, stretch slightly, and then slowly lower your arms;
- Lie on your back, relax your body. Bend left leg in the knee, then swing it slightly left and right, relax the muscles. Repeat with the opposite leg;
- Lie on your stomach, place your hands under your chin. Bend your knees and alternately touch your heels to your buttocks. After this, relax all your muscles and rest a little;
- Lie on your back. Start bending and unbending your leg at the knee and moving it in different directions;
- Take the same starting position as in exercise 4. Bend your leg at the knee and pull it towards your chest with your hands. Repeat for each leg;
Treatment during the recovery period
At this stage, medication and physiotherapeutic treatment remain the same.. The difference is that the dose of medication is significantly reduced; some groups of drugs may even be excluded from the course by your attending physician. Physiotherapeutic procedures remain the same.
Physiotherapy
For recovery period characterized by an increase in the volume of physical activity. It is important to consult with your doctor when expanding your gymnastics complex.
Exercises to perform:
- Starting position - lying on your stomach. The doctor bends and straightens the leg at the hip, fixing it for 6-8 seconds in an extended state;
- Starting position - lying on your stomach. Alternately move the left one, then right leg from the body;
- Starting position - lying on your stomach. Raise your straightened leg at a slight angle (over time, the lifting angle needs to be increased);
- Starting position - lying on your side with healthy side. Bend the affected leg at the knee and move it away from the body;
Surgical intervention
The decision to remove a hernia is made by your doctor based on certain symptoms that may seriously threaten your health.
Among these symptoms is a narrowing of the spinal canal (despite all medical complex), numbness of the limbs, severe weakness in the muscles, dysfunction of the pelvic organs, compression of the “cauda equina” (the end of the spinal cord, consisting of a bundle of nerve endings, pinching or irritation of which causes unbearable pain in the perineum and lower extremities).
Surgical intervention in in this case represents the release of the spinal cord from the hernia compressing it.
There are several ways to do this:
- Endoscopy;
- Endoprosthetics;
- Percutaneous discectomy;
Each of these methods is used under certain characteristic conditions of the disease.
Folk recipes
In order to make conservative treatment even more effective, you can use some traditional methods that can help relieve unwanted symptoms of the disease.
Disease prevention and recovery prognosis
In order to prevent the formation of a hernia, First of all, you need to monitor your own weight. In most cases, it is excess weight that causes the formation of a hernia, since our spine cannot withstand such a strong load.
Besides watch your diet and lifestyle, eliminate smoking, minimize alcohol consumption, eliminate strong physical activity, play sports (running, swimming, walking, cycling), choose a hard mattress for sleeping, establish a daily routine.
If you notice the first symptoms of the disease, consult a doctor immediately. He will prescribe you a treatment course that can avoid surgical intervention or serious complications. Timely treatment will help defeat the disease in the early stages.
Conclusion
Since intervertebral hernia of the lumbar spine is one of the most common diseases of the musculoskeletal system these days, you should know as much as possible about it, to prevent the disease in time or choose the right treatment:
- The initial symptoms of the disease may be completely ignored by the patient, since they are not pronounced. More severe symptoms will become when the hernia is finally formed. At the first signs, we advise you to contact a specialist and undergo an examination;
- In medical practice, lumbar intervertebral hernia has three main periods of the disease: acute, subacute and recovery. For each of these periods there is a complex therapeutic measures, therefore, only your attending physician can prescribe certain procedures based on the symptoms that are bothering you at a particular moment;
- The acute period of the disease is characterized by severe pain and limitation motor functions , so you need to stay in bed and give your body maximum rest until the crisis is over;
- In addition to conservative treatment methods, some folk recipes . But you should consult with your doctor, and also take into account the individual characteristics of your body before using any unconventional methods;
- It is much easier to prevent any disease than to treat it later, so check out the preventive techniques that will help you avoid the appearance of a hernia.
Rheumatologist, Orthopedist
Engaged in the management of traumatological and orthopedic patients, reading radiographs and interpreting test results, as well as conducting conservative and operational methods treatment.
Pain in the back and limbs should not be left without proper attention. Since in approximately half of patients, back pain is caused by an intervertebral hernia. However, often the disease is discovered by chance during computed tomography. The disease occurs with a frequency of 100 cases per 100,000 population. Intervertebral hernias are more often detected at the age of 30-40 years.
Table of contents:Causes
The spine is the main support of the body. The spinal column consists of vertebrae connected to each other by intervertebral discs. The function of the latter is to provide shock absorption when walking, running, as well as flexibility of the entire spine. The intervertebral disc consists of an outer shell - the fibrous ring, as well as the nucleus pulposus, located in the center of the disc. Normally, the fibrous ring is quite dense and can withstand physical stress. But the properties of the connective tissue membrane can change.
When the motor fibers of the spinal roots are compressed, weakness of the leg muscles and decreased reflexes are observed. When the sensory fibers of the spinal roots are compressed, there is a decrease in skin sensitivity, tingling, and a crawling sensation along the back of the leg, from the buttock to the heel. These symptoms are considered to be manifestations of radiculitis.
Autonomic disorders may be observed: the skin of the lower back and legs turns pale, red or white spots may appear on it, and increased sweating is recorded.
In addition, when compression of the roots innervated pelvic organs, the patient complains of urination and defecation disorders, as well as impaired potency.
If the spinal cord is compressed or damaged, paresis or paralysis in the lower extremities may occur.
With this type of intervertebral hernia, a person is worried about constant aching pain in the neck, which is the most early sign illness. With compression of the nerve roots and vertebral artery headaches occur. Moreover, the pain can be diffuse or concentrated in the back of the head and temples. Symptoms such as dizziness and tinnitus also occur. Due to inadequate oxygen supply to neurons, constant weakness and rapid fatigue develop. In addition, there may be an increase in blood pressure.
When the sensitive fibers of the spinal roots are compressed in the neck, back of the head, and arms, sensations of numbness, tingling, crawling, and decreased skin sensitivity occur. When the motor fibers of the spinal roots are compressed, weakness of the arm muscles is observed. Autonomic disorders are characteristic: the skin of the neck and arms turns pale, and there is increased sweating.
With severe compression of the spinal cord herniation, paralysis can develop.
With this type of disease, a person is bothered by back pain, mainly between the shoulder blades. However, the pain can radiate to chest, lumbar region, neck, upper limbs. Painful sensations noticeably intensify when coughing, sneezing, laughing, or turning the body. It is noteworthy that the pain is often girdling in nature.
Sometimes the pain spreads to the abdominal area, which can mimic organ pathology abdominal cavity. When the spinal cord is compressed below the site of injury, paresis and paralysis occur.
In the presence of characteristic symptoms and a person’s complaints are examined by a neurologist. The doctor determines muscle tone, skin sensitivity, and the state of reflexes. To confirm the diagnosis, the patient should undergo instrumental studies.
Most accessible method is a radiography of the spinal column in frontal and lateral projections. The intervertebral discs are not visualized in the images, and therefore the hernia cannot be determined. But with the help of radiography, it is possible to identify the cause of the development of the disease: vertebral injuries, signs of osteochondrosis, congenital anomalies.
The most effective research is magnetic resonance imaging. This method allows you to assess the condition of soft tissues. Using the resulting images, you can study the condition of the intervertebral discs, as well as the presence of a hernia.
Not all herniated discs require active treatment. Thus, patients with intervertebral disc protrusion up to three millimeters and no symptoms only need observation.
If there is severe pain, it will not be possible to avoid taking medications. For this purpose, drugs related to NSAID group(diclofenac, meloxicam, ketorol). At intervertebral hernias with pronounced inflammatory process resort to the use of ointments containing glucocorticosteroids (flucinar, triacort, esperon, dermovate).
Quite common and effective procedure is to carry out a therapeutic blockade. This is the introduction of anesthetics (lidocaine, novocaine) into the epidural space. The goal of the procedure is to eliminate pain and muscle spasm. The patient experiences relief after just a couple of minutes. The effect of the blockade may last for several weeks.
Additionally, the doctor may prescribe B vitamins (neurovitan, milgamma), which ensure the regeneration of damaged nerve fibers, as well as improving the conduction of nerve impulses. To repair the cartilage tissue of the discs, chondroprotectors (structum, alfutol) are prescribed.
If, despite conservative therapy, the pain does not leave the person and worries more and more every day, which means it is necessary to consider the option surgical treatment. Compression of the cauda equina requires immediate surgical intervention.
Operations are performed openly and endoscopically. During the operation, the doctor removes the hernia and restores the integrity of the fibrous ring. If the intervertebral disc is severely damaged, operations are performed to replace it with an implant.
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