Spinal hernia (lumbar, cervical hernia): causes, symptoms, treatment

The intervertebral disc is a round formation, in the center of which there is a nucleus pulposus of a gel-like consistency, and at the periphery there is a dense fibrous ring. These anatomical formations are necessary to give the spine flexibility, shock absorption and even distribution of load during movement. Normally, the disc is clearly located between the bodies of adjacent vertebrae. When exposed to unfavorable factors, it can shrink and become deformed. This condition is called protrusion. A herniated disc is the next stage of the pathological process and is characterized by displacement of the disc and its extension beyond the bodies of adjacent vertebrae.

Reasons for formation

The main reasons for the formation of intervertebral hernia are:

increased load on the disk;
disk power failure;
disc asymmetry due to incorrect position of the overlying and underlying vertebrae.

Most often, a hernia is formed due to osteochondrosis, a disease characterized by degenerative-dystrophic changes in the spine. As a result of this process, the core tissue extends into the area of the annulus fibrosus. The disc ceases to fully perform its functions, and the vertebra, which is located above, shifts in relation to the lower one. The result of dystrophic changes is the formation of a hernia with disruption of the integrity of the fibrous ring and compression of the nerves by the nucleus pulposus, and in severe cases, the spinal cord.

Factors that may contribute to the formation of a herniated disc include:

lifting weights;
constant exposure to vibration;
improperly distributed load on the spinal column during curvature;
obesity;
previous spinal injuries.

The risk of developing intervertebral hernias is higher in people who lead a sedentary lifestyle. Those who subject their bodies to increased physical stress, such as professional athletes, are also at risk.

Types of hernia

There are several classifications of this disease. Depending on where the hernia is located in the spine:

between the cervical vertebrae;
in the thoracic region;
in the lumbosacral area.

In addition, the disease has several stages of development:

protrusion, or “pre-herniation”, in which the disc is strongly compressed; initial deformation of the fibrous ring may be observed, but there is no violation of its integrity;
prolapse – a small local or diffuse protrusion is formed associated with stretching of the fibrous ring;
extrusion – when the integrity of the fibrous ring is broken, and the tissue of the disc core comes out;
sequestration – prolapse of part of the disc into the spinal cord canal. This is the most serious stage of development of a hernia in the intervertebral space. This condition requires urgent surgical intervention.

Doctors distinguish another classification of intervertebral disc herniations based on their location relative to the center of the vertebral body. The direction of the protrusion can be anterior (ventral), posterior (dorsal), posterolateral (media-lateral), or lateral (lateral).

Restrictions on physical activity and sports

Patients suffering from a spinal hernia should follow the following rules when performing physical exercises : avoid fast, hasty movements; do not increase the load, even if signs of improvement appear.

Pay attention to what types of physical activity are contraindicated for a hernia. The following restrictions are also necessary when engaging in physical activity:

blows;
jumping;
pushes in the back;
twisting the torso;
a strong increase in the load on the spine;
sudden movements.

Among sports, restrictions should be introduced on the following types : bodybuilding, power squats, deadlifts and lunges, running and jumping competitions.

When engaging in other sports permitted by the attending physician, preliminary warming up of the muscles and wearing a special corset is required.

At what stage should you not exercise?

In general, experts believe that patients who have been diagnosed with a herniated disc can engage in certain sports. It is important that classes are carried out exclusively during periods of remission, provided that the patient’s history does not contain concomitant pathologies, which may also be contraindications to exercise.

When engaging in gentle sports, they will have a beneficial effect on the body for reasons:

uniform distribution of loads on all muscle groups, providing a mild training effect on the affected area;
improving blood circulation and enhancing metabolic processes in tissues, which will launch restoration processes in all systems of the body;
relaxing spasmodic back muscles when performing slow, stretching exercises, concentrating breathing, helping to return the vertebrae to their original position;
the formation of positive mental attitudes that, as a rule, accompany the process of training the muscular system.

What types of exercises are contraindicated for a hernia?

When performing a set of exercises, patients suffering from a herniated disc should avoid the following types of exercises:

deep body tilts, the angle of which is more than 90%;
twisting, especially around the central axis of the spine;
movements in which only the back muscles are involved;
jumping elements;
running and high leg swings.

Video: “Advice from Koklyaev: what to do in case of herniated discs?”

Symptoms of the disease

A hernia in the spine is one of the most serious manifestations of osteochondrosis. Disc displacement is most often observed in people over 40 years of age, although this process can begin much earlier. An intervertebral hernia is dangerous because if it occurs, the patient may lose ability to work for a long time and even become disabled.

Typically, a disc herniation takes several years to form. From the moment the disk finds itself in a compressed and skewed state. However, until the nerve is pinched, it does not manifest itself in any way. At the same time, an osteopathic doctor can determine which discs are in the “risk zone”, and most importantly, identify and eliminate the cause of misalignment and overload of the discs.

The very first and main symptom of the disease is pain, which appears due to the fact that the disc moves back or to the side and compresses the nerve. The result is inflammation and swelling. Irritation of the nerve leads to a reflex muscle spasm in the damaged area. The muscles compress the disc, further disrupting its nutrition, which causes even more inflammation and swelling. The circle closes. The localization of pain and the appearance of other characteristic symptoms is determined by the part of the spine in which the disc herniation occurs.

Manifestations of the disease in the lumbosacral region

Symptoms of a lumbar disc herniation are the most common, as this location of disc displacement is the most common. This trend is explained by increased load on the lower back in combination with:

weakening of the posterior longitudinal ligament at the level of the lower lumbar discs;
typical loading from the front of the body, often in a tilted position, which leads to compression of the anterior part of the disc and extrusion of the nucleus pulposus posteriorly.

In addition, the frequency of vertebral hernia formation in this area is associated with anatomical features: the distance between the vertebrae here is greater than in other departments.

The following stages of disease development are distinguished:

First, pain occurs in the lower back, which indicates the beginning of the degenerative process. Its intensity may vary. Usually, a dull pain initially appears, which intensifies with physical activity and goes away during rest. Over time, the severity of pain increases. Sometimes the first manifestation of a disc herniation can be very severe pain in the lower back, which sharply deprives a person of the ability to move independently. However, often the first stage passes unnoticed, without obvious manifestations.
At the second stage, the nature of the manifestations changes. A herniated disc causes compression of the spinal cord roots, which send nerves to the lower part of the body. Severe pain occurs, which can be localized in the buttock, go along the side or back of the leg, moving to the toes, and can be constant or transient. In this case, pain in the lumbar region may subside or disappear altogether.

With a hernia of the lumbar spine, autonomic disorders are observed along the nerves: a decrease in local temperature and an increase in dry skin. In addition, patients often occupy a fixed position and cannot fully bend and straighten their back due to muscle tension.

Sometimes the patient is unable to straighten his leg due to severe pain. In advanced cases, paresis (weakness, limited mobility) or paralysis (complete immobilization) of the lower limb on one or both sides may be observed. Another possible sign of a lumbar intervertebral hernia is muscle atrophy, which is externally manifested by “thinning” of the leg.

In neurological terms, in the early stages of the disease there are symptoms of irritation, and in later stages there are signs of loss of function. If left untreated, the functioning of the pelvic organs may be disrupted: urinary and stool incontinence and loss of sensation in the genital organs may develop.

Symptoms in the cervical region

There are three main groups of signs of intervertebral hernia of the cervical spine:

Pain syndrome, which includes neck pain and limitation of movement. The most characteristic is considered to be pain spreading to the shoulder girdle, one- or two-sided. Patients are forced to keep their neck in a fixed position, due to which reflex torticollis is formed. Also, pain syndrome is usually accompanied by spasm of the neck muscles.
Radicular syndrome is compression of a root or spinal nerve. In the early stages of the disease, patients note numbness and a crawling sensation in the area innervated by the affected bundle. The pain that occurs with compression spreads to the scapula, shoulder, forearm and hand, and intensifies with movement. In addition, there may be weakness and atrophy of the muscles of one or both upper extremities, a significant decrease or complete loss of tactile, pain and temperature sensitivity.
Cervical myelopathy - develops when the spinal cord is compressed by a deformed disc. This process is accompanied by symptoms of intervertebral hernia such as headache and dizziness, visual disturbances, tinnitus and hearing loss. In advanced cases, pressure on the spinal cord in the neck can lead to the formation of paralysis of the upper and lower extremities, disruption of the functioning of internal organs, and changes in sensitivity below the level of the lesion.

In addition, the signs of a cervical disc herniation may vary depending on the level of the lesion. With pathology of the disc between the C4 and C5 vertebrae, weakness of the shoulder girdle muscles and pain that spreads to the shoulder will predominate. A hernia at the C5-C6 level leads to decreased biceps strength, as well as a feeling of numbness and crawling in the thumb area. A lesion in the C6-C7 region causes triceps weakness and pain that travels down the back of the upper limb to the middle finger. Finally, with a C7-Th1 hernia, the patient finds it difficult to clench a fist and notes painful sensations that radiate to the little finger.

Consequences of severe overloads during spinal hernia

In the absence of sufficient attention to the well-being and sensations in the back caused by irritation of the nerve endings during the progression of the intervertebral hernia, the patient’s condition can sharply worsen, causing such negative signs as :

numbness;
paralysis of the limbs, especially the lower ones;
painful spasms in the muscles of the legs and buttocks;
progression of other concomitant pathologies of the spine, for example, with damage to the lumbar region, the development of radiculitis cannot be ruled out;
dysfunction of the nervous system.

To understand what complications of disc protrusion can lead to, it is necessary to study which zone of sensitivity each part of the spine is responsible for.

The fact that the development of pathology does not occur according to the best scenario will be indicated by the appearance of pain of an acute, aching nature, a state of discomfort, difficulties when trying to make a turn or straighten the body.

Diagnostics

A doctor can suspect the presence of an intervertebral hernia based on characteristic symptoms. However, pronounced manifestations of the disease are observed even when the process is far advanced. In the initial stages, it is almost impossible to detect pathology without special diagnostic methods.

CT and MRI help to identify a vertebral hernia and determine the tactics of its treatment. Magnetic resonance therapy is more informative, since it allows one to obtain better images of soft tissues, and due to this, the doctor can assess not only the stage of the disease, but also the degree of compression of the spinal cord and its roots.

If a patient exhibits symptoms of a herniated disc in the cervical spine with signs of circulatory disorders in the vertebral artery, vascular studies may also be used. These include vascular MRI, vascular ultrasound (duplex, triplex) and rheoencephalography.

INTERVERTEBRAL HERNIA OF THE LUMBAR REGION: TREATMENT

If you experience any pain in the lower back, you should see a neurologist or vertebrologist. You will need to undergo an X-ray or MRI.

The cost of removing a herniated disc using the DRX robot is comparable to the cost of a surgical operation. However, it will be incomparably cheaper in terms of the risks to which the patient is exposed, often at an advanced age, under anesthesia and complex surgical intervention.

The course of treatment is determined individually, depending on the complexity of the pathology, on average 10-20 sessions. For non-residents and patients with restrictions in independent movement, accommodation is provided in a comfortable ward on the territory of the medical center in the branches of the city of Chelyabinsk and Kazan. However, treatment can also be done on an outpatient basis.

It is important that the author’s treatment regimen for intervertebral hernia is aimed specifically at eliminating the cause of the disease, while the operation eliminates its consequences. Most often, a year or two passes after the operation, and the hernia appears again.

Throughout the progressive world, neurologists have long abandoned surgical treatment for spinal hernia, and the doctor risks losing his license if he prescribes surgery before being convinced of the effectiveness of other methods of removing the hernia.

At the Doctor OST medical center, they consider the main goal not to relieve pain or even remove a hernia, but to provide a comprehensive healing effect on the musculoskeletal system. For this purpose, a whole team of specialists is involved, and in addition to spinal traction using special devices DRX-9000 and Elite Track, complex treatment is prescribed, for example:

VTES;
HILT laser;
magnet;
acupuncture;
reflexology with catgut to combat excess weight;
massage, exercise therapy, manual therapy;
UVT.

In 96% of cases, a hernia - even a large and old one - disappears on its own, which is clearly visible on MRI images. Why? Because all the conditions for this have been created: the position of the vertebrae has been restored, space has been freed up for the intervertebral disc, its nutrition has been normalized, inflammation and swelling have been stopped, and the deficiency of cartilage tissue has been restored. How to do it? Medical neurologists know and are better than others.

Treatment at Doctor Simkin's Clinic

How to cure a vertebral hernia? How to prevent the development of severe complications and surgical intervention? The answer is simple: the earlier the disease is detected, the greater the effect of conservative treatment of a spinal hernia.

Make an appointment Biketova Alexandra Viktorovna Osteopathic doctor Specializes in the diagnosis and treatment of pain syndromes in the cervical, thoracic, lumbar spine, chest, shoulder girdle and pelvic area, in the joints of the arms, legs, pain in the foot and heel area, numbness or swelling of the extremities, pain syndromes after operations and injuries of various ages, dysfunction of internal organs with and without pain syndrome. Consultation from 2000 rub.

Osteopathic doctors at Dr. Simkin’s clinic have experience in treating this disease. As mentioned earlier, disc deformation can occur for various reasons. A qualified osteopath can find the true source of the problem and provide treatment for a herniated disc without surgery.

It is best to contact our clinic as planned, without waiting for a disc herniation to appear. Those people who have already developed back pain characteristic of osteochondrosis need prompt help from an osteopath. Our specialists guarantee an individual approach to each patient, since no two cases of the disease are the same. Before treating an intervertebral hernia, the doctor questions the patient in detail about what injuries and illnesses he suffered during his life, when he first felt back pain, what treatment he uses, etc. If the patient has the results of instrumental studies, there will be no It would be superfluous to take them to the appointment.

Before treating a spinal hernia, the osteopath performs a special diagnosis, during which the specialist evaluates the functioning of the body as a whole. The fact is that the root cause of the progression of osteochondrosis and the formation of disc pathology may be hidden in processes such as damage to connective tissue and local circulatory disorders, which can be located in any part of the body as a result of a previous injury or surgery. As a result, spasm of the back muscles, displacement of the vertebrae, misalignment of the discs, etc. occurs. Such provoking factors are identified at the diagnostic stage.

Further, in the process of treating intervertebral hernia, our clinic’s specialists, using gentle osteopathic techniques, eliminate the cause of the disease. Osteopaths treat using their hands. By correcting changes in tissues in the area of primary traumatic disorders, and then, coping with local edema and stagnation of blood in the area of a displaced vertebra, and a disc clamped in a distorted state, acting in a complex manner, they are able to restore harmony to the functioning of the whole organism and prevent signs of a spinal hernia from appearing .

An integrated approach can achieve good results. The combination of osteopathic methods and the work of related specialists (neurologists, gymnastics instructors) in the treatment makes it possible to provide quick and effective assistance to patients with a herniated disc.

Unfortunately, in advanced cases, the disease is treated surgically. We are talking about those situations where severe deformation or destruction of the disc has occurred, and the symptoms of a spinal hernia are so severe that the patient faces disability. Today it is possible to perform an operation using an operating microscope or using endoscopic technology. This is safer for the patient than before, but it is still better not to delay contacting a doctor and to treat intervertebral hernias without surgery.

Rehabilitation after surgery

Recovery after surgery should occur under the close supervision of a specialist. This process usually lasts about 3 months. Proper rehabilitation after surgical treatment of a spinal hernia ensures rapid pain relief, prevents the development of postoperative complications, and helps restore a person’s motor activity.

During the first 2 weeks, wearing a corset, light exercise in bed, and breathing exercises are recommended. Next, the patient is prescribed osteopathic treatment, a special complex of physical therapy, as well as physiotherapeutic methods.

It is important to include osteopathic sessions in the rehabilitation plan after surgical treatment of a serious intervertebral hernia. Osteopaths will help improve blood flow and the condition of soft tissues damaged as a result of the intervention area, as well as restore body functions previously impaired as a result of the disease.

Treatment

At the First Medical Clinic, treatment of lumbar hernia is carried out using effective non-surgical methods:

drug blockades;
local injection therapy (administration of muscle relaxants, painkillers, anti-inflammatory and other drugs);
method of spinal reconstruction - introducing into the affected disc a complex of medicinal substances that promote tissue regeneration;
treatment with Karipazim;
autoplasmotherapy;
administration of hyaluronic acid preparations (“liquid implant”) and/or chondroprotectors;
osteopathy and manual therapy;
shock wave therapy;
reflexology;
transcutaneous electrical neurostimulation , etc.

The required amount of therapeutic assistance can only be determined by a specialist after diagnostic procedures. If signs of a lumbar hernia appear, we recommend that you contact the First Medical Clinic in a timely manner.

You can make an appointment for a consultation and appointment by phone

Prevention

In order to avoid the formation of a spinal hernia, it is necessary to take up the prevention of postural disorders from childhood. Here are a few tips to help keep your spine healthy:

Performing regular gymnastics to strengthen the back muscles (avoiding jumping and sudden swings).
Frequent walking in comfortable shoes.
It is important to visit an osteopathic doctor for preventive purposes, who will work not only with the spine, but with the entire body as a whole. This will help reduce the risk of diseases of the spine and joints and increase the lifespan of the body.
Using a comfortable orthopedic mattress and pillow.
Avoid lifting excessive weights. If you need to carry a load, it is better to distribute it evenly in your left and right hands. And entrust the lifting and moving of cargo to specially trained people - in the end it will cost you significantly less.

People who already have osteochondrosis, a disc herniation, or so far only a protrusion, need to take even more careful care of their health. Moderate physical activity is extremely important, but vigorous exercise should still be avoided. Patients diagnosed with osteochondrosis are advised to periodically undergo MRI of the spine. Thus, an intervertebral hernia can be detected at an early stage and a conservative treatment method can be selected for it, that is, without surgery.

Conservative treatment

If the disease is detected at the stage of protrusion or slight protrusion in the absence of a pronounced neurological deficit, patients are prescribed conservative therapy. In such situations, it is highly effective and allows you to avoid surgery.

As part of conservative treatment, patients are prescribed:

drug therapy;
physiotherapy;
exercise therapy;
manual therapy.

Thanks to full compliance with medical recommendations, many patients with small hernias of the lumbosacral spine manage to achieve significant remission and improvement in their general condition.

Drug therapy

All patients, without exception, are prescribed a number of medications, but which specific ones will be prescribed depends on the characteristics of the patient’s condition and the presence of concomitant diseases. In general, drug therapy is aimed at eliminating pain, inflammation and improving the condition of intervertebral discs. For these purposes the following are used:

NSAIDs – have analgesic and anti-inflammatory properties;
corticosteroids – have a powerful anti-inflammatory effect, prescribed in short courses;
muscle relaxants – have a relaxing effect on muscles spasmed as a result of acute inflammation;
psychotropic drugs – increase the effectiveness of anti-inflammatory therapy and have a positive effect on the psycho-emotional state;
chondroprotectors – saturate the tissues of the intervertebral disc with the compounds necessary for its restoration;
B vitamins - used to improve the quality of nerve impulses.

For very severe pain, patients can undergo novocaine blockades. They involve the introduction of solutions of anesthetics and corticosteroids into the paravertebral region, which allows almost instantaneous relief of even very severe pain. But blockades can only be performed in medical institutions under sterile conditions by specially trained medical personnel. Otherwise, there is a high risk of complications.

Physiotherapy

Physiotherapeutic procedures help reduce the severity of pain, increase muscle tone of the limbs and normalize nerve conduction. For these purposes, patients are prescribed:

electrophoresis;
magnetic therapy;
diadynamic currents;
kinesitherapy;
reflexology.

Traction therapy gives good results. The procedure involves traction of the spine using a special apparatus. As a result, it is possible to increase the distance between the vertebral bodies, free the spinal roots and create optimal conditions for the restoration of intervertebral discs. After traction of the spinal-sacral region, you must remain lying down for at least 1–2 hours, and then to consolidate the result, you should wear an orthopedic corset.

Exercise therapy

In conservative therapy, great importance is given to physical therapy. An individually selected set of exercises helps strengthen the muscles that provide support for the spine. With their help, it is possible to reduce the severity of pain and achieve stable remission of the disease. When performing specially selected exercises, it is possible to eliminate compression of the nerves and

But all exercises should be performed slowly, smoothly, without sudden movements. The load can be increased gradually and only after obtaining permission from the attending physician. Therapeutic gymnastics should be done daily. This must become a way of life, otherwise it will not be possible to achieve significant improvement in the condition.

Manual therapy

Outside the period of exacerbation of the disease, a course of manual therapy sessions is indicated. Using your hands on the spine and back muscles allows you not only to increase blood circulation in the lumbosacral region, but also to relieve the increased tone of the back muscles and thereby improve the quality of nutrition in the affected area.

In addition, special manual therapy techniques make it possible to restore the normal position of the vertebrae and restore the normal distance between them. This allows you to reduce pressure on the intervertebral discs, eliminate their pressure on the nerve roots and is an effective prevention of the progression of the disease.

Diet

Proper nutrition for a herniated disc is an element of complex treatment. The diet therapy method is aimed at maintaining the patient’s well-being and optimal weight.

It is important to choose a diet rich in vitamins and microelements. Food should be varied, you should eat more fresh fruits and vegetables, nuts, fish, and whole grains. A sufficient amount of protein must also be supplied to the body. Glycosaminoglycans, which are part of cartilage tissue and prevent its destruction, are found in products of animal origin: beef, poultry, and sea fish. Therefore, vegetarianism is not recommended for intervertebral hernia.

However, you shouldn’t get carried away with meat dishes, especially fatty, fried and spicy ones. Every person should remember that obesity is one of the factors that provokes the onset and progression of the disease.

So, we talked about how to cure a herniated disc and what the danger is if you ignore this disease. If you experience back pain, you should not rely on painkillers and put off seeing a doctor for a long time, because the key to the success of treatment is its timely start.

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General restrictions for spinal hernia

At the first stage of treatment, the doctor sets the goal to exclude further development of the inflammatory process and reduce the severity of the painful syndrome. Therefore, one of the most important rules during this period is the maximum restriction of movements in the event of acute attacks . Only this will help prevent further displacement of the spinal discs.

If the hernia is in the acute phase, then it is necessary to lead a sedentary lifestyle. For this reason, the main contraindications for this disease include:

refusal to perform active movements;
maintaining a healthy diet and switching to the right diet to avoid the danger of gaining excess weight, thereby increasing the load on the spine;
Avoid exposure to drafts and hypothermia;
do not use warming ointments, especially during the acute phase of the pathology;
do not get carried away with home treatment methods, carefully follow the doctor’s recommendations;
Do not use potent medications without the prescription of a specialist.

In addition, the following actions should be excluded:

lifting and carrying heavy objects, as well as increasing any other load on the back;
lifting weights with outstretched arms;
prolonged stay in a bent position;
bends;
sitting in one place for a long time;
running, jumping, cycling;
any sudden movements, turns of the body and head, especially from an inclined position.

It is best that restrictions for a hernia are introduced immediately after the diagnosis is clarified . This will significantly alleviate the patient’s condition and prevent further progression of the disease.

General absolute contraindications

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Next fact

A patient who has been diagnosed with a herniated disc should avoid the following actions , which may have a negative impact on well-being and provoke an acceleration of the development of pathology:

warming up the spinal area at the site of the hernia, as well as any steaming, for example, in a bath or sauna - despite a slight reduction in pain during such procedures, the overall condition of the pathology will only worsen;
avoid hypothermia, being in drafts, which can cause muscle spasms;
do not rub or knead the hernia in any way;
avoid blows;
Intensified vertical stretching of the spinal column, for example, hanging on a bar, which, due to increased muscle overload, will cause a reverse reaction, is prohibited;
during exacerbations, massage is prohibited, which can increase tissue swelling;
painkillers can be used only in cases of extreme necessity;
smoking is highly discouraged for patients suffering from a hernia due to the destruction of the cartilage tissue of the discs from the action of nicotine due to a decrease in the amount of oxygen in the blood and deterioration in the nutrition of the intervertebral discs;
Frequent consumption of coffee also worsens blood circulation in tissues;
Obesity significantly increases the load on the spine, so weight gain is extremely contraindicated;
it is necessary to avoid situations of conflicts and stress, because a depressive state does not have the best effect on the condition of the muscles, in which spasm and soreness intensify;
Women should avoid wearing high heels.

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