Features of the development of a hernia in the lumbar spine

Every organ is harmoniously located where it belongs, and fully functions only when it is in its natural position. A hernia is a pathological protrusion of an organ from a natural cavity. In this case, a hernia of the lumbar spine is a partial deformity of the intervertebral disc, which is shifted from its normal anatomical position in the lumbar region. Such a shift further leads to rupture of the fibrous ring - the structure in which the core of the disc is located.

Doctors involved in the treatment of the disease:

1. Orthopedist - this specialist treats the hernia directly.
2. Neurologist - deals with the consequences associated with the impact of the protruding nucleus on the structures of the nervous system.
3. Therapist - treats pathologies of internal organs that occur against the background of defective activity of the nerve fibers that innervate them.

For a deeper understanding of the mechanisms of the formation of hernial pathology, one should understand the normal structure of the spine. The spinal column is an elongated structure consisting of 34-35 vertebrae interconnected. Between the latter are intervertebral discs - cartilaginous substances. Their function is to evenly distribute pressure, absorbing any load when running, walking, lifting weights. However, the degree of load does not always correspond to the upper threshold of the capabilities of these structures, so the formation of a lumbar vertebral hernia has its own prerequisites.

Among them are the following:

1. Severe road traffic accident in which "whiplash" occurs - a sharp and strong jerk head first and then back.
2. Prolonged heavy physical activity. Usually, this category includes people whose work is related to power work: builders, loaders.
3. Constant stay in a sitting position.
4. Concomitant diseases of the musculoskeletal system: osteochondrosis, scoliosis, lordosis and kyphosis. A hernia of the lumbar, in this case, is formed against the background of senile changes, when the vertebra is not able to perform a layer of its functions.
5. Violation of proper nutrition (obesity increases the load on the lumbar region).

In addition to these factors in the development of pathological prolapse of the nucleus, there are also congenital and constitutional causes:

• heredity, where the predisposition to the formation of pathology is higher than in the population;
• gender differences (in women, the risk of developing an ailment during pregnancy is higher);
• the person's age;
• individual features of the structure of the body.

Stages of formation of a hernia of the lumbar spine

Before the kernel is outside the disk, it goes through a series of changes:

1. Protrusion - minor changes in the fibrous ring surrounding the nucleus. At this stage, this ring partially loses its former elasticity, due to which the core shifts inconspicuously towards lower pressure. At this stage, the disease can be prevented by using the alternation of rest and exercise.
2. Partial loss of one of the sections of the disk. The second stage does not completely repeat the first, but the degree of destruction of the fibrous ring increases. Also, this stage is accompanied by a stronger aspiration of the nucleus to the side.
3. Prolapse is a stage preceding the stage of the final formation of a hernia. The nucleus of the intervertebral disc protrudes beyond the ring itself, squeezing parts of the nervous system.
4. sequestration . This stage is the full flowering of hernial pathology. In this condition, it falls into the spinal canal (dorsal herniated discs), causing a variety of problems, from allergies to blockage of blood flow to the spinal cord. An intervertebral hernia of the lumbar spine threatens with a complete loss of sensation in the areas of the lower extremities and a violation of the activity of the pelvic organs.

Clinical picture of the disease

The course of this disease is progressive. An intervertebral hernia of the lumbar spine manifests itself in a number of signs, combined into three main syndromes:

1. Pain syndrome.

Pain, as a symptom, is constant, appears at the beginning of pathological changes in the intervertebral ring and accompanies the sufferer until the cure. In the initial stages, the patient feels slight pain, which then flows into severe pain.

The degree of unpleasant feeling increases when a force begins to act on the spine, or on its individual parts. Initially, pain sensations are localized in the place of direct protrusion of the nucleus - it is aching, dull, aggravated by movement. Then it can move to neighboring sections of the spinal column. Pain can disappear only when the sufferer takes a supine position.

2. spinal syndrome.

Pain, unfortunately, is not an isolated phenomenon, and its consequences affect muscle tone: with constant pain, the muscles in the lumbar region take on a spasmodic state. Constant muscle contraction activates a vicious circle: constant algia provokes muscle spasm, which, in turn, compresses the nerve endings, from which the pain intensifies. It becomes impossible to straighten the back: the patient constantly takes a stooped posture. The size of the hernia also affects the pain - it gets worse. In the compressed roots, trophism is disturbed, which leads to the formation of certain segmental symptoms: sensitivity worsens on the outer surface of the thigh, on the skin of the lower leg and the underside of the foot.

3. Root Syndrome.

This syndrome is reflected by such signs:

• the thigh muscles, as well as the muscles of the lower leg and foot, become weak. It is increasingly difficult for a patient with a hernia of the spine to squat, climb stairs, jump;
• the muscles of these parts of the body weaken, therefore, they atrophy (reduce in size). Outwardly, there is a decrease in the leg;
• paresthesias appear - qualitative changes in the sensitive sphere: there is a subjective sensation of crawling, tingling, numbness of the skin;
• the regulation of sweating is disturbed: the skin can be extremely wet, or vice versa - dry;

With a long course of the disorder, lumbodynia occurs - sensations of a backache in the lumbar region.

Violation of the work of some internal organs:

1. Intestine: alternating diarrhea and constipation, regardless of the specifics of the food taken.
2. Genitourinary system: increased urge to urinate. Sometimes there is complete urinary incontinence. Also, a hernia of the intervertebral disc of the lumbar region is accompanied by a decrease in sexual activity: libido drops, the quality of erection is disturbed, the appearance of prostatitis; women suffer from gynecological diseases.

Diagnosis of a hernia in the lumbar spine

The study of pathology is carried out by using instrumental methods. However, before making such a diagnosis, a neurologist studies some aspects of the course of the disease.

What the doctor pays attention to:

• tendon reflexes and their manifestations;
• lifting a straightened leg;
• study of such types of sensitivity: temperature, vibration, tactile.

After that, the study of the lumbar region is carried out by the following methods:

1. Magnetic resonance imaging.
2. CT scan.
3. Computed multislice tomography.
4. Contrast methods: myelography, transcranial dopplerography.

Only on the basis of these methods is the diagnosis of "herniated disc of the lumbar" carried out.

What to do with a hernia of the lumbar spine

If you find in yourself, or people from your environment, a group of symptoms similar to this pathology, you should contact the appropriate specialist. It is extremely important to remember: the sooner you see a doctor, the more chances there will be for a complete cure. Actually, the treatment of the disease consists in the elimination of pain, spinal and radicular syndrome. Also, the goals of therapy include strengthening the muscle corset that supports the chest and spinal column, eliminating comorbidities, preventing complications and rehabilitation with recovery.

 

After the diagnosis, doctors can go in two ways: surgery or conservative therapy.

The choice of type of treatment depends on the clinical stage of the disease:

• acute stage: the patient complains of pain, aggravation during movements and paresthesia;
• subacute stage: the degree of pain decreases, there are almost no disturbances in sensitivity;
• recovery period: no pain, lesions of the sensitive area too.

 Treatment of the acute period involves:

1. Bed rest with maximum restriction of any movement.
2. Medications: painkillers, anti-inflammatory, muscle relaxants that relieve muscle spasm of the department and a vitamin complex. The nervous system is most sensitive to B vitamins - and it is prescribed.

Treatment of the patient in the subacute period:

1. Half bed mode.
2. Medications: the same groups of drugs, but with an adjusted dose - reduced.
3. Physiotherapeutic procedures: massage, self-massage, reflexology. Some doctors may also include alternative methods in medicine, such as hirudotherapy - treatment with leeches.
4. At this stage, the physical therapy complex begins: a set of simple exercises aimed at the gradual restoration of the body.

Therapy of the patient in the recovery period:

1. At this stage, drug therapy is used to a small extent and only according to indications.
2. Physiotherapeutic methods and methods of alternative medicine repeat the previous step.
3. The priority of the recovery stage is exercise therapy, which is aimed at the rehabilitation of the muscle tone of the back and legs. Therapeutic and physical culture complex involves performing exercises related to extension, flexion, flips, weight lifting. It also includes endurance exercises.

Contraindications for hernia of the lumbar spine

When treating, there are a number of restrictions in the period of home recovery:

• you can not take potent drugs on your own without a doctor's prescription;
• discard untested methods of traditional medicine;
• do not use warming ointments.

Indications for surgery:

• narrowing of the canal of the spinal column;
• gross dysfunction of the pelvic organs;
• lack of effectiveness after conservative therapy;
• complete prolapse of the hernia;

Contraindication is the bearing of the child by the mother.

The purpose of the operation is to release the sections of the spinal cord or specific roots that are pinched by a hernia.

Consequences of the disease

Neglecting to see a doctor, a suffering person may experience a number of complications and consequences:

• chronic pain syndrome;
• complete paralysis of the muscles of the lower extremities;
• constant constipation, drifting;
• chronic stoop;
• limitation of movement in the back or legs.

Lifestyle

How to live with a hernia of the lumbar spine, and how to live in such a way that it does not develop at all? In order to prevent relapse or prevent the development of pathology, it is necessary to adhere to a number of measures.

The main ones are:

1. Eliminate bad habits from life: smoking, excessive drinking.
2. Make a balanced daily diet containing the entire set of minerals and vitamins.
3. Carefully manage your weight. Prevent sudden weight gain.
4. Balance between rest and exercise. Perform simple charging.

By living and adhering to such a lifestyle, one can not only nullify the residual manifestations of the disease, but also forget about it forever.