Spinal hernias are often the cause of severe back pain. Their formation is characteristic of people of mature age (35-50 years). And to eliminate the 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 by special disks - a kind of gaskets that protect the bone from injuries during movement. In addition, they provide good flexibility to the entire spine. Disks consist of two parts - the fibrous ring and the pulpous nucleus. And what is a vertebral hernia? This is a deformation that is formed due to damage to the disc and its sticking out. As a result of this change, the nerve endings of the spinal cord are pinched, and a hernia appears.
Pathology entails the occurrence of discomfort, malfunctioning of the internal organs and a decrease in the sensitivity of the limbs. Most often, a vertebral hernia of the lumbar region is diagnosed, but in the neck and chest it is much less common. For the formation of a deformation, strong physical exertion is not necessary at all - sometimes a sloppy 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 begin treatment. But it is timeliness in such a situation that is the key to success.
Reasons for the appearance
Most often, the following factors lead to the development of hernia:
- osteochondrosis;
- kyphosis;
- scoliosis;
- lordosis;
- heavy fall or hit;
- spinal injury.
Although in fact, pathology can develop for other, less obvious reasons:
- Sedentary lifestyle. Regular driving, long work in front of the monitor, violation of posture - all this can sooner or later lead to a hernia.
- Overweight.
- Severe hypothermia.
- Smoking for several years.
- Regarding sex, a hernia is much more common among the fair sex.
- Reduced physical activity. Drives get the nutrition they need thanks to the deep back muscles. If they are not subjected to regular loads, there is a loss of tone and strength.
- Age over 30 years and height above 170 cm.
- Increased physical activity. Sudden careless movements and excessive loads can cause injury to the fibrous membrane of the discs.
Symptoms of a hernia of the vertebral section
Treatment depends on how a person feels and what specific signs of a problem he is worried about. Sometimes it is not necessary to resort to surgical intervention to recover, many patients manage to cope with the disease with the help of conservative therapy.
The main symptom of a hernia of the vertebral section is pain, which can vary depending on the location of the damage. In addition, the clinical picture is often supplemented by:
- increased sweating;
- muscle tone;
- lowering the sensitivity of the legs and arms.
The remaining signs of the disease depend on the variety of pathology.
Lumbar hernia
In this case, the person feels burning, sharp pains, which are explained by the strong pressure of the hernia on the nerve receptors located nearby. Usually sensations spread to the back of the body. The main symptoms of lumbar vertebral hernia:
- numbness of the toes;
- pain in the foot, lower leg, thigh or buttock;
- disruptions in the activity of the pelvic organs;
- a feeling of tingling or tingling in the lower limbs;
- pain in the lower back, 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 it often disguises itself as a heart and digestive disease. At the same time, pain covers the chest, but can go down a little to the upper abdomen.
Pathology also has other characteristic manifestations:
- goosebumps, numbness, or tingling in the abdomen, chest, back, or arms;
- complete or partial paralysis below the affected area;
- severe weakness in the hands;
- 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 exposure of the bulging disc to 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 the damage. In case of trauma to the upper region of the spine, complete paralysis is not ruled out, in which motor function remains only at the head. But such cases are extremely rare.
Cervical hernia
Injuries in this zone occur in approximately 20% of all cases, which makes such a 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 spine, signs may cover the entire upper body. Patients usually observed:
- loss of sensation in the hands;
- noise in ears;
- sudden surges in pressure;
- severe dizziness;
- migraine;
- systematically arising pain in the neck and shoulders, which gradually become permanent;
- difficulties with neck and shoulder movements;
- significant increase in pain at the time of bending, turning, or even coughing.
Vertebral Hernia Syndromes
Without appropriate treatment, discomfort and other symptoms of pathology gradually progress. Because of this, a person may develop vertebral hernia syndromes, which further worsen a person’s well-being.
Radicular syndrome. Due to prolonged compression, the roots of the spinal cord gradually die. As a result, tissue nutrition and ability to move are impaired. First, the leg muscles weaken, which complicates the usual climb up the stairs and squats, then their atrophy occurs, even complete paralysis is not ruled out. The susceptibility of the skin is reduced, it is likely a violation of the sweating process. Over time, the activity of the pelvic organs becomes more difficult.
Vertebral Syndrome. Against the background of constant pain, 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 bias. The consequences depend on the size of the hernia and its location. If the pathology covers the spinal cord, over time, diseases of related organs and systems are necessarily diagnosed.
Diagnostics
A doctor may suspect a spinal hernia during a physical examination. In doing so, he must check:
- reflexes
- range of motion;
- sensitivity;
- soreness;
- muscle strength;
- quality of walk.
To recognize the deformation of the disk makes it possible to tomography - magnetic resonance and computer. Moreover, MRI is more preferable because 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, for whatever reason, is contraindicated in patients, contrast myelography should be performed. An intervertebral hernia often has a clinical picture similar to the manifestations of other pathologies. For differential diagnosis, gastroscopy, ECG or radiography may be necessary.
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 the performance of some exercises. The tactics of treatment for a hernia of the vertebral section are always chosen by the doctor, based on the degree of the disease and the severity of the symptoms that appear.
It must be understood that without therapy, the pathology will progress rather quickly, which sooner or later will lead to the need to lie on the operating table.
Drug treatment
The optimal scheme is selected individually, sometimes this requires the consultation of several narrow specialists. Taking medications can be supplemented by therapeutic exercises or special procedures. Sometimes even monotherapy is effective, but nevertheless complex treatment is considered more preferable. Usually, doctors prescribe several categories of drugs at once:
- Nonsteroidal anti-inflammatory drugs. Available in the form of tablets and ointments - Ibuprofen, Diclofenac, Indomethacin. They allow you to quite quickly get rid of pain, but negatively affect the digestive tract, so they are recommended to be taken in parallel with special protectors. Most often, doctors prescribe Almagel and Omeprazole.
- Novocainic blockade. It even relieves 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. Effective in the early stages of the disease, they cope well with the restoration of cartilage. Ideal for the treatment of vertebral hernia of the lumbar spine. Most often, doctors prescribe Structum and Teraflex.
- Muscle relaxants. They help relax muscles, relieve cramps. The most commonly used are Midokalm and Sirdalud.
- Corticosteroids. Stop the inflammatory processes. But such drugs can not be used for too long, as they are capable of leading to a number of side effects. Doctors advise Metiprednison and Decadron.
Physiotherapeutic procedures
Such sessions are not used independently - they serve as an auxiliary component of the main treatment for vertebral hernia. Symptoms of the disease recede literally after several procedures. Physiotherapeutic 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.
Physiotherapeutic procedures:
- stimulate metabolic processes;
- improve blood microcirculation;
- accelerate the regeneration of damaged areas of the body;
- eliminate pain;
- cope with stiffness of movements.
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 focus of 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. It is never used as an independent treatment.
- Laser Therapy It allows you to get rid of pain and inflammation, significantly improves regeneration.
Physiotherapy
What is a vertebral hernia? This is a deformation of the discs located between the vertebrae, accompanied by pain. If the patient does not have pain or he managed to eliminate it with the help of medications, 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 scans.
Most often, therapeutic exercises are recommended for the treatment of vertebral hernia of the lumbar spine. But it is also suitable for improving the condition with problems with the thoracic and cervical spine.
All exercises are done in the supine position, as smoothly and slowly as possible. Doctors recommend doing 10-12 repetitions. If in the process of the patient overtakes soreness or movements are given to him with difficulty, gymnastics should be stopped.
- Twisting the body. Put your feet shoulder width apart, cross your arms over your chest. Gently and, most importantly, gently rotate the torso first to one side and then to the other side. In this case, the lower body should be motionless.
- Bending in a prone position. Accept the same position as in the previous exercise. Gently torso the body first to the right, and then to the left. It is advisable to stretch as much as you do, but so that there is no discomfort.
- Hips Straighten your legs, press your hands with your palms to the floor, slightly spread them apart. Rotate your hips to leave your feet in the starting position.
- Slip feet. Take the same position as last time, put your legs together. Move them to one side or the other, using lateral and lumbar muscles.
Such gymnastics is very effective in vertebral hernia of the lumbar spine.
Surgical intervention
Surgery is the last measure resorted to in the absence of the effect of conservative treatment. Surgical intervention may be required for those who have been delayed with drug therapy or for patients who have discovered the disease too late.
If the condition rapidly deteriorates, then the removal of the vertebral hernia operatively will be the only solution to the problem. However, it is worthwhile to understand that surgical intervention:
- may have negative consequences;
- may require reoperation;
- Needs full rehabilitation.
After surgery on a vertebral hernia, the patient needs to be as attentive to his health as possible 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 medications and physiotherapeutic procedures do not help? For this, doctors offer several ways:
- Discectomy. Assumes partial or complete removal of the deformed disk. It is performed through an 8 cm incision under general anesthesia. True, this technique is now considered obsolete due to the long rehabilitation and the need for antibiotics for 10 days.
- Endoscopy It is carried out through a section 5 cm long with the help of miniature devices. This method is considered more preferable due to the absence of muscle damage, which accelerates the healing process. The intervention is carried out quite quickly, the patient is discharged the next day. Rehabilitation takes about 3 weeks. True, the procedure has drawbacks: a high risk of relapse and the need for spinal anesthesia.
- Microdisectomy. It is carried out through a 4-cm incision under a microscope under general anesthesia. It is used most often because nerves are released without concomitant muscle damage. It makes it possible to eliminate several violations at once. In the hospital, the patient remains no longer than 3 days.
- Nucleoplasty An improved technique involving the use of local anesthesia. The operation is carried out using a laser, plasma or radio frequency rays through needles with a diameter of 2-3 mm. During the procedure, the pressure exerted on the nerve decreases, the pain is completely stopped. A patient can be discharged in a few hours. True, in this way you can remove a hernia no larger than 7 mm.
Rehabilitation
The quality and speed of recovery in fact largely depends on the patient himself and the correctness of the rehabilitation. After surgical removal of a hernia of the spine, a person needs an integrated approach, the components of which are selected individually.
Most often, doctors recommend patients several stages of rehabilitation that allow you to achieve a positive result as quickly as possible:
- Medicines Prescribed to eliminate pain, prevent a variety of complications and accelerate the process of tissue regeneration.
- Physiotherapeutic procedures. They increase the effectiveness of other methods and tools.
- Physiotherapy. It allows you to restore muscle activity and significantly improve the mobility of the vertebrae.
- Sanatorium rehabilitation. It involves a whole range of useful procedures, for example, therapeutic applications, massage sessions and mud baths.
Now you know whether conservative treatment can be done with vertebral hernia and how to deal with unpleasant symptoms. , : .