What is a herniated disc and how is it treated? Signs and symptoms of an intervertebral hernia of the lumbar: what to do during an exacerbation, the rules for further treatment How to treat a hernia in the explanatory section.

Content

One of the most common diseases of our time is a hernia of the lumbar. Pathology of the musculoskeletal system is diagnosed in men 30-50 years old, but periodically develops in women and young people. The disease requires timely diagnosis and therapy, because there is a high risk of severe complications. The last stage of the pathology (sequestration) leads to paralysis and atrophy of the muscles of the limbs. Treatment of a hernia in the lumbar spine involves conservative and/or surgical techniques.

Treatment of a hernia of the lumbar spine

The therapeutic scheme includes the relief of pain, the elimination of spasms of the vertebral muscles, ischemia of the spinal cord, its roots. In addition to this, the treatment of a lumbar hernia should be accompanied by the formation of a strong muscular corset, balancing the joints between the vertebral processes and removing their subluxations. To choose the correct and effective tactics of therapy, pathology is divided into three stages of development.

In the acute initial stage of the disease, only conservative methods are prescribed. Among them, taking medication, physiotherapy, massage, exercise therapy, wearing a corset, and so on. The subacute and recovery periods are more dangerous for human health, as the hernia begins to increase. In this case, a surgical operation is performed. There are several types of it, which are selected specifically for each patient.

Medical treatment of intervertebral hernia of the lumbar

For the treatment of hernia, a number of medicines of different effects are used. Tablets, capsules, ointments help get rid of pain and restore the normal functioning of the area affected by the pathology. In most cases, drugs are prescribed for the relief of the acute form of the disease. Often use such drugs for a hernia of the lumbar spine:

NSAIDs (non-steroidal anti-inflammatory drugs). They are necessary to reduce pain, eliminate the inflammatory process. The effectiveness of NSAIDs is based on a decrease in the level of histamine, which eliminates edema and slows down the development of pathology. Ibuprofen, Nimesulide, Diclofenac, Meloxicam, Indomethacin, Lornoxicam are often prescribed.

When non-steroidal drugs are ineffective or do not have positive dynamics at all, the doctor prescribes hormonal (steroid) medications. They perfectly clean the inflammatory process, reducing the functions of macrophages and leukocytes. The most famous drugs in this group: Hydrocortisone, Dexamethasone, Diprospan.

Sometimes treatment with diuretics (diuretics) is prescribed. They are needed to combat edema with a hernia of the lumbar. In order not to develop a water-salt imbalance and hypotension, diuretics are rarely prescribed, in short courses. Apply Furosemide, Clopamid, Metolazone, Ethacrynic acid.

The analgesic result is given by muscle relaxants, which relax the muscles well, improve blood circulation and normalize the normal nutrition of the affected tissues. Effective means: Diazepam, Mydocalm, Sirdalud, Baclofen, Tizanidin.

Tricyclic antidepressants are prescribed for a sedative, relaxing effect. As a rule, the patient takes Amitriptyline, Melipramine, Anafranil, Novo-Triptin.

To improve the nutrition of the affected tissues and blood circulation, use Pentoxifylline, Vasonite, Agapurin.

To restore the functionality and structure of the discs between the lumbar vertebrae, chondroprotectors are used. Cartilage tissue is restored due to drugs such as Chondroxide, Teraflex, Artra, Structum, Aflutop.

Alpha-lipoic acid helps to regenerate the membranes of the cells of the nervous system, improves blood flow. For example, Berlition, Thiolipon are used.

Vitamins of group B are also prescribed (to normalize nerve conduction, restore compressed nerve fibers). Neuromultivit, Milgamma, Neurovitan, Neurobion are often used. Calcium, vitamin D increase metabolic processes in bone tissues, optimize neuromuscular contractility and conduction.

Massage

Comprehensive conservative treatment includes massage. It is necessary to stimulate microcirculation (blood, lymph), eliminate muscle spasms, and strengthen the immune system. The procedure should be performed exclusively by a qualified specialist, too intense impact on the area of the spinal column can lead to negative consequences. There are several types of effective massage therapy:

Water massage (hydromassage). By means of a strong underwater jet of water, the general well-being of the patient is improved, the symptoms of pathology are eliminated. Such a massage is considered the best for stretching the spine, relieving pressure from pinched nerves and pain.

Classic type used as a preparation before stretching the vertebrae or correcting existing problems. As a rule, the treatment procedure consists of several stages: rubbing, kneading, vibration, stroking. Massage allows you to relieve pain and tension in the muscles, restore normal blood supply to the spine and tissues, and relieve swelling from the damaged area.

Cupping (vacuum) massage. It is often used because of its high efficiency and convenience. The procedure is carried out with classic glass or silicone jars. Vacuum massage actively enhances lymph flow and blood circulation.

exercise therapy

Therapeutic physical culture (LFK) is one of the important components of the treatment process. Special gymnastics helps block the development of a lumbar hernia and alleviate the general condition. When the disease is at an early stage of development, exercise therapy can cure it; at an advanced stage, exercises remove unpleasant symptoms well. Before performing any complex and minimal physical activity, you should consult a doctor.

Exercises for lumbar hernia are best done under the supervision of an instructor. It is advisable to use a special unloading corset. Several effective exercises (do 10-15 times, not counting the first):

Get on all fours, straighten your arms and back. Go around the room several times without changing position.

Lying on your back (on a hard surface), do reverse twists - torso to the left, legs to the right, or vice versa.

The starting position is the same, only you need to sit on a soft surface. Pull the toe of the right foot to the chest, then the left.

Sit on a chair, feet shoulder-width apart. Place your palms on the lumbar region, keep your back straight. Slowly lean back and forth and left and right, while tensing the abdominal muscles.

Sit on your heels with your buttocks, put your hands on the floor in front of you, palms down. Bend the spine in the lumbar up, moving the upper limbs forward to the maximum.

Physiotherapy

Another addition to conservative therapy is physiotherapy. Such methods help to increase the level of regeneration of damaged areas. Physiotherapy is very effective in combination with medications, it helps to recover faster after a hernia and prevent the development of complications. Most popular methods:

Laser therapy– treatment with red and infrared radiation.

Electrotherapy- the impact of a small current on the body through the electrodes.

electrophoresis- the introduction of drugs through the mucous membranes or skin by means of a direct electric current.

shock wave treatment– impact on the body of acoustic low-frequency impulses.

Magnetotherapy- the use of special equipment with adjustable frequency of the magnetic field.

Paraffin therapy- the introduction of medicines using ultrasound a few centimeters deep into the body.

Acupuncture- treatment of hernia, by influencing active biological points.

Operation on the intervertebral hernia of the lumbar

In some cases, a herniated lumbar spine can only be removed surgically. There are a number of indications for surgical intervention:

Narrowing of the spinal canal.

Methods of conservative therapy are ineffective, the disease progresses, dysfunction of the pelvic organs develops.

The hernia significantly narrowed the spinal canal.

Squeezing the cauda equina (the end of the spinal cord, a bundle of nerves, the pinching of which causes severe pain in the perineum and lower extremities).

The main task of the surgical operation is the release of the lumbar region from the hernia. There are several types of such treatment:

Laser reconstruction. The laser vaporizes structures containing moisture.

Endoprosthetics. Removal of a damaged vertebral disc, its replacement with an implant.

Percutaneous discectomy- an operation in which its destroyed nucleus is removed through a puncture of the intervertebral disc. Then the core is replaced with a special substance, which must be cooled to obtain the desired properties.

Microdiscectomy- excision of a small part of the vertebral bone tissue or intervertebral disc (annulus fibrosus), which is located above the nerve. This is necessary to stop squeezing the hernia.

Endoscopy. The surgeon makes three micro-incisions next to the spinal column. A camera is inserted into one of them, which transmits the image to the monitor. Through the remaining incisions, the operation is performed with microinstruments. Remove the hernia itself and its remnants.

Innovative Methods

To date, several innovative methods are used against intervertebral hernia. The most famous and effective of them:

SCS or spinal cord stimulation. The use of a neurostimulator that produces weak electrical impulses. The device acts on the nerve endings of the spinal cord through microelectrodes that are implanted in the epidural space (between the dura mater and the vertebral periosteum).

Laminectomy– percutaneous laser decompression. By means of a microlaser, a hernia is reduced and the pressure on the tissues adjacent to it is significantly reduced. Additionally, the device regenerates collagen fibers of cartilage tissues and eliminates small cracks in the articular cartilage.

Another innovative way to treat hernia is chemonucleolysis. An enzymatic medication is injected into the deformed disc, which dissolves the nucleus pulposus (the central part of the intervertebral disc). The liquefied part is sucked off, thereby reducing the size of the hernia.

ethnoscience

To enhance the effect of conservative therapy and for the prevention of hernia, traditional medicine recipes are used. Before using herbal compresses, ointments, baths, infusions, you should consult your doctor. The duration of therapy is prescribed by a specialist. Some effective recipes:

First you need to gently rub the affected area with fir essential oil. Mix honey (200 grams) and mummy (2 g) dissolved in water. Lubricate the lower back with the resulting mixture, wrap yourself in a blanket or other warm thing. Perform the procedure before bed.

Bran (1 dessert spoon) pour purified water (400 ml). Boil 40 minutes. Drink a warm decoction of 250 ml three times a day. The next day, prepare a new fresh medicine.

Pour greens, rose hips in equal parts with boiling water (200 ml). Insist 30-40 minutes. Take 120 ml before each meal.

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- a serious disease that causes pathologies of internal organs and the musculoskeletal system. It is possible to alleviate the condition and eliminate unpleasant symptoms with the help of operational and conservative methods. Treatment of intervertebral hernia of the lumbar without surgery is medicines, alternative medicine methods, physiotherapy, acupuncture and exercise therapy.

A herniated disc is a serious disease that needs to be treated.

Which doctor should I contact?

When observing the symptoms of an intervertebral hernia, it should first of all. A general specialist will examine the patient, interview and establish a preliminary diagnosis.

to a vertebrologist dealing with bone diseases;
treating pathologies of the musculoskeletal system;
with neurological disorders caused by MPG;
to a physiotherapist in the treatment of physiotherapy methods;
to a specialist in exercise therapy for the selection of an individual set of exercises.

You may also need the services of a chiropractor and a massage therapist with a higher medical education.

When to Avoid Surgery

Effective treatment of a herniated disc without surgery is possible in 90-95% of cases of the disease.

A hernia can be treated conservatively in the absence of the following symptoms:

Painful syndrome, stopped exclusively by opioids for six months.
Manifestation of spondylolisthesis: displacement of the vertebrae inside the spinal column.
Pathologies of the pelvic organs: impotence, involuntary urination and others.
Paralysis of the lower extremities, violation of their sensitivity and mobility.

If there is spondylolisthesis of the vertebrae, then surgery is necessary

Such manifestations of the disease can be cured only by surgery. In other cases, conservative therapy will help to cope with the disease.

Methods of treatment of intervertebral hernia of the lumbar

Before any of the methods of treatment, you need to consult with a specialist and make sure of the diagnosis.

Medications

For non-surgical treatment of intervertebral hernia, different dosage forms of drugs are used: tablets, injections and ointments of various groups.

Non-steroidal anti-inflammatory	They relieve pain, reduce fever, inflammatory and degenerative processes in the musculoskeletal system.	Diclofenac, Ketorol, Meloxicam
Steroid drugs (glucocortisoids)	They are used when NSAIDs are ineffective, help to anesthetize the back and reduce inflammation.	hydrocortisone,
Local anesthetics	They are injected directly into the pain focus, locally relieve pain and swelling. The effect of drugs is short-lived.	Novocaine, Lidocaine, Ultracaine
Opioid analgesics	They are used to relieve severe pain syndrome, which drugs of other groups cannot cope with.	Tramal, Codeine, Promedol
Muscle relaxants	Relax muscles, help relieve pain caused by excessive muscle tension.	Mydocalm, Norflex, Diazepam
Chondroprotectors	They slow down degenerative processes in tissues, improve cartilage regeneration and promote recovery.	Dona, Artra, Teraflex
Medications to improve microcirculation	Accelerate blood circulation and increase blood oxygen saturation, are introduced using a dropper.	Cavinton, Pentoxifylline, Vasonite
B vitamins	Increase immunity, normalize protective functions, relieve severe back pain.	Milgamma, Neurobion, Neurorubin
Antioxidants	Contribute to the restoration of nerve fibers in the pinched zone, improve overall well-being.	Glutargin, Mexiprim

Folk remedies

Interdiscal hernia can be treated with folk remedies. Recipes used at home will help relieve pain and reduce inflammation. To achieve a pronounced effect, it is worth combining folk methods with other methods of treatment.

Kalanchoe leaves

The Kalanchoe plant helps to relieve inflammation of any origin. In the absence of this flower, you can replace it with aloe: the therapeutic effect of these plants is similar.

Application method:

Cut off the leaf of the plant, remove the film from it.
Apply to the affected area as a whole or cut in half.
Cover with cellophane or cling film, secure with plaster or bandages.

The leaf is left on the hernia for 6-8 hours, best of all - at night.

Rub honey with mumiyo on the sore part of the back

Horse fat is a pharmacy remedy for inflammation, fever and pain.

It is applied like this:

Grind until smooth.
Attach to the hernia, cover with cling film.
Secure with bandages, do not remove for 10-12 hours.

Horse fat compress can be left on the body for up to 2 days, removing only during washing.

Tincture of cinquefoil root can be taken internally and externally.

Homemade ointment

Homemade homemade ointment will help to cope with the inflammatory and degenerative process.

She prepares like this:

500 g of comfrey root is ground manually or with a meat grinder.
350 g of melted pork fat is added to the root.
The mixture is heated over low heat for half an hour, after which 300 ml of alcohol is added to it.
The mass is cooled to solidification and removed in the refrigerator.

Aloe juice with honey should be applied to a relaxed back

The use of dried fruits

Dried fruits will help to strengthen the spine, saturate the intervertebral tissues and speed up the metabolism.

They are used in the following ratio:

5 pieces of dried apricots;
1 part figs;
1 part prunes.

The combination of products helps to strengthen the immune system, normalize digestion, nourish the body with vitamins and remove excess toxins.

Dried fruits will help strengthen the spine

Physiotherapy

Physiotherapy methods are the treatment of diseases by influencing the body of various physical factors. Physiotherapy relieves inflammation, accelerates recovery.

Methods used in the treatment of a herniated disc include:

ultrahigh-frequency, or UHF-therapy;
laser therapy;
a magnetic field;
diadynamic currents;
galvanization;
medicinal electrophoresis.

UHF therapy is used to treat hernia

Mud, showers and baths with a pronounced therapeutic effect are also used. Physiotherapy is a complementary method and works best in combination with other treatments.

exercise therapy

Physical therapy during remission helps to relieve muscle spasms of the spinal column, relaxes nerve fibers, improves metabolism and relieves inflammation.

Exercises for a hernia of the lumbar spine:

Lie on your back. Bend your arms at the elbows, place your palms near your shoulders. Stretch your chest up, arching, linger in the pose, count to 10 and return to the starting position.
Stretch your arms along the body, bend your knees. Raise the pelvis up, squeezing the gluteal muscles, linger, tighten the muscles of the back, count to 10 and lower.
Straighten your legs, stretch your arms. Leaning on the palms, try to rise from the floor, while straining the spinal muscles.
Take your hands off your head. Bend one leg at the knee, pull it to the chest, then straighten and lower. Repeat for the second leg.
At the same time, raise the straightened arm and leg on one side, hold for 10 seconds, lower back. Repeat for the second side.
Straighten your arms and legs. Raise your legs up: bend one at the knee, the other straight. Hold on like this for 20 seconds, lower your legs, swap their positions.
Lie down on your stomach. Bend your elbows, press your palms to your ears, lift your torso up. Hold the pose for 10 seconds, then lie back.
Bend your elbows, palms rest on the floor. Raise the torso up, bending in the back, count to 5 and lower.
Spread your arms to the sides, bend your knees. Dangle your feet for 20-30 seconds.

The number of repetitions is selected individually and depends on the age, the course of the disease and the physical fitness of the patient.

It is necessary to do exercise therapy only under the supervision of a specialist: excessive stress, improper exercise and exercise during the acute period of the disease will do the body more harm than good.

Manual or manual therapy is an effective method of getting rid of a hernia in the early stages. The method is allowed for any indication, except for neurological disorders on the background of the disease. Before the procedure, you should consult with your doctor, take into account contraindications and possible risks.

The therapeutic effect of manual therapy is the following effects:

Getting rid of periodic and systematic pain in the spine.
Improvement of metabolic processes in the tissues of the back.
Decrease in cerebrospinal fluid pressure.
Decreased muscle tension, increased tone.
Correction of the displacement of the position of the vertebrae.

Manual therapy is effective in the early stages of the disease

The procedure should be carried out by a chiropractor with a higher medical education. It is best if it is a neurologist with an appropriate additional specialization.

Manual therapy procedures can alternate with classical massage techniques: this will achieve a more pronounced and stronger effect.

Acupuncture is a non-traditional treatment, which is Chinese acupuncture, also known as acupuncture. The method accelerates metabolism and regeneration by means of point stimulation of certain zones.

Acupuncture helps get rid of a hernia

In modern medicine, acupuncture is combined with drug treatment, special massage and exercise. You can get rid of a hernia using traditional needles or laser acupuncture: the method uses a laser beam to act on points without damaging the skin.

Hardware treatment

For physiotherapy at home, hardware methods can be used: they include the use of devices and apparatus that can be used without the supervision of a doctor.

Darsonval is a multifunctional device that passes high-frequency pulsed currents and electric charge. It is used at home in the treatment of inflammatory diseases, to get rid of rashes and age-related changes.

Darsonval - a multifunctional tool

With intervertebral hernia, Darsonval demonstrates the following effects:

expansion and strengthening of blood vessels, improvement of blood flow;
activation of metabolic processes in the body;
regeneration of damaged cartilage tissues;
stop degenerative processes in the spine.

Darsonval is used 5-7 times a week, the exposure time is 10-15 minutes. The full course of procedures is 2-3 weeks.

Almag is a home magnetotherapy device that generates a low-frequency magnetic field. Under the influence of the charged particles of the device, oxidation, reduction processes and ionization are launched.

Almag-01 - apparatus for magnetotherapy

The impact of the device on the body:

acceleration and strengthening of metabolic processes;
reduction of the inflammatory process;
elimination of edema of the limbs and back;
relieving muscle tension;
relief from spasms and pain.

Almag-01 should be used in accordance with the instructions, without exceeding the exposure time.

Sanitary-resort treatment

In sanitary-resort conditions, various methods of treatment are used:

physiotherapy hardware methods;
therapeutic mud baths;
special souls to restore the body;
physiotherapy exercises with a moderate load;
manual methods and massage;
correct daily routine and nutrition.

The combination of these methods contributes to the rapid cure of the intervertebral hernia.

Therapeutic shower helps the body recover

Compliance with the regime

What to do during periods of acute illness:

Do not lift or carry heavy objects.
Avoid jumping and active sports.
Sleep at least 8 hours in a comfortable position.
Do not perform sharp bends and extensions.
Reduce the calorie content of your diet.
Exclude salty, smoked, spicy foods from the menu.
Reduce the amount of fast-digesting carbohydrates, add fiber.

Eliminate smoked and spicy foods from your diet

You should sleep on a special orthopedic mattress. During wakefulness, you should wear a corset or bandage that fixes the spine in the correct position and relieves tension from the muscles.

What happens if a herniated disc is not treated?

An untreated herniated disc can lead to serious consequences:

to deterioration of work of heart;
to gastritis, colitis and pancreatitis;
to chronic bronchitis;
to difficult to treat sciatica;
to impaired blood circulation of the brain;
to pathologies of the pelvic organs;
to the onset of a stroke.

In the advanced stages of the disease, it can cause a disorder of motor activity, paralysis of the arms and legs.

Intervertebral hernia is fraught with disorders in the blood circulation of the brain

Prevention

The appearance of an intervertebral hernia can be prevented in the following ways:

Smoking cessation: Nicotine constricts blood vessels, which can cause spinal herniation.
Classes in the pool: swimming strengthens the muscular corset, improves the functioning of the musculoskeletal system, keeps the spine in the correct position.
Home gymnastics: independent exercises for the development of flexibility strengthen muscles and improve posture.
Therapeutic massage: normalization of blood supply in cartilage improves metabolism and tissue oxygen saturation.
Strengthening the immune system: Reducing the number of inflammatory and infectious diseases reduces the likelihood of inflammation of the cartilage discs and hernia.
Increasing the level of collagen: timely treatment of liver diseases and the use of drugs with collagen will strengthen the intervertebral discs.
Stress resistance: nervous overload constricts blood vessels in the body, which can provoke the appearance of a lumbar hernia.

Swimming strengthens your back

An intervertebral hernia is a serious disease, but it can be eliminated if you start fighting it in a timely manner. Correctly drawn up treatment regimen and performed procedures will help prevent surgical intervention.

Intervertebral hernia is a degenerative disease of the intervertebral disc, characterized by a violation of its integrity and structure.

The lumbar spine consists of five vertebrae, between which there are intervertebral discs that play the role of a kind of shock absorbers. Normally, the intervertebral disc consists of a pulpous nucleus of a liquid consistency, around it it is closed into a fibrous ring, and the disc is covered from above and below by the endplates.

With excessive axial load on the spine, there is significant pressure on the intervertebral discs in the lumbar region.

Most often, these problems occur when:

weight lifting;
excessive weight;
long walk.

Because of this, microtraumas are formed in the intervertebral discs, damage that has the ability to self-heal if the processes of tissue regeneration proceed at a good level.

Photo: computed tomography for a hernia of the lumbar spine

With age, the ability to regenerate decreases, and with a sharp movement, lifting a load or injury, the fibrous ring breaks, followed by protrusion of the nucleus pulposus of the disc to the back or side, squeezing the roots of the spinal cord.

Such a bulge is called an intervertebral hernia. In this regard, there are various symptoms, such as pain in the projection area of the damaged disc, extending to the buttock and spreading along the back and outer side of the leg on the side of the lesion. But pain is not the worst symptom!

It is dangerous when pain sensations go away and weakness appears in the lower extremities, sensitivity disturbance, tingling, defecation, urination, and potency decrease. This suggests that irreversible changes have begun in the compressed roots.

Treatment Methods

There are two main methods of treating a herniated disc in the lumbar spine:

conservative (includes medications, physiotherapy, massage);
surgical.

Some separately distinguish alternative methods of treatment. In this section, we will look at each of the treatments in more detail.

Folk remedies

Treatment of an intervertebral hernia of the lumbar with folk remedies can to some extent be attributed to the methods of conservative therapy. Its purpose is to relieve swelling of the roots of the spinal cord and remove pain.

The most widely used bee products.
Also popular are compresses from marsh cinquefoil grass, which has good anti-inflammatory properties, relieves swelling and pain.
Compresses from horse fat and rubbing with fir oil have similar properties.

But such methods of treatment are only temporarily able to relieve the pain syndrome, but not eliminate the main problem.

Honey is used for massage and rubbing in the affected area, bee venom relieves inflammation, and royal jelly strengthens the overall protective reserves of the body.

Removal operation

An operation on a herniated disc is the treatment method that eliminates the cause itself. The indication for it is a serious neurological symptomatology associated with dysfunctions of the pelvic organs and weakness and decreased sensitivity in the extremities.

The operation consists in removing the hernia and part of the affected disc, replacing this part with an implant and installing a special fixation system on the vertebrae for a stabilizing effect.

Now, when performing surgical interventions, doctors are trying to use innovative technologies that can significantly reduce the rehabilitation period, the scars after them are invisible, since the size of the incision is minimal.

Another method is endoscopic hernia removal.. The incision for such an operation is only 2 - 2.5 cm, the risk of relapses and complications is very small, and patients can get up and walk almost immediately after the operation. However, the method is new and not fully developed, in addition, there are restrictions on the localization of the hernia and its size.

The standard of modern treatment is microdiscectomy. It is performed using special optical equipment under multiple magnification, the incision is only 3-4 cm.

Photo: transfacet hernia removal

Treatment without surgery

Most often, the treatment of an intervertebral hernia of the lumbar without surgery is performed. After it, improvement occurs in 70-80% of patients. Methods of conservative treatment set themselves such tasks as removing swelling of the roots, pain, neurological symptoms, and preventing or reducing the frequency of relapses.

In addition to drug therapy, methods such as:

physiotherapy;
massage;
physiotherapy.

They are aimed at strengthening the muscles of the back. Traction methods of treatment using skeletal traction are also used.

The spine, as it were, is stretched, the compression of the roots by the affected disc is removed. But all these methods require lifestyle changes, limiting sudden movements and lifting weights up to 2-3 kg.

Conservative therapy includes the appointment of anti-inflammatory and analgesic drugs, muscle relaxants, and therapeutic blockades.

Laser

Laser vaporization is one of the modern methods of treatment of intervertebral hernias. It consists in heating the disc with a laser, thus water is removed from it, edema and the volume of the hernial protrusion are removed, pain and neurological symptoms disappear.

The terms of rehabilitation are no more than a month. In addition, this technique has a number of contraindications:

history of spinal surgery
spondylolisthesis
narrowing of the spinal canal
spondyloarthritis
extrusion of the disc with compression of the nerve roots.

But it is important to remember that by themselves degenerative changes in the intervertebral disc do not go anywhere, therefore, the risk of relapse is not excluded.

Rehabilitation

Rehabilitation after surgery to remove an intervertebral hernia requires a serious approach. The patient cannot sit for 3 months and needs to wear a corset, at first it is worn constantly, then 3 hours a day is enough. Another important method in rehabilitation is exercise therapy.

Photo: physiotherapy exercises after removal of the intervertebral hernia

Gymnastics starts from 1 day after the operation. It includes flexion-extension movements in the knees, circular rotation in the ankle joints, pulling the legs to the stomach. Throughout life, you also need to remember about therapeutic exercises, daily push-ups, shallow squats; cycling, swimming will also strengthen your back muscles.

FAQ

How painful is it to treat a lumbar hernia?

Operative treatment is always carried out under anesthesia, so any pain is excluded. Pain may occur only in the postoperative period, but this is completely normal.

How long does the treatment last?

To relieve pain in a conservative way, sometimes a few days are enough, but sometimes it takes months. Surgical treatment includes only the time of the operation and subsequent rehabilitation, it takes up to 3 months.

Is it possible to do without surgery?

If the hernia is not accompanied by a violation of sensitivity and weakness in the lower extremities, a disorder of defecation, urination, potency, then you can do without surgery. Otherwise, an operation is necessary.

Is hernia treatment effective with conservative methods?

If with the help of conservative therapy it is possible to achieve relief of symptoms and prevent or reduce the frequency of relapses, then it can be considered effective. But the root cause of the disease will not be eliminated.

Content

Lumbosacral disc herniation occupies a leading position among disorders of the musculoskeletal system. This pathology requires timely diagnosis and the appointment of competent therapy. Advanced forms of the disease can have very dangerous consequences in the form of paresis or paralysis.

Causes of pain in the lumbosacral spine

With discomfort in the lumbar region, many are familiar firsthand. In this case, a person may experience pain of a different nature. Is it transient (acute) or chronic. The first passes faster than the cause that provoked it. The second lasts even after the cessation of the action of irritating factors. The causes of each of the above syndromes can be the following conditions:

The appearance of acute pain is provoked by:

muscle injury;
vertebral fractures;
radiculopathy;
rupture of the ligament;
lumbosacral hernia;
epidural abscess.

Chronic pain occurs due to:

deforming spondylosis;
oncology;
osteomyelitis;
myositis (inflammation) of the spinal muscles.

Hernia of the lumbosacral spine

Intervertebral fibrocartilaginous formations consist of a nucleus, rings surrounding it with collagen fibers and hyaline connective tissue. Due to this structure, they provide strength and cushioning of the spine. This greatly reduces the risk of damage due to injuries, heavy physical exertion, sprains. It happens that under the influence of negative factors, the development of pathologies of the disk space occurs.

Intervertebral hernia of the lumbosacral spine is formed when the annular collagen fibers are torn. There is a protrusion of the pulpous nucleus. The result is a hernia that compresses the nerve roots and leads to inflammation of the adjacent tissues. In the absence of proper treatment, the patient consistently develops such stages of the formation of a lumbosacral hernia of the spine:

Protrusion. At this stage, there is a small protrusion (3 mm).
Prolapse. The size of the lumbar hernia is about 1.5 cm.
Sequestration. The stage is characterized by pinched nerve roots and constant severe pain.

Symptoms

The first signs of the development of degenerative changes in the intervertebral space are often ignored by patients. The dull, aching nature of recurrent syndromes is simply "experienced" by them from day to day. Due to such a careless attitude to the problem over time, patients experience a progressive displacement of the pulp nucleus outside the disk space. The following symptoms of a hernia of the lumbosacral spine are distinguished:

muscle atrophy;
pain syndrome when lifting the leg (a specific sign of a hernia of the intervertebral space);
shootings extending to the lower limbs;
numbness;
lumbar pain;
decrease in reflex activity;
the development of sciatica, as a consequence of a hernia;
dryness of the skin.

Risk factors

Degenerative changes in the intervertebral discs, manifested by a lumbosacral hernia, can occur due to many reasons. Modern lifestyle often provokes the development of dysfunction of the musculoskeletal system. An increase in physical activity, a balanced diet, and a reduction in possible stressful situations will help to avoid the negative impact. The main risk factors for the formation of an intervertebral hernia of the lumbosacral spine include:

heavy physical labor;
work involving a long stay of the body in a static position;
neglect of the principles of physical activity;
bad addictions and habits;
excess weight, additionally loading the lower spine.

Treatment of intervertebral hernia of the lumbar

In the stage of protrusion of the fibrous ring, therapeutic measures to eliminate the protrusion in the lower spine are limited to bed rest, the appointment of anti-inflammatory and other drugs. Advanced forms of pathology require the use of measures for the medical removal of swelling of adjacent tissues, the release of intervertebral discs and the elimination of compression of the nerve roots. In addition to these, there are the following methods on how to treat a lumbosacral hernia:

through conservative therapy involving the use of medications:
- synthetic hormonal drugs injected into the epidural space of the spine (methylprednisolone);
- opioid analgesics;
- NSAIDs (Indomethacin, Movalis), used at the beginning of the formation of a lumbosacral hernia;
- blockade injections of novocaine or lidocaine into the lower spine;
- drugs to improve blood circulation (Actovegin, Trental);
- injections with B vitamins to accelerate the recovery of tissues adjacent to the hernia area;
- external agents with non-steroidal components.
through surgery:
- Endoscopic discectomy - resection of the damaged disc space. The “breakage” is removed along with the hernia through a small incision in the skin.
- Laminectomy - extraction of the vertebral arch.
- Ligamentectomy - scraping of the disc.
- Chemonucleolysis - drying of the resulting hernia.
- Spinal fusion - transplantation of a new bone disc from the patient's pelvic bone.
- Laser disc decompression - laser evaporation of an existing hernia.

Therapeutic exercises for the lumbar spine

The recovery period is of paramount importance in the entire process of treatment of intervertebral hernia. Therapeutic physical culture (LFK) helps the body adapt to the changes that have occurred and gradually develop a new set of conditioned reflex motor reactions. The lower spine is at high risk of recurrent hernia. In view of this, it is important to follow the basic rules of physical activity.

Therapeutic exercises for a hernia of the lower spine include measures aimed at stretching the bearing part of the skeleton, for example, swimming. Engage in these types of activities regularly:

To perform the exercise, get on all fours with support on your knees and elbows. Next, you need to simultaneously raise the right arm and left leg, fix the body for 5 s. Take the starting position, and perform the approach on the other side.
Take a horizontal position with straightened arms and legs bent at the knees. Raise the pelvis with emphasis on the back and fix the position for 3 s.
Lie on your stomach and put your hands under your chin. Gently raise the body without lifting the lower body from the floor surface. You need to hold this position for 5 s.

During the rehabilitation period, it is strongly recommended to adhere to moderate physical activity. After 2-3 months after the extraction of the lumbosacral hernia, the patient can start exercise therapy, take short walks. You can speed up the processes of adaptation and healing with the help of spa treatment, including baths with radon, turpentine, sulfides.

You can significantly reduce the risk of recurrence of an intervertebral hernia if you follow such recommendations as:

maintaining an active lifestyle without heavy loads on the spine;
the use of preventive means of protection against injuries of the bearing part of the skeleton;
visiting the pool;
reduction of excess body weight;
conducting regular classes;
maintaining constant control over the correct posture;
preventing the body from being in a static uncomfortable position;
taking frequent walks in the fresh air.

Video: Exercises for the lumbosacral spine

Attention! The information provided in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can make a diagnosis and give recommendations for treatment, based on the individual characteristics of a particular patient.

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Bardukova Elena Anatolievna
neurologist, homeopath, work experience 22 years
✔ Article checked by a doctor

Famous Japanese rheumatologist:“THIS IS AMAZING! Russian methods of treatment of joints and spine cause only bewilderment. See how doctors offer to treat back and joints in Russia: Voltaren, Fastum gel, Diclofenac, Milgamma, Dexalgin and other similar drugs. However, these drugs DO NOT TREAT THE JOINTS and BACK, they only relieve the symptoms of the disease - pain, inflammation, swelling. Now imagine that…” Read full interview »

How to effectively treat a hernia of the lumbar spine? Is it possible to completely cure a lumbar hernia of the spine? Patients who have been diagnosed with this always want to know the honest answer. Do not worry! It can be completely cured! But it is necessary to make the maximum amount of effort, since there are many methods for treating lumbar hernia.

Remember a hernia of the spine is not a sentence!

Sometimes a hernia of the spine is confused with ankylosing spondylitis and other diseases, so you need to make an appointment at the clinic for diagnosis.

Important! The advantage of selective NSAIDs: they have virtually no side effects on other organs of the body and act only on the affected area.

Muscle relaxants

They are necessary to relieve muscle spasm, improve blood circulation and reduce pain.

Muscle relaxants in combination with NSAIDs give a good therapeutic effect.

They are not taken separately, but only in combination with other drugs. This group of drugs includes: Mydocalm, Sirdalud, Diazepam, Tizanidin, Tetrazepam, Baclofen, Tolperison, Tizalud, Tolperil.

Paravertebral blockade

Chondroprotectors

Treatment in the subacute period

Medications: take muscle relaxants and painkillers in combination, vitamins of group B. Below we will consider all the recommended methods of treatment in the subacute period.

Physiotherapy

Physiotherapy is necessary to accelerate the recovery of the patient, it is necessarily used in the complex treatment of lumbar hernia. There is a high chance of getting rid of a hernia without surgery.

Effective physiotherapy:

Complementary Therapies

Massage

This method of treatment should be performed only as prescribed by the attending physician. It should be entrusted only to experienced specialists in the field of massage.

Cryotherapy

Therapeutic exercise (LFK)

Physical education should not be accompanied by pain. You can use a special corset to reduce the load. The attending physician should choose a set of exercises for you. With a lumbar hernia, exercise therapy should be done strictly under the supervision of an instructor, especially in the first lessons.

If you do exercises without the supervision of a specialist, you can harm yourself. Basically, exercise therapy is aimed at stretching the spine, in which the discs are set into place, the muscle corset is strengthened and the hernia is reduced.

Exercises in the subacute period

Position - on the back. Legs and arms are straightened. The muscles of the body are relaxed. We slowly raise and lower our hands. Repeat 15 times;
The starting position is the same. Bend the right leg and unbend at the knee. Move your foot left and right. Do the same with the other leg. The number of repetitions is 10-15 times;
Lying on the stomach, hands under the chin. Bend your legs, trying to touch your buttocks with your feet. Repeat 10 times;
Starting position standing. Swing your legs in different directions. Repeat 15 times;
The starting position is the same. Take turns pulling your bent legs to your chest, using your hands.

Treatment during the recovery period

During this period, the number of drugs taken is much less: only therapeutic blockades and then, if there is a pain syndrome when performing physical education.

A course of muscle relaxants and B vitamins should have come to an end.

Physiotherapy procedures in the recovery period are the same as in the subacute.

exercise therapy. The number of types of physical exercises is increasing, because it is necessary to restore posture, strengthen the muscular corset and leg joints.

Starting position - lying on your stomach. Raise your straight leg, increasing the angle of inclination over time. Repeat 10-15 times;
Stand with your back next to the wall, your back should be even. Tilt the pelvis of the body back a little so that the buttocks and heels touch the wall. Rise on toes, freeze for 5 seconds. Then return to the starting position.
Exercise - walking with a straight back, squats, stepping over obstacles. At the same time, a bag of sand is placed on the head, weighing a maximum of 500 grams.
Exercise with stairs. Under the supervision of a doctor, perform a variety of exercises with dumbbells, balls, do half-hanging and hanging on the horizontal bar.

Video: physiotherapy exercises for a hernia of the lumbar spine

Surgical treatment

The surgical method is a last resort. Indications for which an operation on a hernia of the lumbar spine can be prescribed:

low efficiency of conservative treatment, in which the pain does not go away within 3-6 months;
impotence;
problems with urination and intestines;
loss of sensitivity, paralysis, paresis;
part of the hernia got into the spinal canal (sequestration of the hernia);
there was a narrowing of the spinal canal (stenosis);
compression of the cauda equina (nerves at the end of the spinal canal).

What are the types of hernia surgeries?

Video: how to get rid of a herniated disc in one day?

Rehabilitation

After the operation, the patient must be rehabilitated. He is forbidden to sit for three months. Be sure to do physical therapy.

Prevention and diet

You must adhere to the following simple rules and recommendations:

carefully monitor your posture, the curvature of posture leads to scoliosis, and this is the right way to earn a hernia;
sleep on an orthopedic mattress;
no smoking;
distribute the carried load in both hands;
exercise regularly, go swimming;
spend less time at your desk
refuse fatty, spicy foods;
limit the consumption of flour and sweet products;
application of the Kuznetsov applicator;
include fish, fruits, vegetables, nuts in the diet.

Video: how to treat an intervertebral hernia without surgery. Tips from Elena Malysheva

If you start treatment of a lumbar hernia in time, then return to your previous lifestyle in a week. Do exercise regularly and follow the above tips and diet, and you will forget about a herniated disc.

Be healthy!

Findings and Conclusions

What are our Russian doctors silent about? Why in 90% of cases, drug treatment gives only a temporary effect?

Unfortunately, most of the drugs that "treat" diseases of the back and joints, which are advertised on TV and sold in pharmacies, are a complete divorce.

At first it may seem that creams and ointments help, BUT in fact they only TEMPORARILY relieve the symptoms of the disease.

In simple words, you buy a regular painkiller, and the disease continues to develop, turning into more severe stage. Ordinary pain can be a symptom of more serious diseases:

dystrophy of muscle tissue in the buttocks, thighs and lower legs;
pinching of the sciatic nerve;
the development of arthritis, arthrosis and related diseases;
acute and sharp pain - backache that leads to chronic sciatica;
cauda equina syndrome, which leads to paralysis of the legs;
impotence and infertility.

How to be?- you ask. We have studied a huge amount of materials and, most importantly, tested in practice most of the remedies for the treatment of diseases of the spine and joints. So, it turned out that the only new tool which does not remove the symptoms, but really heals - this is a medicine that is not sold in pharmacies and is not advertised on TV! So that you do not think that you are being sucked in another "miracle remedy", we will not tell you what an effective drug it is. If you are interested, you can read all the information about it yourself. Here is the link" .

List of used literature

Evgeny Cherepanov "School "Healthy Spine", 2012;
Alexey Ivanchev "Spine. Secrets of health", 2014;
Victoria Karpukhina "Health of the spine. Popov, Bubnovsky systems and other methods of treatment", 2014;
Yuri Glavchev "The spine is a provocateur of all diseases", 2014;
Stephen Ripple "Life without back pain. How to heal the spine and improve overall well-being", 2013;
Galli R.L., Speight D.W., Simon R.R. "Emergency Orthopedics. Spine.", 1995