Intervertebral hernia of the lumbosacral region. Intervertebral hernia of the lumbar region - how to treat. Exercises for the lumbar spine

Hernia lumbar region spine - protrusion of the central part of the intervertebral disc (nucleus pulposus) to the side and back beyond the space between two vertebrae. Most often, hernias are found in the lumbar spine, which experiences maximum stress when sitting, walking and lifting loads.

Causes and risk factors

The cause of the appearance of hernias in the lumbar spine is seen in degenerative-dystrophic changes in the intervertebral discs. Gradual dehydration and thinning of the fibrous ring - the peripheral areas of the intervertebral disc contribute to the protrusion of the nucleus pulposus into vulnerable places. Clinical manifestations intervertebral hernias are usually associated with compression of the spinal nerve roots and blood vessels by the protruding edges of the intervertebral discs. In the most advanced cases The spinal cord is also subject to compression.

Among the factors influencing negative impact on the trophism of the intervertebral discs in the lumbar spine include:

sedentary lifestyle;
excess body weight;
tall height (from 180 cm for men and from 170 cm for women);
unbalanced mode of physical activity ( long periods immobility are replaced by intense loads);
lumbar spine injuries;
congenital hip dysplasia;
poor posture and persistent spinal deformities;
heavy physical labor associated with lifting heavy objects and staying in a bent position for a long time;
professional sports;
sudden lifting of heavy loads with insufficient preparation;
improper performance of exercises with weights;
endocrine disorders and metabolic pathologies;
hereditary predisposition.

Stages

The formation of a herniated intervertebral disc is preceded by a slight displacement of the nucleus pulposus to the periphery without damage to the fibrous ring. At this stage, the process of hernia formation can be stopped with the help of therapeutic exercises and others preventive measures, however, due to the absence of complaints, the initial stage of intervertebral disc degeneration is most often discovered by chance. Most patients consult a doctor if there is a formed extrusion.

Uncomplicated lumbar hernias disappear on their own in 80% of cases due to dehydration of damaged tissue within 6–12 months.

The progressive development of a hernia of the lumbar spine goes through four stages.

Protrusion. Partial loss of elasticity of the fibrous ring with displacement of the nucleus pulposus to the side by more than 2-3 mm. Clinical manifestations are usually absent.
Extrusion– partial protrusion of the edges of the intervertebral disc with rupture of the fibrous ring in the thinnest area. Sensory-motor symptoms are observed on the side of the protrusion.
Intervertebral disc prolapse. When a hernia protrudes into the spinal canal, the protruding edges of the nucleus pulposus compress the vertebral bodies, blood vessels and roots peripheral nerves.
Sequestration. The protruding part of the nucleus pulposus penetrates into spinal canal, interfering with normal blood supply to the spinal cord and squeezing soft fabrics. Damage to nerve structures can cause dysfunction pelvic organs and paralysis of the lower half of the body. Allergic conditions caused by a reaction are common immune cells cerebrospinal fluid on foreign tissue of the intervertebral disc.

Symptoms of a hernia of the lumbar spine

The pronounced clinical picture of a hernia of the lumbar spine appears mainly at the extrusion stage. The most common complaint is severe pain in the right or left leg, covering the inner thigh and radiating to the buttock. Depending on the size and location of the hernia, pain may extend from the hip to the heel and the back of the foot. The pain is sharp, burning in nature and intensifies when coughing, sneezing, sitting for long periods of time, sudden movements, driving on uneven terrain, trying to bend forward or roll over to the other side. Often, several weeks before the onset of pain, patients experience moderate discomfort in the lower back.

If the hernia affects the dorsal roots of the spinal nerves, painful sensations unilateral sensory disturbances in the leg, lower back or perineum are added. Patients may complain of chills, burning, tingling, numbness, or goosebumps. Impaired nerve conduction due to weakening or compensatory muscle tension leads to limited mobility of the lumbar region. Patients have difficulty going up and down stairs, squatting, jumping and bending while keeping their legs straight; gait becomes unsteady and unbalanced. Patients often take forced postures, stoop and shift their body weight to one limb; when looking at the bare back, protruding psoas muscles On the one side.

Indirect symptoms of a hernia of the lumbar spine indicate insufficient blood supply and atrophic phenomena. One leg may be thinner, cooler, or paler than the other; There is also less hair on the body on the side of the hernia.

When the spinal cord is pinched, the pain spreads to both legs and is accompanied by disruption of the nervous regulation of the pelvic organs. Patients experience frequent urge to urinate, urinary and fecal incontinence, diarrhea or constipation; women may be concerned about gynecological disorders, and men may have problems with potency.

The most common complications of hernias of the lumbar spine are progressive atrophy of the nerve roots, etc. cauda equina syndrome, which occurs when the spinal canal is completely blocked and several nerves are simultaneously pinched.

Diagnostics

A preliminary diagnosis is made by a neurologist based on anamnesis, clinical picture and physical examination. To identify paresthesias and biomechanical disorders characteristic of spinal compression syndromes, standard diagnostic procedures have been developed:

study of tendon reflexes of the lower extremities;
functional test with straight leg raise;
measuring muscle strength and tone;
determination of pain, temperature and vibration sensitivity of the legs, buttocks, perineum and lower abdomen.

External manifestations of compression of the nerve roots and spinal cord allow us to judge the size and localization of the pathology, but do not have sufficient specificity for diagnosing a hernia of the lumbar spine. Inflammation of the nerve roots or oncopathology can manifest themselves in a similar way, so the decisive word in the diagnosis of intervertebral hernias belongs to instrumental soft tissue imaging techniques - MRI and CT. If spinal cord injury is suspected, contrast myelography is prescribed.

Most often, hernias are found in the lumbar spine, which experiences maximum stress when sitting, walking and lifting loads.

Treatment of hernia of the lumbar spine

In the absence of complications, treatment of small intervertebral hernias is reduced to pain relief and activation of blood circulation in adjacent tissues. To remove acute pain A short course of painkillers and/or non-steroidal anti-inflammatory drugs is usually sufficient. If the response to drug therapy is poor, X-ray-controlled blockade of the damaged nerve roots may be performed. Muscle relaxants are used to eliminate muscle spasms. For the first 3-5 days after the onset of an exacerbation, the patient must observe bed rest with lumbar immobilization. It is recommended to lie on your back with a soft cushion under your lower back.

After cupping pain syndrome Exercise therapy, kinesiotherapy and post-isometric relaxation are indicated to help restore soft tissue trophism and form a muscle corset to support the spine. At first, all exercises for a hernia of the lumbar spine are performed in a lying position or standing on all fours. You should start by lifting, abducting and bringing your legs bent at the knees, and after 3-4 weeks of regular exercise, you can exercise at the wall bars, with a ball or with gymnastic sticks. A visit to the swimming pool is also recommended.

If the effectiveness of conservative treatment is low and complications occur, surgical intervention is considered. The least traumatic method of surgical treatment of intervertebral hernias is microdiscectomy - removal of the nucleus pulposus through a puncture using a thin endoscopic manipulator and replacement of destroyed tissue with a special substance. In some cases, the disc is completely removed and an endoprosthesis is installed in its place. Massage and manual therapy can be indicated only in the presence of subluxations of the vertebral joints. Therapeutic effect acupuncture, heat therapy and UHF therapy for herniated intervertebral discs have not been proven.

Possible complications of a herniated lumbar spine

The most common complications of hernias of the lumbar spine are progressive atrophy of the nerve roots, etc. cauda equina syndrome, which occurs when the spinal canal is completely blocked and several nerves are simultaneously pinched. In such cases, to prevent paralysis, it is indicated emergency surgery within 24 hours of the onset of signs of severe neurological deficits, such as weakness of the knees and feet, numbness of the legs and perineum, loss of urinary and bowel control.

Forecast

Uncomplicated lumbar hernias disappear on their own in 80% of cases due to dehydration of damaged tissue within 6–12 months. Adequate treatment started at an early stage greatly increases the likelihood of a complete cure.

With prolonged compression of the roots of peripheral nerves and the spinal cord, irreversible damage to nerve structures occurs with promising total loss mobility and ability to self-care. For this reason, lumbar hernias, even with an asymptomatic course, require constant medical monitoring and monitoring of the dynamics of the process.

Prevention

To prevent intervertebral hernias, it is important to maintain physical activity, monitor weight and posture, give up bad habits and promptly seek treatment. medical care in case of spinal injury. It is recommended to eat enough protein and B vitamins. When working sedentarily, it is useful to take breaks for industrial exercises every 2-3 hours.

Video from YouTube on the topic of the article:

A lumbar spinal hernia is a lipoma, the site of which is the intervertebral disc. The disease can occur in people of different genders and ages. A lumbar hernia, the symptoms of which can be varied, requires the use of drug treatment. To enhance its effect, you can use traditional medicine, gymnastics, massage, etc. The choice of a specific treatment method directly depends on the characteristics of the disease.

Symptoms of the disease

Lumbar spinal hernia is characterized by the presence of a huge number of symptoms. On initial stages Symptoms of the disease may be completely absent or manifest as discomfort. For more late stages disease symptoms become pronounced. Manifestations of a hernia include:

In most cases, pain is observed with a hernia of the lumbar spine. The pain increases when the patient moves his torso. Some patients complain of soreness in the buttocks and legs. The disease can also manifest as shooting pain that radiates to the legs.
When examining a patient, doctors discover swelling in the area where the hernia appears;

Sometimes, as a result of the development of the disease, disability may develop and the inability to move independently.

A hernia of the lumbar spine in most cases is accompanied by general weakness;
During development of this disease most patients complain of loss of sensation in the legs;
If the hernia protrudes inward, this in most cases leads to intervertebral hernia;
A hernia of the lumbar spine is very often accompanied by numbness in the lumbar region;

There are often cases when, in the later stages of the disease, the functioning of organs located near the hernia may be disrupted.

When the nerve endings are damaged by a hernia, patients experience unpleasant tingling sensations;
With the development of this disease, numbness is observed in the lumbar region;
Also, this disease may be accompanied by weakness in the legs;
With a hernia of the lumbar spine, the performance of the pelvic organs is significantly reduced;
When this disease appears in patients, the Achilles reflex decreases.

Important! A hernia of the lumbar spine is characterized by the presence large quantity symptoms. When the first symptoms appear, the patient needs to mandatory seek help from a doctor.

Main causes of the disease

A hernia of the lumbar spine can occur in patients for a variety of reasons:

the disease is most often diagnosed in patients who are susceptible to frequent physical activity;
if the patient intervertebral discs located on high altitude, then this can lead to a hernia;
The cause of this disease may be the special structure of the vertebrae;
if the patient sharply tilts and turns the body at the same time, this can lead to the appearance of an intervertebral hernia;
with strong physical stress on the spine, a hernia of the lumbar spine can also occur;
in the case where the longitudinal ligament is sufficiently narrow and weak, this can lead to the occurrence of the disease.

There are many reasons for the appearance of a hernia of the lumbar spine. That is why the patient needs to be as attentive to his health as possible and limit exposure to negative factors on your body.

Features of drug treatment at home

In most cases, treatment of intervertebral herniation of the lumbar spine is carried out with medications. With the help of medications, pain in the lumbar region is eliminated, and the severity of the inflammatory process is reduced. If the disease is treated in the early stages, then in most cases it can be eliminated. This requires the use of complex therapy.

Important! Before starting treatment with medications at home, it is extremely important to consult a qualified specialist.

Painkillers

These medications are prescribed to alleviate the patient's condition. With their help, pain is temporarily eliminated for a short time. Depending on the components of medications, they can be narcotic or non-narcotic. If the patient’s pain intensity is low, then he is prescribed non-narcotic medications. The most commonly prescribed medications are analgin and paracetamol. They can be used in pure form or as part of other medications. These medications are characterized by a short-term effect, which requires the use of a regimen for their administration. Narcotic drugs are characterized by a longer lasting effect. They should be taken only on the recommendation of a doctor.

Chondroprotectors

These drugs are intended to relieve or completely eliminate degenerative processes. When taking medications, cartilage tissue is nourished and the possibility of its destruction is eliminated. To obtain a positive effect, medications must be taken for a long period. These medications are taken according to a specific schedule for 2-3 months. When a hernia of the lumbar spine occurs, patients are in most cases prescribed Dona, Alflutop, and Strutum. To ensure a high effect of a particular drug on a lumbar hernia, it must be prescribed by a specialist.

Nonsteroidal anti-inflammatory drugs

A hernia of the lumbar spine is in most cases accompanied by an inflammatory process. To eliminate it, it is necessary to take non-steroidal anti-inflammatory drugs. In addition to the anti-inflammatory effect, medications in this group are also capable of relieving pain. Nonsteroidal anti-inflammatory drugs can relieve swelling in the lumbar region, which significantly reduces the pressure of the tumor on the nerve fibers. Treatment of lumbar disc herniation can be carried out using medications such as diclofenac, ibuprofen, indomethacin.

Muscle relaxants

When an intervertebral hernia of the lumbar spine occurs, the muscles try to fix the spine in its original position and therefore spasm. In order to eliminate muscle spasms, muscle relaxants are taken. Medicines also have a positive effect on relaxation skeletal muscles. Most often, patients are prescribed mydocalm or methaqualone for intervertebral hernia of the lumbar spine. If the patient regularly takes medications from this group, this will eliminate the possibility of disc displacement in the future.

The release of medicines can be carried out in various forms. That is why they can be used for treatment at home. In this case, the patient must strictly adhere to the doctor’s recommendations.

Traditional medicine in the fight against disease

Treatment of intervertebral hernia of the lumbar spine can be carried out using traditional medicine. They are made from natural ingredients, which allows them to be accepted by absolutely all categories of patients. With the help of folk remedies, you can eliminate pain and also significantly reduce the inflammatory process.

Let's look at a few popular recipes:

Herbal collection

A fairly effective medicine in the fight against the disease is a herbal tincture. To prepare it, you need to take wheatgrass roots, lingonberry leaves, rosehip shoots, meadow lumbago, blueberry shoots, mint, sweet clover, thyme, plantain, kidney knotweed. All these components are crushed and mixed in equal quantities. Pour the mixture with water and simmer in a water bath for half an hour. Next folk remedy infuses for three hours. The patient is advised to take warm medicine. The patient should drink half a glass at a time.

Alcohol tincture

To treat this disease, it is often recommended to use alcohol tinctures. The preparation of the medicine can be made from garlic, mint, birch, St. John's wort, cinquefoil, wormwood, comfrey, sweet clover. In order to prepare a medicine, you need to take any component, grind it and add alcohol. The medicine is infused in a dark and cool place for a week. After this time, you need to take out the tincture and strain. The folk medicine is widely used for rubbing. It must be taken in a small amount, applied to the skin and rubbed until the skin becomes dry. The course of treatment with this drug is ten days. After this time, you can prepare a tincture from another component and undergo treatment again. The tincture is used until the symptoms disappear.

Garlic compress

Garlic has a strong warming and analgesic effect. Therefore, it is widely used to treat lumbar disc herniation. To prepare the medicine, you need to take one head of garlic, peel it and pass it through the garlic worm. You also need to add potatoes to the compress. The raw tuber is cleaned and passed through a meat grinder. Next, the ingredients must be mixed in equal quantities and used to apply a compress. To do this, take a piece of clean tissue, lay out the composition on it and apply it to the area where the hernia appears. The compress should be kept for no more than two hours to avoid skin burns.

Kalanchoe

Everyone knows people's doctor– Kalanchoe flower can also be used to treat hernia. To prepare the medicine, you need to take the leaves of an old plant and pass them through a meat grinder. The resulting pulp must be placed on gauze and applied to the site of the hernia. The compress is secured with a bandage. You need to wrap the hernia with a cotton scarf on top. To enhance the effect of this drug, it is necessary to carry out the procedure at night before bedtime. The course of treatment with this drug is from one to two weeks.

Horse fat

For a hernia of the lumbar spine, it is recommended to apply compresses based on horse fat. If this product is not available, it must be replaced. badger fat. Before using the medicine, horse fat must be cut into thin slices and spread on a piece of cloth. You can also melt it in a water bath and soak gauze in it. The compress must be applied to the site of the hernia. The patient should place polyethylene on top. The lower back is wrapped in a warm scarf. The compress must be changed once a day. The patient should use this medicine for a week.

Turpentine baths

Preparing this bath remedy is quite simple. To do this, you need to take one tablespoon of pre-grated baby soap and completely dissolve in a glass of hot water. The resulting composition is mixed with the same amount of turpentine. It is also necessary to add half a glass of salicylic alcohol to the medicine. During patient acceptance warm bath All this medicine is added to it. Initially, the patient should take a bath for no more than five minutes. The patient is recommended to gradually increase the duration of the procedure. You are allowed to stay in the bathroom for a maximum of half an hour.

Dandelion decoction

Fresh dandelion flowers are characterized by a high effect in the treatment of intervertebral hernia of the lumbar spine. To prepare the medicine, you need to take a handful of flowers of this plant and fill them with two liters of water. Next, you need to boil the medicine for half an hour and add a kilogram of sugar to it. Boil the folk medicine again. The broth must be cooled and strained. It is necessary to take folk medicine three times a day. The patient is recommended to take no more than one tablespoon of the drug at one time.

Traditional medicine is characterized by a high level of effectiveness in the treatment of intervertebral hernia.

Important! Medicines, prepared according to folk recipes, can be taken only after consultation with a doctor.

With the help of traditional medicine, which mainly act locally, it is possible to eliminate painful inflammation and reduce the severity of the inflammatory process. This will have a positive impact on the patient's well-being.

Using gymnastics

In order to enhance the effect of traditional and traditional medicines, gymnastics is used. It consists of performing a set of exercises that have a beneficial effect on the spinal column. With the help of physical therapy, the level of pain and inflammation at the site of hernia formation is significantly reduced, and swelling is also relieved.

Let's look at a few exercises:

This exercise is performed on a chair with a backrest. The patient should sit on a chair and clasp his hands at the back of his head. Next, you need to arch your back so that it presses as tightly as possible against the back of the chair. When performing this exercise, not only the back is arched, but also the chest. After this, the patient bends forward. The lesson must be carried out at the slowest pace possible.
To perform the next exercise, you need to sit on a chair. The patient should extend his arms above his head. Right hand take the wrist of your left hand and tilt your torso in left side. The hand that holds the wrist should resist tilting, which will provide maximum high effect impact.
In order to perform the following exercise, you must use a roller. The patient lies with his back on the floor and places a cushion under his chest. The man's hands are folded behind his head. Patients are raised as slowly as possible with their upper torso.

All these exercises are basic, and therefore they are prescribed to almost all patients diagnosed with a hernia of the lumbar spine.

Important! Despite high efficiency physical training for a hernia of the lumbar spine, the patient must consult a doctor before using a certain complex.

If, when performing a certain exercise, the patient experiences discomfort or pain, then he needs to abandon it. In this case, the patient should consult a doctor who can replace the exercise in accordance with the individual characteristics of the person. Painful exercise can be used as an indicator. It is performed once a week. At the same time, the patient evaluates his condition. This allows us to determine the degree of effectiveness of physical therapy.

Application of massage

Treatment of intervertebral hernia of the lumbar spine should be carried out in a complex manner. An integral part of the treatment course is massage. With the help of such therapy, it is possible to restore the metabolic process in the area of damaged discs due to intervertebral hernia of the lumbar spine.

The objectives of such treatment are:

reduction or complete elimination of pain, which is the main symptom of this disease;
relieving swelling in the lumbar region;
partial elimination of the inflammatory process;
relieving muscle spasms at the site of intervertebral hernia.

Important! It is strictly forbidden to perform massage on your own to avoid complications. At home, the course can be conducted by a specially trained master with a medical education.

Before using massage, the patient must undergo a computer or magnetic resonance imaging scan. These research methods make it possible to determine the location of the lumbar disc hernia.

Initially, the massage is performed at the lowest intensity level. Its increase is made gradually with each subsequent procedure. During therapy, the patient's spine should be as relaxed as possible, which will ensure high effectiveness. The purpose of the massage is to return the fallen nucleus to its place. This treatment method fully combats discomfort and pain in the area of the hernia.

A hernia of the lumbar spine is serious illness which requires timely treatment. In this case, traditional and folk medicine can be used. To enhance their effect, physical therapy, massage and other physiotherapeutic procedures are used. The treatment complex should be prescribed to the patient only by a doctor after diagnosis, which will ensure high effectiveness.

A lumbar intervertebral hernia is a protrusion of the central part of the disc between two vertebrae beyond the space between them. Most often, such a diverticulum is directed towards the spinal canal and compresses the roots of the spinal nerves, but it can also impair blood circulation in the spinal cord itself. The disease causes symptoms in the perineum, legs and pelvic organs.

Treatment is most often conservative, consisting of a complex: medications, exercise therapy, physiotherapy, blockades also help well. Surgical removal of a damaged section of a disk or its entirety is rarely used, as it carries quite high risks. Basically, this happens through the fault of the person himself: either when he comes in late, considering what is happening to his back and legs as “manifestations of age” or “trifle”, or in case of neglect of the rules of treatment, which differs in different periods of the disease.

What is a hernia

The spinal column is a collection of 34 vertebrae connected in pairs by intervertebral discs. It is not straight: from the head to the coccyx it makes several alternating bends: the bend is convex forward - in cervical spine, with a convexity back - in the chest, then in the lumbar region there is a forward bend again, and then the sacrum along with the coccyx bends back. All this is necessary to provide the shock absorption associated with walking on two legs. But this structure also causes the center of gravity to be concentrated in the lumbosacral region. Nature provided for this by making the lumbar vertebrae the thickest and strongest, and the sacral vertebrae completely soldered together.

All vertebrae, except the sacrococcygeal ones, have a special structure. They consist of a cylindrical body, which bears the main load, and processes that provide us with the ability to bend over. different sides, turn, twist. The two parts are connected by two semicircular arches on both sides so that there is a gap in the middle. This is the spinal canal, and it is intended for the spinal cord. The latter is a kind of “checkpoint” of the second rank (after the brain), carrying impulses from the brain to the organs and vice versa.

The peripheral endings of myelon (the so-called spinal cord) are spinal nerves, coming out of it as part of the roots. The anterior roots are motor. They carry commands to the muscles. The dorsal roots are sensitive and, on the contrary, are directed from the organs to the brain. At first, the roots are not divided into anterior-posterior, but only into right-left, emerging laterally from the spinal cord through the hole between the processes of the upper and lower vertebrae. Having passed the bone ring, separation immediately occurs.

Compression of the spinal cord itself by a herniation leads to disruption of a large number of functions at once: they stop working internal organs, sensitivity and movement of the limbs are impaired (in the case of the lumbosacral region - only the lower ones). If the disc begins to protrude towards one of the roots, this will cause sensory-motor disturbances in only one limb.

Now about the hernia itself. This is a protrusion of the central part of the disc, which normally has the consistency of a very dense and springy jelly. This structure is called the nucleus pulposus and is the main shock-absorbing element and can move inside the disc and spread out depending on the direction and force of the load on nearby vertebrae. At the same time, normally the surrounding tissues do not change their structure and do not suffer, remaining in density the same as the tendon of any muscle. As soon as thinning of the fibers occurs in the peripheral part of the disc (fibrous ring), the nucleus pulposus, under the influence of load, rushes into weak point. While it has not yet gone beyond the disc, it is not yet a hernia, and the situation can still be corrected.

In fact, the annulus fibrosus is not easy to destroy, because it consists of fibers lying in several layers and intersecting in three planes. But this is possible either due to a single action of high pressure on the nucleus pulposus, or when replacing the usual disc tissue with scar tissue. The latter occurs when the disk power supply fails. How does he eat?

The disc is somewhat like a sponge: it receives oxygen and nutrients during the movement of the spine, when cartilage fills. When it, again under the influence of movements, contracts, waste substances are forced out of it. At the same time, in order for the trophism of the intervertebral disc to be complete, the movements must be performed in full, including bending, flexion and extension. Sharp increase type and amplitude of physical activity after a period of prolonged low mobility spinal column, oddly enough, does not increase the nutrition of cartilage, but significantly increases the risk of rupture of the fibrous ring.

A little about myths

The diagnosis of “intervertebral hernia of the lumbosacral spine” is made very often when magnetic resonance imaging reveals any protrusion of the disc in any direction. But with age, the nutrition of the disc deteriorates, and the appearance of an intervertebral “diverticulum” of 2-3 mm, without nagging pain in the leg, coldness of its skin can be considered a variant of the norm. Even multiple 2-3 mm protrusions in a person 40 years of age and older are not a diagnosis and do not require special treatment. But, being a borderline state (between normal and pathological), they signal to a person that it is time for him to pay attention to his spine, because so much depends on it. To do this, you do not need to take any pills, but increase the range of movements of your back, as well as periodically, in courses, classic massage- what you need. Once again: no medications and, especially, no operations!

How does a hernia form?

The nucleus pulposus does not immediately appear outside the disc. Before this there are several stages:

Disc protrusion. The annulus fibrosus slightly loses its elasticity, as a result the nucleus pulposus shifts to one side. If at this stage the correct alternation of rest and therapeutic exercises is ensured, the process of intervertebral herniation can be stopped.
Incomplete prolapse of a section of the disc. The fibrous ring is destroyed in one area, and material from the nucleus pulposus rushes there.
Complete disc prolapse. The nucleus extends beyond the fibrous ring, compressing the vertebral bodies and structures of the nervous system.
Disc sequestration. This is the name of the condition when a section of the “freed” nucleus pulposus enters the spinal canal. This causes allergic reactions, since the substance is foreign to this location. Sequestration is also dangerous due to disruption of the blood supply to the spinal cord and its nerves. May cause paralysis of the lower extremities and pelvic organs.

Causes of hernia

Most often, lumbar spinal hernias appear with osteochondrosis, when, due to age-related changes, the trophism of the fibrous ring worsens, it becomes drier and brittle. However, osteochondrosis and intervertebral hernia are different diseases.

A hernia can also be caused by:

spinal injuries: road accidents, blows, falls on the back;
lifting heavy weights incorrect position back: a person lifted a load from a standing position, bending at the waist, whereas it was necessary to sit down and, standing up, keep the lower back straight. You can “get” a hernia by lifting weights, bending over and turning to the side;
scoliosis or lordosis of the thoracic or lumbar region, when the load on certain vertebrae of the lower back increases significantly;
dysplasia hip joint on one or both sides. Degenerative changes in the intervertebral discs of the lower back develop due to increased and improperly distributed load on them;
diseases of the spine: tuberculosis, tumors, ;
due to illness endocrine organs, chronic processes accompanied by intoxication or due to genetic diseases.

Risk factors

The more items in the list below that fit “your” case, the greater the chance of developing lumbosacral hernias. This:

Great weight, that is heavy load on the spine, the lumbar region of which suffers the most.
Male gender: Men are more likely to suffer from intervertebral herniation.
Ages 30-50: The years of “maximum strength” and confidence in one’s experience are where the heaviest weights are most likely to be lifted and people are most likely to have accidents or work-related injuries.
Physical inactivity: sedentary work, “transfer” from the computer to the steering wheel and back. If the volume of movements performed by the spine is insufficient, the nutrition of its structures deteriorates, especially intervertebral discs. Moreover, both in the car and at the workplace, the back most often takes a bent position.
Hard physical work. In this case, the intervertebral discs do not have time to receive necessary substances, constantly receiving load. Monotonous movements are especially dangerous.
Smoking. In this case, the saturation of the blood, and then the intervertebral discs, with oxygen is disrupted.
Frequent “minor” spinal injuries, each of which disrupts the nutrition of the disc. These injuries do not make themselves felt immediately, but after several years (up to 5).

How to recognize a lumbosacral hernia

It cannot be said that the symptoms of a hernia of the lumbosacral spine are very specific, and a diagnosis can be made from them: in exactly the same way, a tumor that has developed in this section and compresses the roots, or local inflammation of the root can manifest itself. Although the latter diseases are quite rare, they cannot be discounted. Therefore, after reading the symptoms, do not rush to make this diagnosis.

The symptoms that manifest a hernia of the lumbar spine can be divided into several groups:

Symptom	Characteristic
Pain	Localization: depends on where the pinched nerve root is located. Most often it goes along inside thighs, reaching the knee, shin, inner ankle. It can radiate into the buttock and leg, reaching the foot, and can be felt on the sides of the legs. May be localized at one point in the lumbar region Gradually the pain changes its localization, going down to the heel, the back of the foot, especially in the area thumb Intensity: in the initial stages - from a “lumbago” to a heavy, aching sensation. When it intensifies: when standing, walking for a long time, turning or tilting the body, coughing, lifting heavy objects, performing sudden movements, exercising with tension in the lower back muscles, raising the straight leg on this side up, sitting for a long time, driving on uneven roads. How it is weakened: in the initial stages upon adoption supine position the pain goes away, later it helps to remove the pain by lying on the healthy side with the affected leg bent in all joints
Limitation of movements	Due to muscle weakness and deterioration in the receipt of “commands” to them, one or both legs make a smaller range of movements than before. It is more difficult to lift the leg; it may not bend completely at the knee. A smaller range of motion is also observed in the lower back: now it is not so easy to bend completely with straight legs, lean to the side, and so on
Weakness of the leg muscles (if the hernia is compressing the spinal cord - symptoms apply to both legs)	It becomes difficult to squat, climb stairs, and jump. The leg gets tired quickly. If we are talking about compression of the spinal cord, then weakness of the leg muscles without treatment can result in paralysis of both lower extremities
Sensory impairment	It may manifest itself as numbness, tingling, burning or freezing. The sensation of hot-cold and pain worsens. The sensitivity disorder is localized either in the lumbar region with a transition to the outer side of the thigh, or in the area of the sacrum and the outer side of the thigh, or from the perineum and, according to inner surface thighs to shins and below. It depends on which disc the hernial protrusion is located in:
Skin changes on the affected leg (if the spinal cord is compressed, both legs are affected)	Compared to the “healthy” leg, the diseased leg is paler, thinner (due to muscle atrophy), and less hair grows on it. Its greasiness and sweating also differ, both more and less. The affected leg is usually colder. Important: the pulse in this leg can be felt on the thigh, below the knee, and between the big and index toes.
Dysfunction of the pelvic organs. This symptom characteristic of compression of the spinal cord herniation	From the intestines: mainly constipation, less often - diarrhea. This almost does not depend on the nature of the food taken (but the situation with constipation improves somewhat when eating liquid food), and is not accompanied by abdominal pain or bloating. If nervous regulation is disturbed bladder, there is a frequent urge to urinate, while urine is released in small portions, clean, without blood, and urination itself is painless. Urinary incontinence may occur. The regulation of the genital organs is disrupted. This is manifested by a decrease in libido, in men – erectile dysfunction, in women – gynecological diseases
Symptoms noticeable to relatives and friends of a sick person	A person close to the patient may notice that he is hunched over, stooping, one leg seems shorter than the other, his posture has changed, and his movements have become unstable. If you look at the bare back in the lumbar region, you can see tense muscles on one side of the spine (they protrude and feel like a dense cord to the touch). The smoothness of the gluteal fold is visible. Pressure on the spinous processes of the vertebrae (these bones that form the contour of the spine) in the lumbar region causes pain

Diagnostics

Before deciding what treatment a lumbar hernia will receive in this particular case, you need to make a diagnosis. This is done using instrumental methods(about them below), but the neurologist will be able to indicate which area of the spine needs to be examined by a radiologist or magnetic resonance imaging specialist only after:

determination of reflexes from the tendons located on the legs;
straight leg raise test;
studies of temperature, pain and vibration sensitivity over the entire surface of the legs, in the buttocks, perineum, and lower abdomen.

With an intervertebral hernia of the lumbosacral region, sensory disorders will be noted in the area innervated by the affected root, the neurologist will determine loss or decrease in tendon reflexes, and identify deep disturbances in the biomechanics of movements of the affected limbs.

In addition to the preliminary determination of the affected segment, such an examination helps to determine the degree of innervation disturbance, treatment tactics, and after it begins, to see the dynamics of the changes occurring.

The diagnosis itself is made on the basis of one of the tomographies - magnetic resonance or computer multislice - of the lumbosacral region (see). If spinal cord damage is indicated, the diagnosis can be supplemented with contrast myelography - a study in which an X-ray contrast agent will be injected into the spinal canal through a lumbar puncture. Next, an x-ray is performed, which shows how contrast agent passes into spinal canal, whether it accumulates at some level (the latter means that the spinal cord is compressed and, most likely, in order to prevent its death, an operation to remove a lumbar hernia is needed).

Treatment of the disease

Therapy for a hernia of the lumbosacral region is aimed at eliminating pain, relieving spasm of the “squeezed” (to maintain relative balance) spinal muscles, and eliminating ischemia of the spinal cord and its roots. In addition, it is necessary to create a strong muscle corset, balance the joints between the processes of the vertebrae, and eliminate their subluxations, since these phenomena can provoke the growth of an intervertebral hernia.

How is a lumbar hernia treated? There are 2 main treatment methods used here: conservative (pills, injections, exercises) and surgical. The course of the disease is divided into three periods:

Spicy. Here you feel pain, stiffness of movement, and loss of sensation in your legs.
Subacute. Starts after 3-5 days. Characterized by a decrease in pain severity. Sensitivity is restored slightly.
Restorative. It begins at 3-4 weeks of treatment and is not always present. It is characterized by the absence of pain and minor sensory disturbances.

This division is necessary in order to apply the right tactics treatment. So, in acute period Only conservative therapy is carried out; subacute and recovery may be the time when surgical treatment is involved.

Let's consider the conservative treatment plan by period.

Acute period

Here you need bed rest with minimal physical activity in the lumbar region. Lie on a small pillow, on your back, with a small cotton-gauze roll under your back. The doctor must adjust the position of the back, depending on which area of the disc there is a rupture, so that it can heal. If there is neuralgia sciatic nerve, legs need to be bent at the knee and hip joints.

Medicines

Painkillers are also anti-inflammatory. Usually - in the form of injections for the first 3-5 days: "", "Rofika", "Movalis". Then you should gradually replace the injections with similar tablets (“Meloxicam” and others).
Blockade with novocaine with the addition of an anti-inflammatory hormone. This remedy can relieve pain immediately – and for 2-3 weeks. During the course you can apply 3-4 such blockades, only in different places near the affected disc.
Centrally acting muscle relaxants: "", "Sirdalud". They are needed in order to relieve painful muscle spasms on one side of the spinal column.
Vitamins B1, B6, B12 in a complex (preparations "", "Neurovitan", "Neurobeks"). They have some relaxing effect, restore nerve tissue, and improve the conduction of impulses in the pinched fiber.

Manual therapy

Not applicable during this period.

Exercise therapy

You can only move your toes, nothing more.

Subacute period

Mode - semi-bed. In this case, you need to pay attention to how you feel and not perform movements that cause pain.

Drug therapy

Painkillers and anti-inflammatory drugs in tablets, muscle relaxants in tablets and vitamins are the basis of drug therapy.

Physiotherapy

The following methods are used:

thermal procedures;
acupressure;
acupuncture;
diadynamic therapy;
underwater massage.

Additional Methods

The use of medicinal leeches – hirudotherapy – has proven itself well. These worms, injecting special substances into the tissue, help resolve fragments of the protruding disc. Leeches help 7 out of 10 patients. Course – 10-12 procedures, with an interval of 3-4 days.

Massage. This method should be used with extreme caution, only if there is no pain in the leg.

Manual therapy. The method is most effective when there is not only a hernia, but also displacement of the intervertebral joints. Optimally 2-7 sessions with a chiropractor in combination with following method– post-isometric relaxation.

Postisometric relaxation. These are classes with a specialist. They consist of a combination of 5-10 seconds of isometric work (tension and tension, but without pain) of the muscles and the same time of passive stretching of the muscle.

Exercise therapy

Exercises for lumbar hernia in the subacute period should be performed from the starting positions:

lying on your back;
on all fours;
on the stomach.

They should not be accompanied by pain. When it appears, stop the exercise and rest. It is optimal to use an unloading corset during exercise therapy.

Lying on your back, arms and legs straight. All muscles are relaxed. Raise your arms slowly up, stretch, lower your arms.
Lying on your back. The body is relaxed. Bend your right leg at the knee, swing it left and right, relax the muscles. Repeat the same with your left leg.
Starting position – on the stomach, hands under the chin. Bend your knees, touch your buttocks with your heels, relax your muscles, and rest.
Standing with your face or side to the gymnastic wall, lift your legs one by one, swing back and forth and to the sides.
Lying on your back. Bend and straighten your leg at the knee, move it to the sides.
I.p. - Same. Using your hands, alternately pull your right and left leg bent at the knee to your chest.
Standing, feet shoulder-width apart. Slowly turn your torso to the right and left, while simultaneously spreading your arms to the sides. When raising your arms, inhale; when lowering, exhale.
Standing, feet shoulder-width apart, knees bent, heels close to the buttocks, shoulder-width apart. Inhale. As you exhale, alternately tilt your knees inward without moving your pelvis.

This is an approximate set of exercises. The doctor and exercise therapy instructor who deal specifically with your case should tell you more.

Recovery period

The scope of drug treatment at this stage is much less: painkillers are not used (novocaine blockades can only be used if pain reappears while performing some exercise), the course of vitamins and muscle relaxants has already ended or is ending by this time.

Physiotherapy and methods alternative treatment(hirudotherapy, acupuncture) in the recovery period do not differ from what it was in the subacute period.

Exercise therapy

The scope of exercises for a lumbar hernia is expanding, because you need to strengthen the muscular corset of the back and lower extremities, as well as recreate the correct posture:

Lying on your stomach. The doctor bends and straightens the leg at the hip, holding it for 5-7 seconds in an extended position.
Lying on your stomach. Bring and abduct the right and left legs alternately from the body.
Lying on your stomach, lift your straight leg first by a small angle, then by a larger angle.
Lying on your side on the side of your healthy leg, move your affected leg away from your body, bent at the knee.
Standing with your back to the gymnastics wall, straighten your back and slightly move your pelvis back so that the shoulder blades of the buttocks, calf muscles and heels touch the wall. Raising yourself on your toes, stand there for 3-5 seconds, then return to the starting position.
Walking with a bag filled with clean sand weighing up to 500 grams on your head. Step over imaginary obstacles without bending your back. Also, without slouching, squat down, trying not to drop the bag.

Exercises with gymnastic apparatuses: balls, dumbbells, gymnastic sticks are also carried out under the supervision of an instructor. It is also necessary to perform half-hangs (on the horizontal bar, but without releasing your legs) and, gradually, hangs. It is also important to do exercises on stairs.

Surgical treatment

The decision that removal of a lumbar hernia is necessary is made based on the following indications:

if there is a narrowing of the spinal canal;
despite treatment, numbness of the limbs, muscle weakness increases, or dysfunction of the pelvic organs has also appeared;
when conservative therapy was effective for a short time, then deterioration occurred in the same part of the spine;
a portion of the hernia has fallen into the spinal canal;
compression of the cauda equina occurred (the end of the spinal cord in the form of a bundle of nerves, irritation or pinching of which causes terrible pain in the perineum and legs).

The essence of the operation is to free the spinal cord or roots from the hernia compressing them. This can be done as follows:

Endoscopically. 3 micro-incisions are made in the spine area; a camera is inserted into one, which will transmit the image to the monitor; through the other 2, surgeons work with micro-instruments. The hernial protrusion and residual elements of the nucleus pulposus are removed.
Percutaneous discectomy. This intervention involves removing its destroyed core through a puncture in the intervertebral disc. Next, it is replaced with a special substance, which, to purchase required properties, should cool down.
Disc endoprosthetics. The damaged disc is removed and an implant is placed in its place.
. The nucleus pulposus is most saturated with water. This is what the laser is designed for, which has the property of evaporating moisture-containing structures.

Prevention

To prevent the development of hernias in the intervertebral discs in the lumbosacral regions, you need to:

control your own weight, preventing it from increasing significantly;
eat well;
no smoking;
limit physical activity;
exclude physical inactivity;
sleep on a hard mattress, in a supine position.

If you start treatment with a neurologist on time, you can return to your usual activities within 5 days after pain relief. By following the above rules and performing the recommended exercises, there is a very high probability that you will no longer remember the symptoms of an intervertebral hernia.

Intervertebral discs are pads that act as shock absorbers between the vertebrae. Structurally, these pad discs consist of a strong outer ring of fibers called the annulus and a soft, jelly-like nucleus pulposus.

The annular space is the outer layer of the disc and its strongest ligament, which connects each vertebrae together. The mushy core of the disc serves as the main shock absorber.

A disc herniation occurs when the outer fibers of the intervertebral disc (in the annulus) are damaged and the soft inner material from the nucleus pulposus leaks out of its normal space.
Often this compresses one of the nerve roots, causing pain, numbness and weakness in the skin and muscles that are in the area of the compressed nerve root.
It usually occurs on one side of the spinal canal.

Typically, hernia is most common among young and middle-aged people. In older people, degenerative changes, which occur in the spine during aging, reduce the risks of this disease.
Discs can rupture suddenly due to too much pressure on the disc - such as falling down a flight of stairs.

Symptoms of a spinal hernia

A herniated lumbar disc usually causes a “sciatic” type of pain:

starts in the back of the back
gives to the buttocks,
from the buttocks radiates to the thigh and leg,
the pain is localized on one side.

The following are the most common symptoms of lumbar disc disease:

, the pain is aggravated by movement, coughing, sneezing.
Back muscle spasm
The pain starts in the lower back or buttock and radiates down the leg,
Muscle weakness in the legs,
Numbness in the leg
Decreased reflexes in the knee or ankle,
Changes in bladder or bowel function.

IN in rare cases Patients may experience weakness in the limbs or signs of spinal cord compression:

difficulties with gait,
coordination problems,
loss of bowel or bladder control.

Symptoms depending on the vertebra

The pain syndrome associated with a herniated disc depends on the intervertebral level at which the herniation occurred:

L3-4 - pain in the front of the thigh or calf, when bending and straightening the knee,
L4-5 - pain in the back of the leg and when bending,
L5-S1 - pain on the side of the leg, sole of the leg when bending

Diagnosis of vertebral hernia

Symptoms of a herniated disc in the lumbar spine are similar to many other back diseases, so to make an accurate diagnosis you need to do a number of tests under the supervision of an orthopedic doctor:

An X-ray of the spine is usually done after an injury to rule out a fracture or other consequences.
A CT scan of the spine is valuable in assessing bone trauma - for example, the occurrence of cracks. However, this type of examination cannot always reliably show a herniated disc.
A CT scan does not show torn ligaments or minor disc fractures.
MRI of the spine is the best method for visualizing the spinal cord and nerve roots, intervertebral discs, ligaments, etc.
An electrodiagnostic test is useful in assessing weakness in the muscles of the arms or legs and can show whether weakness in the limbs is due to an abnormality or compression of a nerve root or whether there is another cause.

Conservative treatment of lumbar intervertebral disc herniation

Treatment options for a lumbar herniated disc will largely depend on:

duration of symptoms
pain in the back,
nature of symptoms (numbness or weakness in the limbs),
age of the patient.

The treatment itself is divided into two stages: conservative and surgical.

Lumbar intervertebral disc herniation - drug treatment

The first stage lasts from 6 to 12 weeks - non-surgical treatment, which consists of:

physiotherapy,
epidural injection,
blocker medications.

In 90% of patients, improvement occurs through non-surgical treatment methods.
If pain relief does not occur after 6 to 12 weeks and the pain does not decrease, doctors consider a second option - surgery.
In some cases, surgery may be recommended before completing the full 6 weeks of conservative treatment:

if there is severe pain, and the patient cannot lead a normal life,
if the patient experiences progressive neurological symptoms- increasing weakness and/or numbness of the legs.

The main objectives of any type of treatment are:

Providing pain relief, especially leg pain.
Return the patient to his usual way of life.

Medicines for the treatment of lumbar intervertebral disc herniation

As a rule, medications for the treatment of herniated discs in the lumbar spine are combined with other methods - physical therapy or exercises.

List of medications:

Anti-inflammatory drugs such as ibuprofen reduce swelling and pain.
Muscle relaxants such as cyclobenzaprine relieve muscle spasms. Side effects are drowsiness.
Drugs that affect nerve damage include Pregabalin, Gabapentin, and Duloxetine. Side effects - dizziness, fatigue, drowsiness.
Narcotics for severe pain - Oxycodone and Hydrocodone. Side effects include lethargy, nausea, and constipation.
Epidural steroid injections (injected into the cavity just outside the cerebrospinal fluid sac) reduce swelling, inflammation, and pain.
Injections of cortisone directly into the area of the spinal nerves.

Physical therapy and strengthening exercises are more effective methods treatment than bed rest.

Physical therapists can help you choose exercises designed to minimize pain. Often the following are also combined with exercises:

Hot or cold compresses.
Stretching.
Ultrasound.
Electrical stimulation.

Lumbar intervertebral disc herniation - surgical treatment

Surgical treatment of intervertebral herniation of the lumbosacral spine is ultimately necessary in very rare cases - only if conservative methods Treatments do not improve symptoms after six weeks, especially if:

numbness or weakness
problems with movement (pain in the legs),
loss of bladder or bowel control.

Spinal surgery is a last resort option. Even after you have tried all the methods and there is no improvement, do not rush. Even after enlisting the doctor’s support for its necessity, do not rush. Surgery is not always a 100% guarantee of effective treatment.

In many cases surgically can only remove the protruding part of the disc. The entire disk is removed if necessary and in extreme cases. This involves using a special implant to ensure the integrity and stability of the spine. Less commonly, an artificial disc may need to be implanted.

Intervertebral hernia of the lumbar region– this is a rupture of a spinal disc (fibrous ring, cartilage), as a result of uneven load on the vertebrae.

Intervertebral hernia of the lumbar region is one of the most dangerous diseases of the spine, which causes pain in the lower back, can radiate to the leg, over time hampers movement, interferes with normal movement, and leads to disability of the patient.

The lumbar spine consists of 5 vertebrae (the lumbar vertebrae are designated by the letter “L”), connected by intervertebral discs. The spinal discs have an oval shape and perform a shock-absorbing function, providing uniform pressure on the vertebrae. A herniated disc causes a disc to bulge, which puts pressure on the nerves and causes pain. It is in the lumbar region that intervertebral hernias most often occur.

Intervertebral hernias cause unbearable pain, numbness in the legs, tingling, “cotton” sensations, a “crawling” feeling, and more. Often, the patient is only bothered by pain in the leg, and he does not even always guess where this pain comes from and why it hurts.

Carrying out diagnostic tests for lumbar hernia

Symptoms of lumbar hernias

Treatment of the lumbar spine

A spinal hernia can occur in almost any part of the spine; in the lumbar region, in 90% of cases, hernias occur between the 4-5 lumbar vertebrae (L4-L5) and between the 5th lumbar and first sacral vertebrae (L5-S1). The occurrence of hernias in the lower parts of the spine is explained increased loads to this area, anatomical features ligamentous apparatus, and also often concomitant pathology sloping pelvis. Hernia of the lumbar spine quite often causes radiculopathy, inflammation of the sciatic nerve, lumbago, lumbar sciatica and other syndromes.

Typical symptoms for intervertebral hernias of the lumbar spine.

– With an intervertebral hernia at the L4-L5 level, in addition to pain and stiffness in the lumbar spine, there is weakness in the big toe, pain in the upper leg, buttock, sensations of “crawling goosebumps” in the legs, and numbness in the fingers when sitting for a long time legs and other symptoms.
– With an intervertebral hernia of L5-S1, pain occurs in the knee, ankle, spreads along the inner thigh, numbness of the legs and other sensations occur.

Quite often, spinal hernias occur in several places at the same time and then the symptoms overlap each other.

It is worth remembering that the symptoms described above occur during the typical course of the disease and may vary depending on individual characteristics patient. To clarify the diagnosis, use additional methods research.

Causes of lumbar intervertebral hernias

To the most common reasons intervertebral hernias of the spine can be attributed to: injuries, heavy physical activity, prolonged sitting, bad habits, hip dysplasia in childhood, osteochondrosis, scoliosis and others.

According to statistics, spinal hernias quite often occur after road accidents, “whiplash injuries” (a sharp jerk of the head forward and then back). The first symptoms of a lumbar hernia of the spine appear 1.5-3 years after the accident.

Incorrectly selected treatment for hip dysplasia, in addition to disorders in the joint, causes pelvic distortion, which provokes the occurrence of intervertebral hernias in the lumbar region in adulthood.

The role of osteochondrosis is important in the formation of spinal hernias. As is known, osteochondrosis is rapid aging spine, in which the intervertebral discs lose their elasticity and, as a result, the likelihood of the formation of an intervertebral hernia against the background of osteochondrosis is very high.

Bad habits also negatively affect the intervertebral discs of the back, thereby stimulating the formation of hernias. Smoking reduces oxygen saturation in the blood, depriving the spinal discs of vital elements. Drinking coffee worsens blood circulation in the surrounding tissues of the spine; irregular nutrition also negatively affects the spine.

Lack of regular standardized physical activity plays a huge role in the formation of intervertebral hernias in the lumbar region. Modern look life does not always mean regular morning exercises or breaks from working at the computer, and this cannot but affect the spine. From the age of 20, metabolism is ensured only through constant movement, like a piston. Adynamia (lack of physical activity) accelerates the development of osteochondrosis and this is followed by intervertebral hernias.

Removing blocking in the L5-S1 segment

At the same time, heavy physical work in every possible way provokes the formation of spinal hernias.

It is also worth distinguishing between the cause of the disease and what provoked the exacerbation of the intervertebral hernia. Even minor movements can trigger pain. For the lumbar region, the most dangerous movements are those accompanied by bending forward and turning to the side, or lifting a weight in front of you. With such movements, patients with a hernia of the lumbar spine experience a sharp shooting pain, after which it can persist for years.

Treatment of lumbar intervertebral hernias

When treating lumbar hernias, it is important not to miss the moment when you can still help in conservative ways and avoid surgery with all the ensuing consequences. If you consult a specialist in a timely manner, you can stop the progression and prevent possible complications. The goal of treating a lumbar hernia is to eliminate pain, which causes discomfort and hinders movement, and also to create a muscle corset by prescribing specially selected therapeutic exercises, balancing articular surfaces musculoskeletal system, elimination of vertebral subluxations that provoke the growth of intervertebral hernia.

Unfortunately, modern medicine is practically useless in the treatment of lumbar hernias, offering a choice between pain relief (blockade) and surgery - other methods simply cannot be applied on a mass scale. Often, a neurosurgeon is more interested in carrying out 3-4 operations on the spine without results, rather than in bringing the patient out of an acute condition using conservative (non-surgical) methods and completely eliminating all manifestations of intervertebral hernias. In most cases, the question of performing an operation is decided by the patient himself and, having no choice, not knowing the consequences surgical interventions, takes risks. Before performing an operation, it is necessary to undergo a course of conservative treatment and only after that decide on the need for surgery.

Video about the treatment of intervertebral hernia at the Clinic of Dr. Ignatiev

Main section: Treatment of intervertebral hernias

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I have been serving for half a year, a month ago I began to suffer from pain in the lower back and between the scapular region, the MRI results were sent to the hospital, the doctors said about the commission, but in the unit they turn a blind eye to this and force me to carry everything heavy, too. at the moment the leg began to have pain, the right leg began to have daily cramps, numbness in the toes, constant fatigue, the conclusion in the epicrisis is as follows: Development of ostiachandrosis, lordosis, diffuse-dystrophic deformation of the intervertebral lumbar region, hernia L5S1, disc protrusion l4/l5

I did an MRI a few days ago. Two hernias were discovered. I wanted to know how serious this is? I am 38 years old

An athlete's back does not hurt during the day, but only hurts for the first hour after waking up when he lifts his right leg straight

Hello, I am 27 years old, 4 months away. Back pain, I lost 12 kg, my active lifestyle ended. My back hurt, like many people, probably, after a very long trip, etc., but after warming up and sports. the hall had no problems. I woke up in the morning, was frozen, and had a 5-point pain in the lower back. (I’ll calculate the pain on a ten-point scale, 10 means you can’t get up and find a lying position, not even possible pain..). It took a week, I decided to rest for a couple of days, well, it passed. I moved the refrigerator with my hands and feet, just as if I wasn’t writhing. He did the job and left. The pain in the lower back started after an hour, 3 points, after 3 hours, 5 points, went to lie down, got up in the morning 6 points. As a result, I did an MRI of the same paratrusions l4-l5, l5-s1 of 3 mm, they were the same ones I had 2 years ago.. the neurologist prescribed a course of treatment, 3 injections and a drip, for 10 days, at the end of the course from 6 points to 4. A week later, the surgeon prescribed a stronger treatment + with kitanal for 10 days, at the end there was 3 points of pain in the back, but it didn’t last long... the pain was 6 points, radiating to the leg..., they did a blockade, to no avail, after a couple weeks the temperature rose to 38, urine tests went off scale, they admitted me to the hospital, examined the kidneys, abdominal cavity, groin smear, ankylosing spondylitis, ACP and 4 more tests I don’t remember, everything was normal... 2 weeks passed, no effect.. pain for 8 -10 points, goes to the left leg. It was formed instead of lumbar lordosis. Lumbar kyphosis! I went to neurosurgery for 2 weeks, where the neurosurgeon tried everything he could +5 blockades in the left side of the lower back, the muscle was very wooden in tension, the tension was relieved, he was discharged with the same pain of 7-8 points. I completed a course of exercise therapy with Dona injections, Rumalon, TraumeelS with a rehabilitation specialist, the muscles became stronger for 20 days (the pain is still the same). At home, while on sick leave, the whole hospital was overcome by hellish pains, I’m already going crazy with everyone. During these 4 months, three MRIs of the lumbar region, one with contrast... I went to the neurologist for a commission... they said do another MRI………. Well just p.....! Got to the leeches. They did breast therapy at home..(leeches), after two hours he stood up and walked straight, there was no pain in the leg, it was enough for 12 hours. The contrast MRI described probably swelling of the soft tissues from the left from l3 to s2 (all the attending doctors saw the MRI..) On at the moment I have no idea what to do ((((6 points of pain..