How is Schmorl's hernia treated in the lumbar

Schmorl's hernia of the lumbar spine is a common pathology, which is accompanied by the formation of a specific protrusion of the intervertebral cartilage into the vertebra, which is located above or below the defective intervertebral disc. In most cases, people live with this pathology for decades without even knowing it exists.

However, sometimes it turns out that the disease has progressed over the years, because of which the person has characteristic complaints.

So what is Schmorl's hernia? When is it necessary to see a doctor and how to cope with the problem?

Causes of Schmorl's hernia

Shmorlev's hernia is a disease that cannot be considered fully understood. Today, the reasons for its development are still not known for certain, but doctors have already identified a number of factors that unequivocally contribute to the appearance of pathology.

Predisposing factors include:

the presence of a predisposition transmitted from one of the close relatives by inheritance;
the bad influence of external factors on the development of the fetus and the anomalies associated with it;
decreased bone density (osteoporosis);
various defects in the structure of connective tissues;
insufficient blood supply to the bones and, as a result, necrotic changes in them;
various traumatic injuries of bone tissue;
degenerative changes in the body caused by age;
neglect of the rules of a healthy lifestyle;
pathological changes in posture;
the habit of leading a sedentary lifestyle.

Predisposing factors cannot be considered full-fledged causes of the development of the disease. This is explained very simply: under the influence of the same factors, one person may suffer from a disease, while in another person his symptoms and signs will never be revealed.

It is important to remember that reducing the influence of predisposing factors can avoid the development of the disease.

The mechanism of the development of the disease

How does Schmorl's hernia develop in the lumbar region? What processes must take place in the body in order for a person to be diagnosed sooner or later?

It all starts with the impact on the spongy substance of the spinal column of various negative external factors. Under their influence, the density of the spongy substance may slightly decrease, and the cartilaginous tissue in the intervertebral disc may be deformed.

Gradually, the spongy substance is deformed, a characteristic pressure is formed in it, which in shape corresponds to the protrusion of cartilage in the adjacent intervertebral disc. The free space formed as a result of depression is filled with cartilage tissue. Such a formation in medicine is called Schmorl's node.

A feature of the formation of such a defect in the lower back or any other part of the spine is that it does not compress the blood vessels and nerve trunks.

And this means that there is no pain syndrome or any other complaints characteristic of classic hernias. It is in this regard that patients turn to doctors for help rather late.

Most often, lesions of the lumbar and sacral spine are detected. In most older people, with careful examination, it will certainly be possible to find Schmorl's nodules. This is explained by the high load that the mentioned vertebral sections are forced to withstand. Interestingly, the pathology can be both congenital and acquired during the life of the patient.

Symptoms

The symptomatology of the disease depends largely on which part of the spine the pathological nodules are localized and what is their number. Most often, the disease is completely asymptomatic for a long time, but if multiple Schmorl hernias or very large formations are found, specific symptoms may appear.

These include:

pain in the spinal column (different patients give a different description of the pathology, ranging from complaints of stabbing discomfort and ending with a mention of a pulling feeling, the complaint appears mainly during the period of physical activity, and disappears if the patient is at rest);
decrease in flexibility and the number of active movements in the spinal column (the greatest difficulties are noted if the patient tries to perform forward bends);
various pathological changes in the figure and posture (kyphosis, scoliosis, etc.);
a feeling of fatigue and weakness in the back and lower extremities, which is especially strongly felt during active physical exertion;
elderly people may have complaints of reduced sensitivity of the extremities, their numbness, rapid leakage.

With Schmorl's hernia, the patient feels pain not because the protrusion affects the nearest nerve trunks, but because of the negative effect on muscle tissue. Muscles in the area of pathology are in a state of spasm, which causes pain. The doctor, conducting an examination, can even grope for foci of tension.

Diagnostic approaches

Many are wondering how to correctly diagnose before starting treatment for Schmorl's hernia of the lumbar spine?

First of all, you need to visit a specialized doctor. A therapist, orthopedist, traumatologist or vertebrologist will do. Sometimes, if necessary, a surgeon may be involved. The doctor will conduct a survey, clarify the patient's complaints, examine his spinal column and perform palpation, which will help identify foci of muscle tension.

After examining and taking a history, the patient will most likely be referred for an x-ray of the spine. Thanks to this simple measure, it is often possible to establish the presence of a Schmorl hernia, since it is quite clearly visible in the picture.

If the doctor has reason to doubt the correctness of the diagnosis, CT or MRI may additionally be recommended.

The attending physician may additionally prescribe a blood and urine test, a biochemical blood test, and electromyography. All these techniques will help to more accurately localize the location of the hernia, identify the presence or absence of concomitant pathologies, and draw up the correct treatment plan.

Recommended Therapy

How to treat Schmorl's hernia of the lumbar spine? The choice of the optimal tactics is made by the doctor after the symptoms of the disease, the localization of pathological nodules, and the individual characteristics of a particular patient are assessed.

In most cases, if the patient is not bothered by too much pain, conservative therapy is enough to cope with the disease. Various medications are often used, such as NSAIDs, local analgesics, muscle relaxants, chondroprotectors to protect cartilage tissues.

In addition to drug treatment, gymnastics plays an important role in therapy. Exercises are selected for each patient individually and are aimed at maximally restoring the former mobility of the spinal column. The main thing in this case is not to try to self-medicate, but to seek the optimal complex from a doctor.

For the treatment of Schmorl's hernia of the lumbar spine, surgery can be used in exceptional cases, although doctors usually try to avoid such a solution to the problem.

The operation is prescribed if the symptoms of the disease are very pronounced, and conservative therapy does not give any visible effect.

Possible Complications

Many patients believe that squeezing of the spongy substance of the vertebrae is a completely safe pathology that will not affect life and health in any way. Such an opinion is fundamentally wrong.

Patients with Schmorl's hernia are prone to the following dangerous complications:

the formation of a full-fledged hernial protrusion in place of previously harmless nodules;
high risks of developing compression fractures, which are formed in dangerous situations due to the weakening of the spongy substance of the vertebral bodies;
arthrosis of the intervertebral joints, which over time leads to more serious lesions of the musculoskeletal system;
the formation of children's kyphoscoliosis, which negatively affects the general state of health and the appearance of the patient;
sometimes disability is possible due to damage to the spinal nerves, which are very close to hernial protrusions and can be involved in the pathological process at any time.

To prevent such complications, it is recommended to engage in treatment in a timely manner and under the supervision of knowledgeable specialists.

How to protect yourself from illness

Prevention of hernial protrusions is a difficult task, since it must be dealt with from childhood. To protect yourself from a hernia, it is recommended to devote time daily to a minimum set of gymnastic exercises, for example, starting with them in the morning. It is also recommended to go swimming and walk as much as possible, which will provide the body with normal physical activity.

In addition to these measures, it is recommended:

balance the regime of work and rest;
carefully monitor nutrition;
control motor activity, avoiding a long-term sedentary lifestyle;
give up all bad habits;
give up heavy loads and sports that require excessive physical effort.

It is important to remember that gymnastics and physical education should be in moderation.

It is best if the doctor will initially monitor the progress of the exercises. This will help the patient avoid performance errors that may harm him, rather than improve his well-being.

Schmorl's intervertebral hernia of the lumbar spine is a pathology that only seems to many patients to be completely harmless. At the same time, few people are aware that the disease can proceed unnoticed, and then sharply declare itself.

Even if there are no symptoms of a hernia, it is recommended to take the time to prevent and treat it when it is detected, so that in the future you will not encounter various complications that can significantly impair the quality of life. A timely consultation with a doctor will never be superfluous.