Intervertebral hernia – a death sentence or a reason to take care of your own health?

The pace of life in modern society is gaining momentum every year, and therefore not every person has time to do everything necessary for a comfortable life, including monitoring their own health. Failure to respond to alarming symptoms can lead to serious illnesses, including intervertebral hernia.

To understand the causes of the disease, as well as prevent its development, it is important to understand the basics.

Features of the intervertebral disc device

The basis of the skeleton is the spine, normally consisting of more than three dozen vertebrae, between which, to create shock absorption, as well as optimal functionality of the body, intervertebral discs are located, bearing part of the load and ensuring not only the mobility of the spine, but also its flexibility.

The disk structure assumes the presence of three key components:

• annulus fibrosus – protective membrane;
• nucleus pulposus;
• end plate - a protective element located on both sides of the nucleus.

Systematic excessive loads or a one-time negative impact of great force can provoke the development of pathological conditions of the spinal column, in particular hernia.

LUMBAR PAIN

Lumbar pain (LP), like headaches, is one of the most common complaints with which patients turn to both a local (family) general practitioner and a neurologist. According to WHO experts, almost 90% of people have experienced lower back pain at least once in their lives.

Among the most common causes of LBP are diseases of the spine, primarily degenerative-dystrophic (osteochondrosis, spondylosis deformans) and overstrain of the lumbar muscles. However, we should not forget that various diseases of the pelvic and abdominal organs, including tumors, can cause the same symptom complex as a herniated disc that compresses the spinal root.

The 20th century made serious adjustments to the understanding of the etiology and pathogenesis of BE. Initially, the main cause of their occurrence was considered to be inflammation of the nerve roots and trunks, which was reflected in such terms as lumbosacral radiculitis, radiculoneuritis, funiculitis, etc. Back in the 40-50s, “radiculitis” was often treated with massive doses of antibiotics. But subsequently, the infectious-inflammatory theory of the pathogenesis of BE began to be replaced by a vertebrogenic one, which was greatly facilitated by successful operations for disc herniation. They began to look for the cause of all BE in degenerative-dystrophic changes in the spine, in compression of a nerve root disc by a herniated disc. This period also corresponds to certain terminology: discogenic radicular compression syndrome, vertebrogenic radiculopathy, vertebrogenic reflex syndrome. In the 80-90s, the theory of the predominantly muscular origin of BE began to prevail among neurologists. Many researchers believe that in almost 90% of cases the cause of BE is myofascial syndromes, and vertebrogenic disorders account for no more than 10%. This is reflected in the corresponding terminology: dorsalgia, lumbodynia, myofascial syndrome.

• Etiology and pathogenesis of lumbar pain

The most common causes of BE are: pathological changes in the spine (primarily degenerative-dystrophic); pathological changes in muscles (most often myofascial syndrome); pathological changes in the pelvic and abdominal organs; diseases of the nervous system. The following are considered risk factors for the development of BE: heavy physical activity; physical stress; uncomfortable working posture; injury; cooling, drafts; alcohol abuse; depression and stress; consequences of “harmful” professions (exposure to high temperatures in hot shops and radiant energy, sudden temperature fluctuations, vibration, etc.).

The pathogenesis of PB can be reduced to the following simplified scheme. Painful impulses, regardless of the source (spine, overstrained muscle, “sick” internal organ) enter the spinal cord, from where it goes to special organs of muscle sensitivity - muscle spindles, overexcitation of which causes muscle spasm, leading to a change in body posture and increases it, increasing pain . This creates a vicious circle of maintaining pain. Muscle spasms can be aggravated by depression and chronic stress, which lower the threshold for pain perception, as well as alcohol, which softens the control of maintaining posture.

Among the vertebrogenic causes of BE there are: root ischemia (discogenic radicular syndrome, discogenic radiculopathy), resulting from compression of the root by a disc herniation; reflex muscle syndromes, the cause of which may be various degenerative changes in the spine.

Various functional disorders of the lumbar spine may have a certain significance in the development of LBP, when, due to incorrect posture, blocks of the intervertebral joints occur and their mobility is impaired. In the joints located above and below the block, compensatory hypermobility develops, leading to muscle spasm.

• Lumbar pain in various diseases of the spine

In addition to degenerative-dystrophic changes, relatively rare spinal pathology may also be important in the development of BE.

Spondylolisthesis - literally translated (from the Greek spondylos - vertebra and olisthesis - slipping) - a sliding vertebra that is displaced from the underlying one (most often the 4th or 5th, rarely the 3rd lumbar vertebra). Spondylolisthesis is observed in 2-4% of the population and in 7-10% of cases causes lumbosacral pain. The disease does not always manifest itself clinically and can be detected accidentally during an X-ray examination of the spine. It all depends on the nature of the displacement, i.e., on whether it is partial or complete. Depending on the angle of displacement of the sliding vertebra, stable and unstable spondylolisthesis are distinguished. Its stable form is characterized by the fact that when the spine bends and turns, the relationship between the protruding and underlying vertebrae is not disturbed. With unstable spondylolisthesis (more severe), these relationships are periodically disrupted.

Low back pain in childhood and adolescence is most often caused by abnormalities in the development of the spine. Spinal bifida (spina bifida) occurs in 20% of adults. Neurological symptoms occur in the cystic form of this pathology, when the dura mater protrudes and the epidural tissue grows. Upon examination, attention is drawn to hyperpigmentation, birthmarks, multiple scars, funnels and hyperkeratosis of the skin of the lumbar region. Sometimes urinary incontinence, trophic disorders, and weakness in the legs are noted. In this case, it is necessary to exclude rigid filament terminalis syndrome, which is characterized by thickening and shortening of the fila terminalis, which leads to overstretching of the spinal cord.

BE can cause lumbarization - the transition of the S-1 vertebra in relation to the lumbar spine and sacralization - the attachment of the L-5 vertebra to the sacrum. These anomalies are formed due to individual characteristics of the development of the transverse processes of the vertebrae.

Ankylosing spondylitis. In 1882, this disease was first described by the outstanding Russian neurologist V.M. Bekhterev under the name “stiffness of the spine with curvature.” It is currently referred to as “ankylosing spondylitis.” Almost all patients complain of lower back pain. According to various authors, the disease occurs in 0.08-2.6% of the population, and on average its prevalence is one case per 100. The vast majority of patients (up to 90%) are men aged 20-40 years. Rarely, the disease occurs in children and adults over 50 years of age.

Ankylosing spondylitis is manifested by inflammatory lesions primarily of low-moving joints (intervertebral, costovertebral, lumbosacral joints) and spinal ligaments. Gradually, ossification develops in them, the spine loses elasticity and functional mobility, becomes like a bamboo stick, fragile and easily injured. In the stage of pronounced clinical manifestations of the disease, the mobility of the chest during breathing and the vital capacity of the lungs are significantly reduced.

Tuberculous spondylitis. Chronic inflammation of the spine caused by tuberculosis. As a rule, one of the vertebrae is initially affected, in which a tuberculous granuloma develops, gradually destroying bone tissue. The strength of the outer layers of the vertebra prevents its deformation and the process is asymptomatic for a long time. This is the so-called prespondylytic phase, which in adults can last for many years. Clinically, tuberculous spondylitis begins to manifest itself when the process spreads to tissues adjacent to the vertebra or the affected vertebra is deformed. Often (up to 30% of cases), bruises contribute to the manifestation of the disease, and in children, in addition, various infections.

In children, the disease is more violent and the process often spreads to the vertebrae above and below. Gradually, the pain intensifies, local pain occurs when pressing over the lesion, gait becomes difficult, the mobility of the spine is sharply limited and its configuration changes, which leads to the formation of a hump.

When one or more vertebrae are affected by the tuberculosis process, purulent-necrotic masses can form an abscess that sometimes breaks out, forming a fistula.

Diagnosis of tuberculous spondylitis is initially based on X-ray data of the spine and other organs. The first radiological sign is a narrowing of the intervertebral disc. Then local osteoporosis, bone cavity, marginal destruction, wedge-shaped deformity and, finally, edema abscesses appear in the vertebral body. Breakthrough of caseous masses under the posterior longitudinal ligament into the epidural space is usually accompanied by compression of one or more roots, sometimes the spinal cord with the development of lower paraparesis.

Luetic spondylitis. It is a complication of secondary or tertiary syphilis. Differential radiological signs include severe osteosclerosis, defects of adjacent plates of the affected vertebrae, osteophytes (without ankylosis). The luetic nature of the process should be assumed in the case of recurrent meningitis, meningoencephalitis, repeated strokes (especially at a young age), and spontaneous subarachnoid hemorrhages. To confirm the diagnosis, blood and cerebrospinal fluid tests are performed - the Wassermann reaction and immobilization of treponema pallidum (TIPT).

Brucellous spondylitis. The etiology of the disease is associated with undulating fever with widespread rises in temperature (patients tolerate them relatively easily), profuse sweating, arthralgia and myalgia, lymphadenitis with a predominant enlargement of the cervical and, less commonly, inguinal lymph nodes. The diagnosis is confirmed by serological reactions of Wright and Heddelson.

Typhoid spondylitis. It occurs against the background of a long period of imaginary recovery. The diagnosis is confirmed by the Widal serological reaction.

Dysenteric spondylitis. The diagnosis is confirmed by the results of culture of intestinal contents in the acute period of dysentery.

Rheumatic spondylitis. Sometimes it complicates the course of rheumatism, which is typical for young people and is accompanied by relapses, changes in the heart, polyarthritis with damage to large joints. If bacterial endocarditis is added, then in this case there is fever, leukocytosis, a shift in the blood count to the left, and a sharp increase in ESR. To confirm the diagnosis, rheumatic tests, repeated blood cultures, ECG, and echocardiography are performed.

Nonspecific spondylitis. They can complicate any infection, but most often the intestinal and urinary tract.

Spinal osteomyelitis. Inflammatory damage to the bone marrow with subsequent spread of the process to all elements of bone tissue. Accounts for about 2% of all cases of bone osteomyelitis. The lumbar vertebrae are affected more often than the cervical and thoracic ones. There are nonspecific and specific osteomyelitis. The first is caused by pyogenic pathogens (mainly staphylo- and streptococci); the second - may be tuberculosis, syphilitic and other etiologies. With nonspecific osteomyelitis of the spine, the focus of purulent infection can be located in any part of the body in the form of boils, carbuncles, infected skin wounds, eczema, etc. and is transmitted hematogenously. However, the spine is often affected from nearby purulent foci, for example, with open infected fractures and gunshot wounds. Spinal osteomyelitis can occur acutely, subacutely and chronically. With an acute onset, fever, pronounced blood changes, and sharp, shooting pain in the lower back occur quickly. In the subacute and chronic course of the disease, which occurs more often, the pain is less pronounced. Characteristic changes on radiographs are revealed only after 1.5-2 months. after the onset of the disease.

Epidurit. There is a purulent focus: in 80% of cases, pyoderma, septic changes in the blood - leukocytosis, increased ESR, shift of the formula to the left; rapid increase in pain, fever, symptoms of intoxication. At the beginning of the disease, the pain is local, then signs of compression of one or more roots appear: symptoms of tension, sensory and motor disorders; meningeal symptoms. In the advanced stage of the disease, after an average of two days, gradually increasing pelvic and conduction disorders join these symptoms.

Additional studies include magnetic resonance imaging, cultures of blood, urine and discharge from purulent lesions. Lumbar puncture is contraindicated due to the risk of infection in the subarachnoid space.

Intramedullary abscess. In the initial stage, it is clinically similar to epiduritis. The main differential feature is the type of distribution of conduction disorders: ascending with epiduritis and descending with intramedullary abscess.

Multiple myeloma. It manifests itself as local pain in the thoracic or lumbar spine, which occurs gradually against the background of progressive weight loss, sweating, undulating fever and proteinuria. X-rays reveal diffuse osteoporosis, osteosclerosis, and later secondary spinal deformity. When pathological fractures occur, the pain increases sharply, symptoms of tension, radicular disorders, and lower paraparesis appear. In 70% of cases, ESR increases and normochromic anemia is detected.

Electrophoresis of blood proteins reveals paraproteinemia, hypogammaglobulinemia, and Bence Jones protein in the urine. Hypocalcemia is detected in the blood. The diagnosis is confirmed by examining the puncture of the sternum. In this case, myeloma cell proliferation is determined in 90% of cases. In addition, an X-ray of the skull, chest, and pelvic bones should be performed—favorite sites for myeloma.

Spinal tumors. They can be benign or malignant, originating primarily from the spine or metastatic. Benign tumors of the spine (osteochondroma, chondroma, hemangioma) are sometimes clinically asymptomatic. With hemangioma, a spinal fracture can occur even with minor external influences (pathological fracture). Malignant tumors are predominantly metastatic from the prostate and mammary glands, uterus, lungs, adrenal glands and other organs. Pain in this case occurs much more often than with benign tumors, usually persistent, painful, intensifies with the slightest movement and deprives patients of rest and sleep. Characterized by a progressive deterioration of the condition, an increase in general exhaustion, and pronounced changes in the blood. In diagnosis, radiography, computed tomography, and magnetic resonance imaging are of great importance.

Osteoporosis. The main cause of the disease is a decrease in the function of the endocrine glands due to an independent disease or against the background of general aging of the body. Patients who long-term use of hormones, aminazine, anti-tuberculosis drugs, tetracycline may develop exogenous osteoporosis. Radicular disorders occur due to deformation of the intervertebral foramina, and spinal disorders (myelopathy) due to compression of the radiculomedullary artery or vertebral fracture, even after minor injuries.

Myofascial syndrome. According to many researchers, this is the main reason for the development of BE. It can occur due to overexertion (during heavy physical activity), overextension and bruises of muscles, unphysiological posture during work, reaction to emotional stress, shortening of one leg and even flat feet. Predisposing factors include: hypovitaminosis B1, B6, B12, folic and ascorbic acids, deficiency of microelements (potassium, calcium, magnesium, iron), hypoglycemia, gouty diathesis, chronic infections, sleep disturbance. In the literature, this phenomenon is often referred to by other terms: myalgia, myofibrositis, myofasciitis, trigger points (areas, zones).

In addition to myofascial pain syndrome, the cause of LBP can be other muscle diseases.

Myositis. They represent a large group of diseases of various etiologies: rheumatic, tuberculosis, syphilitic, viral, etc. Parasitic diseases - trichinosis, echinococcosis can also lead to muscle damage. In this case, persistent and prolonged pain is noted.

Widespread muscle changes are found in collagenoses, primarily in dermatomyositis, which can begin suddenly, especially after exacerbation of foci of chronic infection, colds or hypothermia. Muscle soreness, including the lower back, is typical. Simultaneously with the pain or after its cessation, weakness and “weight loss” of the muscles occur, limiting the patient’s motor activity. Skin changes: redness with a purple tint, pinpoint or spotty rash, swelling. During bed rest, foci of necrosis may occur with subsequent development of scars. Severe peeling often occurs, causing the skin to resemble fish scales. Muscle pain and skin changes are usually symmetrical. Half of patients with dermatomyositis have calcification in individual muscles. With multiple calcifications, the skin becomes lumpy and dense to the touch. In the ossifying form of the disease, the ossification of the muscles and subcutaneous tissue can be so strong that it fetters the patients, they become as if dressed in a shell.

Scleroderma. There is widespread thickening of the skin and subcutaneous tissue. The pain is less pronounced than with dermatomyositis.

Diseases of internal organs. PA often occurs with diseases of internal organs: gastric and duodenal ulcers, pancreatitis, cholecystitis, urolithiasis, etc. The pain can be pronounced and imitate the picture of lumbago or discogenic lumbosacral radiculitis. However, there are also clear differences, thanks to which it is possible to differentiate referred pain from that arising from diseases of the lumbosacral part of the peripheral nervous system. These are primarily clinical signs of the underlying disease. For example, with a peptic ulcer of the stomach and duodenum, patients, as a rule, complain of nausea, vomiting, heartburn, belching, which does not happen with radiculitis, and attacks of renal colic are accompanied by frequent urination with pain, nausea, vomiting, and bloating. Difficulties in differential diagnosis are caused by cases when the signs of disease of the internal organs are weakly expressed or the patient has reflected pain combined with pain caused by pathology of the lumbosacral part of the peripheral nervous system.

Very often, BE is caused by diseases of the pelvic organs: the uterus, appendages, prostate gland, vas deferens, rectum, which is primarily due to the proximity of these organs to the lumbosacral nerve formations. Therefore, along with reflected pain, pain from direct impact may also appear. In the past, the term “adnexitis-sciatica” was even used. Lower back pain can occur when the uterus is in an incorrect position during pregnancy, and in women who interrupt sexual intercourse to prevent pregnancy. Gynecological diseases are characterized by a predominant increase in pain during sexual intercourse.

Increased pain during bowel movements is typical for diseases of the rectum: hemorrhoids, tumors, fissures, polyps. In these cases, diarrhea alternating with constipation and significant weight loss are noted. A constant sign of the disease is the presence of mucus and blood in the stool. In some cases, hypochromic anemia is detected. When straining, hemorrhoids may fall out. For differential diagnostic purposes, sigmoidoscopy is indicated to exclude colon tumors.

Dissecting aortic aneurysm. The pain radiates to the abdomen, legs and is accompanied by a collapsing state. A tumor-like formation is palpated in the abdomen, over the projection of which a systolic murmur is heard. Additionally, ultrasound and computed tomography examinations of the abdominal organs are performed.

Diseases of the nervous system. In some cases, BE occurs in the initial stages of the disease, is temporary and is combined with various neurological disorders, and in others it is long-term or permanent. Transient lumbar pain can be observed in acute inflammatory diseases of the nervous system: meningitis, myelitis, polyradiculoneuritis, which have a predominantly acute onset and are severe. At the same time, mild or moderate pain in the lower back seems to recede into the background. In addition, they decrease or disappear quite quickly. PB can also occur several years after acute inflammatory diseases of the nervous system.

Spinal cord tumors. Depending on the primary localization, they are divided into intra- and extramedullary, which are more common and are predominantly benign: limited, do not infiltrate the brain tissue. BE in extramedullary tumors is an early sign of the disease. They arise due to a decrease in the free cavity of the spinal canal due to tumor growth, tension in the nerve roots and meninges.

Lumbar pain can be observed with multiple sclerosis, spinal gliosis, and tabes of the spinal cord. They do not play a leading role in the clinical picture.

Finally, one should remember about the possibility of the occurrence of pain in neuroses, which, unlike pain in organic diseases of the nervous system, are not constant and clearly localized. They move from one part of the body to another, and their severity depends on the general emotional state. Usually there are no symptoms of tension in the spinal roots and prolapse from the reflex sphere.

• Clinical symptoms of lumbar pain

Most often, BE occurs at the age of 25-44 years. There are acute pains, lasting, as a rule, 2-3 weeks, and sometimes up to two months, and chronic pains - over two months.

Compression radicular syndromes (discogenic radiculopathy) are characterized by a sudden onset, often after heavy lifting, sudden movements, or hypothermia. Symptoms depend on the location of the lesion. The syndrome is based on compression of the root by a disc herniation, which occurs as a result of degenerative processes facilitated by static and dynamic loads, hormonal disorders, and injuries (including microtraumatization of the spine). Most often, the pathological process involves the area of ​​the root from the dura mater to the intervertebral foramen. In addition to disc herniation, bone growths, scars of epidural tissue, and hypertrophied ligamentum flavum may be involved in root trauma.

The upper lumbar roots (L-1, L-2, L-3) are rarely affected: they account for no more than 3% of all lumbar radicular syndromes. L-4 is most often affected (6%), causing a characteristic clinical picture: mild pain along the inner-lower and anterior surfaces of the thigh, the medial surface of the leg, paresthesia in this area, slight weakness of the quadriceps muscle. Knee reflexes are preserved and sometimes even increased. The L-5 root is most often affected (46%). The pain is localized in the lower back, gluteal region, along the outer surface of the thigh, the anterior outer surface of the lower leg down to the foot and the first three fingers. It is often accompanied by a decrease in the sensitivity of the skin of the anterior outer surface of the leg and the strength in the extensor of the first finger. The patient finds it difficult to stand on his heel. With long-term radiculopathy, hypotrophy of the tibialis anterior muscle develops.

The S-1 root is just as often affected (45%). Lower back pain radiates along the outer back of the thigh, outer surface of the leg and foot. Examination often reveals hypalgesia of the posterior outer surface of the leg, decreased strength of the triceps muscle and toe flexors. It is difficult for such patients to stand on their toes. There is a decrease or loss of the Achilles reflex.

Vertebrogenic lumbar reflex syndrome. It can be acute or chronic. Acute LBP (lumbago, “lumbago”) develops over several minutes or hours, often suddenly due to awkward movements. Piercing, shooting (like an electric shock) pain is localized throughout the lower back, sometimes radiating to the iliac region and buttocks, sharply intensifies with movement, coughing, sneezing, and decreases when lying down, especially if the patient finds a comfortable position. Movements in the lumbar spine are limited, the lumbar muscles are tense, Lasegue's symptom is caused, often bilaterally. Acute lumbodynia usually lasts 5-6 days, sometimes less. The first attack ends faster than subsequent ones. Repeated attacks of lumbago tend to develop into chronic LBP.

Myofascial pain. It is usually long-lasting, ranging from mild discomfort to severe and excruciating pain. It can occur at rest and during movement, is associated with trigger points and is non-segmental in nature, and the zone of greatest intensity is rarely localized at the most trigger (hyperirritable) point in a dense cord of skeletal muscle, painful on palpation. Trigger points are activated by overload, physical fatigue, injury or cold. Pressure on them causes or intensifies painful phenomena in the area of ​​referred pain.

It is worth highlighting a number of clinical symptoms that are not typical for BE caused by degenerative-dystrophic changes in the spine or myofascial syndrome. They should alert you, as they may be a sign of the presence of pathological processes in the pelvic and abdominal organs or diseases of the spine that go beyond osteochondrosis. These symptoms include: the appearance of BE in childhood and adolescence; back injury shortly before the onset of LBP; PB, accompanied by fever and signs of intoxication; PA not associated with spinal movements; unusual irradiation of pain: in the perineum, abdomen, rectum, vagina, both legs, girdle pain; connection of PB with eating, defecation, sexual intercourse, urination; concomitant urinary retention or incontinence; gynecological pathology (amenorrhea, dysmenorrhea, vaginal discharge), which appeared against the background of PB, strengthening of PB in the horizontal position and decrease in the vertical position (Razdolsky’s symptom, characteristic of a tumor process in the spine); steadily increasing pain over one to two weeks; development of paresis of the lower extremities against the background of BE, the appearance of pathological reflexes.

• Examination methods

— External examination and palpation of the lumbar region, identification of scoliosis, muscle tension, pain and trigger points. — Determination of range of motion in the lumbar spine, areas of muscle wasting. — Study of neurological status: determination of tension symptoms (Laseg, Wasserman, Neri); states of sensitivity, reflex sphere, muscle tone, vasomotor and autonomic disorders (swelling, changes in skin color). — X-ray, computer or magnetic resonance imaging of the lumbar spine; Ultrasound examination of the pelvic organs. — Gynecological examination. — If necessary, additional studies are carried out: cerebrospinal fluid, blood and urine, sigmoidoscopy, colonoscopy, gastroscopy, etc.

• Treatment

I. Acute BE (or exacerbation) of vertebral or myofascial origin.

A. Undifferentiated treatment. Gentle motor mode; in case of severe pain in the first days, bed rest, and then walking on crutches to unload the spine; hard bed: the best option is a wooden board with a thin mattress on top of it. For local warming, a woolen shawl, an electric heating pad, and a bag of heated sand or salt are recommended. Local exposure in the area of ​​greatest pain: irritating ointments (phenalgon, tiger ointment, capsin, nicoflex, etc.), mustard plasters, pepper plaster, ultraviolet irradiation in an erythemal dose, leeches or irrigation with ethyl chloride.

Anesthetic electrical procedures (the means of choice are: transcutaneous electroanalgesia, sinusoidal modulated currents, diadynamic currents, electrophoresis with novocaine, etc.); acupuncture.

Novocaine blockades and pressure massage of trigger zones are used. Use analgesics, antihistamines, non-steroidal anti-inflammatory drugs, tranquilizers and/or antidepressants; drugs that reduce muscle tension (muscle relaxants): baclofen (5 to 20 mg three times a day) or sirdalud (1 to 4 mg three times a day). In case of arterial hypertension, sirdalud should be taken with great caution due to its hypotensive effect. If root swelling is suspected, diuretics are prescribed.

B. For discogenic radiculopathy, traction therapy (dry or underwater traction) is used in a neurological hospital.

B. For myofascial syndrome, after local treatment (novocaine blockade, irrigation with ethyl chloride), a hot compress is applied to the muscle for several minutes.

II. Chronic lumbar pain of vertebrogenic or myogenic origin.

In case of disc herniation, it is recommended to wear a rigid corset of the “weightlifter’s belt” type; limiting physical activity; exclusion of sudden movements, bends; physical therapy to create a muscle corset and restore muscle mobility; massage; novocaine blockades; acupuncture; physiotherapy: ultrasound, laser therapy, heat therapy. They use antidepressants, vitamin therapy: intramuscular B vitamins (B1, B6, B12), multivitamins with mineral supplements. For paroxysmal pain, Finlepsin (Tegretol) is prescribed. Psychotherapy is indicated.

In this article we do not touch upon issues of manual therapy and surgical treatment, which require special consideration.

The mechanism of development of the disease

Increased, strong load (age characteristics, excess body weight and other negative factors), affecting the spinal column and all its components, causes asymmetry in the contents of shock-absorbing elements - protrusion. In a situation where the protrusion persists for a long time and is left without proper attention, the disc shell stretches, which after a certain period of time leads to its rupture, releasing the contents of the disc, which forms a hernia.

At the same time, it is important to note that the discs have a fairly large number of nerve receptors in their structure. For this reason, when the integrity of the fibrous membrane is violated, the conductivity of useful substances through the bloodstream to the brain is disrupted, which inevitably leads to the appearance of pain in the affected area, in other words, in one of the parts of the spine.

Stages of formation

Stage I – degenerative-dystrophic changes

Due to increased load, numerous microtraumas occur in the contents of the disc, which leads to a weakening of the outer shell and a decrease in the intensity of blood flow, which significantly reduces the amount of tissue nutrition and provokes a deterioration in shock-absorbing properties.

Stage II – partial protrusion of the disc contents

Stretching of tissues leads to a partial loss of the ability of tissues to withstand loads, which leads to displacement and partial protrusion of the disc (the appearance of protrusion). At this stage, the patient begins to experience pain caused by pinched nerves.

Stage III – hernia

The progression of degenerative-dystrophic changes leads to the release of the contents of the nucleus beyond the disc shell and into contact with the nerve root. In this case, there is a risk of entrapment of the nucleus pulposus, resulting in pain radiating to the lower extremities.

Stage IV – sequestration

An extremely difficult situation when the prolapsed part of the spinal disc is not just separated, but also rises/falls along the spinal canal, which can provoke various kinds of complications.

Psychosomatics of neck pain

At the physiological level, the neck connects the head and body, and at the level of psychology of diseases, it is the place where the spiritual and material connect. Almost all experts in the field of psychosomatics agree that the neck is a symbol of flexibility of thinking, and pain in it is a person’s inability to look at the situation from a different angle. The neck symbolizes the flexibility of the mind and body, and painful sensations in it indicate a person’s stubbornness and reluctance to accept differing opinions; there is a serious internal conflict between his desires and common sense.

A person himself may not notice how he forbids himself to look where he wants or likes. The so-called “self-restraint”. Suppressed desire forms an energy block, which eventually turns into muscle tension.

How to get rid of neck pain and eliminate the psychosomatic cause.

• Give free rein to emotions. Any suppression of emotions leads to the formation of energy blocks in the body, which subsequently leads to physical pain. You need to be able to express all emotions: negative or positive, and do it consciously and on time.
• Develop mental flexibility. It is impossible to always be right; this is a sure sign of a lack of mental flexibility. You need to learn to accept other points of view and look at situations from different angles. Don’t forget to train your body, because everything is interconnected.
• Try to identify internal conflicts. It may be a job you don't like or an environment that is unpleasant to communicate with. You should never do something forcefully for a long time, as it will not lead to anything good. You need to take a break or try to change the situation and change something in your life.
• Reason objectively. A stiff neck can be a sign of narrow-mindedness and ignorance of real facts. Look at the situation from the perspective of a disinterested person.
• Do gymnastics regularly, including for the neck. With low physical activity, stagnant energy processes appear in the body.
• Listen to your body and emotions. Watch what you're doing when it starts to hurt.

Classification of hernia pathology

Today, it is customary to distinguish several key types of hernial pathology, which are determined solely by the location of the pathological condition.

There are three key areas of the spinal column (lumbar, cervical and thoracic disc herniation) where this type of disease can occur. Let's try to study each of them in more detail.

Lumbar

The localization of the pathology is the lower back or, to be more precise, the lumbosacral spine. Prerequisites for the onset of the disease can be intense physical activity, as well as various types of injuries and pathologies.

A lumbar hernia can be determined by the following signs:

• systematic aching pain radiating to the lower extremities;
• “shooting” pain when lifting weights;
• the appearance of a feeling of tingling or even numbness in the legs.

Cervical region

Cervical hernia occurs as a secondary disease in various types of osteochondrosis, which, as is known, are accompanied by pinched nerve roots.

The presence and development of this type of pathology can be determined by the following signs:

• sharp, unexpected pain radiating to the upper limbs;
• partial loss of sensitivity in the hands;
• weakness of the muscular frame, mainly in the upper extremities (shoulder, elbow or hand).

Thoracic region

The presence of a hernia in the upper part of the spinal column indicates the development of pathology in the area of ​​internal organs such as the lungs and heart. Due to the relatively close location, the symptomatic picture often has some similarity with diseases of the respiratory, digestive and cardiovascular systems.

With hernial pathology of the thoracic region the following are observed:

• disturbances in the coordination of movements performed;
• pain of optimally strong intensity, localized in the upper back;
• difficulties in the functioning of internal organs.

How is the operation for endoscopic removal of a cervical hernia performed?

The neurosurgeon makes a small (7 mm) incision in the back of the neck. Under X-ray control, a working port is installed in the wound, into which an endoscope with a diameter of 6 mm is inserted, equipped with micro-forceps, a micro-camera, light and flushing channels. The hernia is removed under detailed visual control. During the intervention, the neurosurgeon carefully moves apart the adjacent muscles, ligaments and soft tissue fibers without injuring them. To gain access to the spinal canal and decompress the spinal root, a small foraminotomy (widening of the intervertebral foramen) is performed. After endoscopic removal of a cervical hernia, that is, cleansing the spinal canal, the pain goes away immediately. The neurosurgeon applies a single suture, which is removed after 10 days. Mobility returns the same day. The duration of hospitalization is 1 day, after which the doctor discharges the patient from the clinic home with simple recommendations for recovery. Recovery is comfortable, so within a month the patient can return to work and normal life.

List of the most likely causes of the development of the pathological condition

A spinal hernia is formed as a result of damage to the integrity of fibrous tissue. The exact causes of the disease remain unknown, despite significant advances in the field of medicine. In most diagnosed cases, it is generally accepted that the causes of hernia are natural aging of the body and wear and tear of connective tissues.

Despite the unclear reasons for the appearance of hernial pathology, it is customary to identify risk factors that increase the likelihood of excessive pressure and unbearable load on the spine. These include:

• awkward bends with non-observance of the optimal angle;
• specifics of work activity (the need to lift a large amount of weights or, conversely, predominantly sedentary work);
• abuse of bad habits;
• excess body weight;
• professional sports;
• various types of spinal injuries.

Factors of this kind can significantly weaken the structure of tissues and lead to the development of serious pathological processes that can significantly worsen the patient’s quality of life and require immediate treatment.

Inguinal hernia in men: prevention

Doctors unanimously say that prevention of the disease is the most effective way to avoid “acquaintance” with it. Regular sports, yoga, and swimming are considered preventative methods for the occurrence of inguinal hernia in men. Short daily walks will be of great benefit.

It is also recommended to normalize your daily routine, alternating work with rest. To reduce the likelihood of an inguinal hernia, you must adhere to the following recommendations:

1. Monitor your diet and avoid constipation. For this purpose, it is necessary to follow a special diet with a high content of plant fibers. If there is difficulty in defecation, then you should resort to laxatives.

2. Avoid increasing pressure inside the peritoneum. It is because of the jerking pressure on the abdominal walls that the organs from the abdominal cavity emerge into the inguinal canal.

3. Monitor your body weight, avoiding its critical increase.

Symptoms of intervertebral hernia

The development of a hernia of this type is predominantly latent, which suggests a mildly expressed symptomatic picture. As degenerative-dystrophic processes progress, pain begins to appear, which is localized in the affected part of the spine.

Among the first symptoms of intervertebral hernia are pain sensations that are transitive in nature, which suggests their intensification with statistical and dynamic load. The pain calms down only in the “lying” position.

Along with the pain, such an unpleasant symptom of intervertebral hernia as muscle-tonic tension develops, which has an extremely negative impact on the patient’s mobility and level of quality of life. The larger the hernial protrusion, the more pronounced the pain and muscle-tonic syndrome and the greater the limitation of mobility.

Excessive tension in the muscular frame can lead to a visually noticeable and very noticeable misalignment of the spine, which has an extremely negative impact on the patient’s condition and aggravates clinical manifestations.

What is psychosomatics?

Psychosomatics is a branch of medicine that studies the impact of psychological factors on the emergence and progression of somatic pathologies. Within this scientific direction, connections between personality characteristics and somatic diseases are studied.

Psychosomatics explains the influence of a person’s reaction, self-esteem and perception of the world on the state of somatic health. Most problems that arise in interpersonal relationships lead to exacerbation of existing chronic diseases and contribute to the emergence of new pathologies.

When studying connections, the following characteristics are taken into account:

• constitutional features;
• character traits and personality type;
• behavioral styles;
• types of emotional conflicts.

It is a popular opinion that most diseases of the body arise as a result of the appearance of psychological inconsistency and disorder that forms in the soul, subconscious and thoughts of a person.

Hysterical individuals experience back pain on an unconscious level

Sigmund Freud developed a theory of the unconscious, according to which disease is a product of the repression of negative emotions at an unconscious level. As a result of the further development of this theoretical teaching, some severe pathologies were classified as hysterical or psychosomatic.

This group of pathological disorders includes diseases such as:

• bronchial asthma;
• allergy;
• imaginary pregnancy;
• headache;
• migraine;
• intervertebral hernia;
• irritable bowel syndrome;
• essential arterial hypertension;
• tension headache;
• panic attacks;
• dizziness.

A person will not be able to avoid the development of such diseases if he does not solve the problem that is the cause of the pathological deviation, but simply ignores it.

Repressing problems does not lead to their disappearance, but helps to transfer them to another level. All ignored problems move from the social level of interpersonal relationships or psychological to physiological.

The most studied are the psychological problems of the appearance of the following pathologies:

• bronchial asthma;
• irritable bowel syndrome;
• essential arterial hypertension;
• headache;
• dizziness;
• vegetative-vascular dystonia.

Somatic diseases, the occurrence of which is closely related to psychogenic factors, are called psychosomatic disorders.

If a medical examination cannot reveal the physiological or organic causes of the disorder, or if the disease is a manifestation of emotional states, then it is classified as a psychosomatic pathology.

The development of psychosomatic pathological conditions may be the result of problems in relationships, exposure to stress or other non-physiological reasons that are related to external factors or people surrounding the sick person.

The main emotional manifestations on which the psychosomatic theory is based are:

• sadness;
• anger:
• interest;
• feeling of fear;
• joy.

To cure psychosomatic pathologies, various types of psychotherapy and alternative medicine methods are used. During the treatment process, antidepressants and tranquilizers are used in combination with psychotherapeutic methods of influence.

Diagnosis of intervertebral hernia

Regardless of the degree and intensity of clinical manifestations, diagnosis is carried out using several instrumental research methods at once, each of which is aimed not only at confirming the expected diagnosis, but also at distinguishing it from other pathologies with similar symptoms.

Which doctor diagnoses herniated discs?

Before going through the full range of diagnostic procedures, it is important to understand which doctor to see. What kind of doctor deals with issues of this kind?

If you feel painful discomfort in the area of ​​the spinal column, you should first of all go to a therapist, who, based on the complaints heard, will be able to conduct an initial examination and refer the patient for an X-ray examination. Based on the results of the initial diagnosis, the general practitioner will determine which specialist the patient needs to be referred to.

An orthopedist and a neurologist are involved in the diagnosis and treatment of hernial pathologies of the musculoskeletal system. In a situation where surgical intervention is required, a neurosurgeon is additionally involved.

Diagnostic techniques used

The diagnostic procedure is complex and consists of a conversation with a doctor, examination, and a series of specialized tests and studies.

To make a diagnosis, various indicators are taken into account, including:

• patient's posture;
• degree of preservation/impairment of reflexes;
• muscle strength;
• the presence of various kinds of sensations in the upper and lower extremities.
• Among the instrumental research methods, the following are mandatory:
• X-ray examination is an auxiliary method to exclude the possibility of vertebral fracture;
• computed tomography (CT) – thanks to a special operating principle, it allows you to create a three-dimensional model of the patient’s tissues from a series of images, allowing you to carefully examine all the details of interest and assess the current state of the skeleton;
• Magnetic resonance therapy (MRI) – makes it possible to obtain a detailed image of the patient’s internal structure.

Detection and treatment of inguinal hernia in men at the A.N. medical center. Begma

Our medical center provides detailed diagnosis and treatment of inguinal hernia using modern technologies. Clinic specialists carefully study all the details of the pathology and determine the most appropriate treatment method in each individual case.

If you have been diagnosed with an inguinal hernia on the right, do not hesitate with adequate therapy. After all, ignoring the problem can lead to infringement with all the ensuing circumstances, even the most fatal ones. The surgical intervention will be carried out at a high professional level, as carefully and painlessly as possible. You are guaranteed high-quality, qualified post-operative care and rehabilitation.

Leading clinic specialists with many years of experience in the field of surgery are waiting for you to conduct diagnostic procedures, make a diagnosis and carry out competent treatment. You should not expose your life to unjustified danger by putting up with the discomfort that this disease brings - it is necessary to solve problems in a timely manner, without waiting for them to worsen.

Treatment of intervertebral hernia

The issue of treatment is quite complex, but at the same time quite real. Anyone who seeks help in a timely manner and is ready to follow all the instructions of the attending physician can cope with the disease.

The process involves the use of several methods at once, each of which has a certain significance. Let's look at each of them in more detail.

The importance of conservative methods

Conservative methods are applicable at the initial stages of development of the pathological condition, provided there are no severe neurological symptoms, expressed in limb weakness, as well as disruption of the internal organs.

The conservative technique is important, because not only the speed of development of the pathology, but also the success of the patient’s recovery largely depends on its correctness and adequacy of application.

Drug therapy

Taking medications is part of conservative treatment, which is implemented in an individual format for each patient.

As part of the implementation of prescribed therapy, an integrated approach is used, which involves taking various groups of drugs, which include:

• NSAIDs (nonsteroidal anti-inflammatory drugs);
• B vitamins;
• analgesics;
• corticosteroids;
• muscle relaxants;
• chondroprotectors.

Taking into account the peculiarities of the pathogenesis of the disease in question, regardless of the location, it is primarily the structures of the connective (cartilaginous) tissue that suffer. The use of chondroprotectors in this case is especially important and useful, because their use allows you to accelerate regenerative processes and maintain the quality of cartilage. Artracam is considered to be one of the most effective drugs in this group.

Physiotherapy and exercise therapy (therapeutic physical education)

Courses of magnetic therapy, electrophoresis, phonophoresis, ultrasound and other physiotherapeutic methods can increase the effectiveness of drug therapy and help speed up pain relief and recovery after surgery.

In the initial stages of the disease and if the patient’s recovery is successful, it is allowed to perform physiotherapeutic procedures at home.

In addition, exercise therapy also acts as an integral component. An individually selected set of exercises allows you to improve the results achieved and maintain optimal loads on the musculoskeletal system.

Surgical intervention as a key method of treating intervertebral hernia

In a situation where the hernial pathology is at a fairly advanced stage and does not respond to conservative methods, the doctor may decide to remove the growth or decompress the spinal canal using surgical intervention.

As a radical method, the following types of operations can be used:

• laser vaporization;
• intradiscal electrothermal therapy;
• nucleoplasty;
• discectomy;
• microdiscectomy.

Indications for surgery

Direct indications for surgical intervention are:

• severe pain localized in the affected area;
• numbness, tingling sensation in the limbs;
• locally increased sensitivity of the skin;
• disruption of the functioning of internal organs (especially the pelvic organs);
• significant deterioration in quality of life.

Inguinal hernia: surgery

If the disease is not in an acute period, infringement is not observed, then a regular operation is performed according to the schedule. Before surgical intervention, a detailed examination of the patient’s body condition is carried out, existing permanent diseases are treated in order to neutralize possible complications.

Operation methods:

• Hernia repair (hernioplasty) of an operative nature - can be tension or without tissue tension. In the first case, the patient’s own tissues are used, which are pulled over the area of ​​the hernia protrusion, which creates a duplication in this place. In the second case, a synthetic material (composite or polymer mesh) is used for this purpose.
• Laparoscopic method - the hernia is sutured using special micro-instruments and a camera with minimal trauma to nearby tissues.

The surgical intervention occurs in several stages: first, the hernial sac is isolated and separated from the tissues; then the bag is cut and its contents are removed. Then the bag is cut off and the wall is restored using the plastic method; at the final stage, the resulting wound and the hernial orifice are sutured.

An inguinal hernia on the right rarely recurs. The causes of a new pathology may be incorrectly selected treatment methods, non-compliance with the recommended postoperative regimen, constipation or severe cough, infection of the postoperative suture area. Often the cause of recurrent inguinal hernia in men is an adenoma that was not treated before surgery.

Forecasts

In 50% of diagnosed cases, with adequate therapeutic treatment, a significant improvement in the condition is observed already in the first months, which is manifested in the absence of symptoms and a significant increase in quality of life.

In other cases, a longer period of treatment and recovery is required, which can reach six months. It may take up to 2 years until complete recovery (if possible).

A third of registered cases indicate successful completion of treatment after surgery within 5-7 years.

Unfavorable prognosis applies only in a situation where the patient has a neurological deficit that persists even after removal of the hernial formation.

What are the consequences of ignoring the problem?

Incarceration (strangulation of the inguinal hernia) is the most dangerous and very common complication of the pathology. The acute period manifests itself in the form of pain in the groin and abdomen, pain in the hernial bulge, vomiting, weakness, chills, constipation, and the inability to straighten the formation. The symptoms are influenced by which organs are pinched in the hernial sac. If it is the colon, then the pain will be more pronounced. When the omentum is pinched, the pain is not so intense, and vomiting may be completely absent.

If the contents of the hernial bulge become infected and become inflamed, then the patient may develop a fever. The skin covering the hernia turns red and becomes hot to the touch. In this case, emergency hospitalization followed by surgery is necessary. If urgent measures are not taken in case of infringement, then necrosis (necrosis) of the organs present in the bulge occurs.

During an emergency operation to treat an inguinal hernia after cutting the hernial growth, the doctor carefully examines the pinched organs, identifying dead areas. These tissues are removed first, and the ring in which the pinching occurred is dissected. After this, the operational process proceeds as usual.

Summary of Complications

In advanced cases, when the patient for some reason did not seek professional medical help or chose to refuse treatment, the following complications may occur:

• radicular syndrome - occurs when the formed hernia has a negative effect on the adjacent spinal nerve. As usual, it has a staged development (from mild irritation to complete loss of nerve functionality);
• discogenic myelopathy - is formed when the spinal canal is narrowed by a herniation and compression of the spinal cord. Has a direct effect on motor function;
• vertebral artery syndrome - observed in a situation where a hernia localized in the cervical spine puts pressure on the vertebral artery. The key manifestation is systematic dizziness, tinnitus and even fainting.

You can avoid all this only by monitoring your own health and taking timely measures to treat various types of ailments, especially those related to the musculoskeletal system.

What is neck pain

The neck performs many vital functions. It connects the head to the body. The cervical vertebrae and muscles are designed to provide the head with the greatest mobility. Between the vertebrae there are discs, next to which the nerves of the neck pass. The anatomical structure of the neck includes: muscles, arteries, veins, lymphatic vessels and nodes, thyroid gland, esophagus, larynx and trachea. Diseases of these organs and systems can cause pain in the neck and make it a rather vulnerable place.

Neck pain (cervicalgia) is pain of varying nature and intensity that occurs in the cervical region. Neck pain may be accompanied by dizziness, a feeling of numbness in the back of the head or arms, and swelling of the skin. The neck may hurt due to infectious and inflammatory diseases of this area, injuries and degenerative processes in the spine, after a long stay in a forced uncomfortable position.

Psychosomatic causes of umbilical hernia

An umbilical hernia is usually detected in newborns. They say it appears due to the child’s long, heart-rending crying. At the same time, intra-abdominal pressure increases, which is the physical cause of the hernia. What makes a child cry incessantly? Fear. Fear of the outside world, fear of inability to adapt to it, as well as other fears. But how can a newborn have such fear? This fear (like others) can appear in a child on a subconscious level, namely, come from neurotic parents. How?

Let us recall that we wrote that children under 12 years of age are very closely connected with their parents at the energetic level. This means that if something is wrong with the parents (meaning negative things: quarrels, aggression, fears, etc.), then, even if this is not shown to the child, the negative information is read by him unconsciously through the general energy field.

Then the child’s mental health begins to deteriorate (hysterics, whims, stubbornness, disobedience, crying, fears). If the negativity continues for a long time, the child becomes physically ill. This is how the psychosomatics of hernia and other diseases of children manifest themselves.

If we are talking about an umbilical hernia in an adult, then remember that the navel “tears” in people who have taken on too much.

Ways to Heal

It turns out (and this is psychologically understandable) that for some reason it is easier for a person to notice other people’s mistakes than to see and analyze his own. And so, instead of sitting down and calmly identifying and considering his internal problems, he begins to look for other people's problems, interfering in someone else's life, and in a negative way.

It turns out to be a vicious circle: a person is pressured by his internal problems - he puts pressure on others with his reproaches and excessive demands. If this other is his child, then the child will have a hernia, because the child cannot bear the exorbitant burden of comments and demands that the parent makes of him.

For clarity, I will give a real example. An elderly couple (retired spouses). She is demanding, emotional, too responsible, burdened with all sorts of responsibilities, living in constant psycho-emotional dissatisfaction in her relationship with her husband. He is a reserved, reserved, stubborn person with a rational approach to life. Both have a hernia: she has an intervertebral (lumbar) hernia, he has an inguinal hernia.

In this case, both suffer. We won’t go into how this happened and who is to blame (although I think that if we are talking about a couple, then both are involved).

We are interested in another question: What to do?

1. These unpleasant consequences can be avoided if a person just has to take care of his inner world and ask himself: What haunts me? What am I afraid of?
2. Having sorted out your inner clutter, sorted your thoughts and emotions, thrown out everything unnecessary and negative from your head and heart, you will suddenly feel peace of mind. And, being in a state of mental comfort yourself, you are unlikely to want to delve into the mistakes of others, and you are unlikely to want to cause mental discomfort to another.

But the problem is that many of us (and especially the previous generation) were not taught how to live in harmony with ourselves, how to maintain inner peace. Therefore, the majority do not even notice their spiritual discomfort: from morning to night they are fussing, busy with something, but not with their soul. Hence inside: chronic dissatisfaction, irritability, aggression, all kinds of fears and other negativity. And all this pours out every day on loved ones and not only: on your spouse, children, neighbors, passers-by and the entire world around you.

1. Let's remember that the World is structured in such a way that if you send something into the World, it comes back to you: if you send negativity to others, you receive it back through completely different people. You send Joy and Love, you receive Joy and Love. The world is simply returning your package to you.

The question arises: What do you want to get?

I choose Joy, Love and Health. I wish the same for you.

Hernia: psychological reasons

Louise Hay about the psychosomatics of hernia

Louise Hay sees the reason for the formation of a hernia in a person’s inability (or unwillingness) to be himself, in the lack of his creative realization in life.

In addition, the occurrence of a hernia may be associated with an event in a person’s life, such as a break in relationships in the family or at work.

Excessive tension, strain both in the physical and psycho-emotional spheres, as well as a state of depression are sure “causal” companions of a hernia.

Healing Affirmations:

I'm a creative person. I easily realize my talent and my abilities. I have every right to be myself. I have good, kind and harmonious thoughts.

Psychology of diseases: Hernia

HERNIA - (Louise Hay)

Broken relationships.
Tension, depression, inability to express oneself creatively. A Possible Solution to Promote Healing

I have positive and harmonious thoughts. I have talent and intelligence. And I can be myself.

HERNIA - (V. Zhikarentsev)

Load, burden, burden, tension. Incorrect creative expression.

A Possible Solution to Promote Healing

My mind is soft, kind, harmonious. I love and approve of myself. I'm free (free) to be myself.

HERNIA - (Liz Burbo)

A hernia is a release of an internal organ or part of it beyond the cavity in which it is normally located. A hernia usually occurs in the lower part of the body.

Anyone who feels driven into a corner suffers from a hernia. He wants to get out of the current situation with the help of some drastic action, a break, but he is stopped by the fear of material troubles.

Instead of feeling trapped in an unwanted situation, think carefully about what you really need. Understand that only your inner attitude prevents you from finding a way out of an unpleasant situation and makes you believe that you are not capable of doing it. Your body is telling you that you have what it takes to get out of this situation. Move gradually, step by step, and you will succeed.

HERNIA - (Guru Ar Santem)

Often people develop a hernia after purchasing a summer house. Finally, you can accumulate some valuables, and in addition to valuables, all the old, unnecessary trash is also piled up at the dacha. If pride is also involved, then the owner’s thoughts take on the following character: “Now I have a lot of things. I will have more than my neighbors! Relatives will come - “I’ll show them how to live, let them envy, etc.” All this can live in a person’s subconscious, and energy obeys subconscious impulses.

There is a specific case of a hernia. In one family, the father earned a lot, ran a lot of business, and a lot of valuables accumulated in the house. The owner himself took this quite calmly, but the son was proud of his father and the security of the whole family. A poor neighbor came to visit, not dressed well. And it was his son who began to look down on him, as if he were “unfinished,” showing pride. The neighbor was offended, sensing the attitude of the owner’s son, although there was no talk about this in words - they were talking about completely different topics. My son developed a hernia, and then his child too, because... the child lived on dad's energy.