Intervertebral hernia: symptoms and treatment
The intervertebral hernia is a characteristic protrusion or prolapse, which is carried out in the vertebral canal by fragments of the intervertebral disc. The intervertebral hernia, the symptoms of which are manifested due to injury to the patient or in the presence of osteochondrosis, is manifested among other things in the form of compression of the nerve structures.
The connection of the individual vertebrae, of which the spine is made, is formed by the intervertebral discs, which have a significant density. These discs consist of a nucleus located in their center, and also of strong rings, this is the nucleus of the surrounding, the rings, in turn, consist of connective tissue. It is thanks to the intervertebral discs that the spine possesses its inherent flexibility and strength. Often, however, there are various diseases of the spine, which involve the destruction of intervertebral discs (eg, lumbar osteochondrosis), which can also lead to the appearance of intervertebral hernias.
Considering the fact that the main load that touches the spine as a whole centers in the lumbar region, it is in this section of the spine that the intervertebral hernia often appears. In addition, the localization of the intervertebral hernia is also possible in the cervical and thoracic regions, which, however, is noted in practice in very rare cases.
If we consider the age category that is most susceptible to the appearance of an intervertebral hernia, then specialists specify frames within 25-50 years. It is noteworthy that the intervertebral hernia in the elderly is a very rare phenomenon, which is explained by the peculiarity of age-related changes, due to which the spinal disc is less susceptible to mobility. As for childhood morbidity, here, although rarely, it is also noted the possibility of the appearance of an intervertebral hernia, while mainly its formation is congenital in nature. In conclusion, we note that this pathology accounts for about 25% of cases of disability.
Causes of intervertebral hernia
More often as a cause of the appearance of intervertebral hernias, various disorders in metabolic processes, trauma, osteochondrosis, infection and posture disorder are distinguished.
As a rule, there is an intervertebral hernia as a result of increasing pressure directly in the intervertebral disc. There are a number of factors that contribute to the growth of such pressure in the intervertebral disk, on the basis of which as a result may develop an intervertebral hernia. We distinguish those of the main causes that contribute to increasing pressure in the intervertebral disc:
- Injury. In particular, it can be a strong blow directed to the back or falling on it.
- Osteochondrosis. Having an anamnesis of this disease is a predisposing factor to the appearance of a hernia. As a kind of push to its appearance, a significant load is determined (for example, when lifting the gravity, including when lifting it from the ground).
- Body weights above normal
- The different scale of the curvature of the spine.
- Sudden body turn of the body to the side.
In addition, there are also specific categories of individuals who are most prone to the appearance of an intervertebral hernia:
- people spending more than two hours driving a day
- people who work at a computer for more than four hours a day
- people who, for one reason or another, daily raise the severity.
Intervertebral lumbar hernia: symptoms
The main symptom inherent in the hernia of this department is the appearance of pain localized in the back and, in fact, the waist. Until the hernia has become large (that is, its projection into the spinal canal has not yet been performed), and the pressure it produces on the spinal cord roots can be defined as insignificant (which in general characterizes the initial stage of the disease in question), the patient encounters With blunt and inconstant pain in the lower back (also known as lumbago). Running, coughing, sitting, standing and sneezing for a long time lead to increased pain (this manifestation is not permanent, the pain subsequently disappears).
Increased hernia, which occurs after some time since the onset of the disease, or a sharp breakthrough leads to an increase in pain and its irradiation to the leg, thigh, or buttock. This, in turn, is defined as radiculitis, and its course is accompanied by ischialgia — a shooting and intensified manifestation of pain. Basically, this type of pain occurs as a result of a sudden change in the occupied position of the body or when lifting weights.
In addition to pain, there is often a symptom such as numbness. It can affect both one and both legs, while the course of it is accompanied by a characteristic weakness and tingling. The appearance of numbness indicates the squeezing of the hernia of the spinal cord.
In addition to the already listed symptoms characteristic of the intervertebral hernia of the lumbar region, there is also a restriction of mobility, in particular concerning the lower back. Severe pain, as a rule, provokes tension formed in the muscles of the back, this, in turn, leads to the fact that the patient simply can not straighten the back completely. As a result, after a while (within six months or a year) after the appearance of a hernia, the patient has a violation of posture (kyphosis or scoliosis).
In addition to these symptoms, in some cases, there are violations of stool (diarrhea, constipation), urination disorders (in the form of incontinence or urinary retention), including impotence, which occurs against the background of the effect of the intervertebral hernia.
Intervertebral hernia of the cervical region: symptoms
As in the previous case, a hernia in this department is accompanied by a trauma or injury that directly affected it.
A characteristic manifestation of the symptomatology in the intervertebral hernia of the cervical region is pain in the hand, the appearance of which is of an unexpected nature, but this is due to pinching of the cervical nerve. The pain is piercing, extending from the shoulder and up to the hand. Sometimes there is a feeling of numbness combined with tingling.
The most common departments in the spine, in the area of which this disease centers, are departments C5-C6 / C6-C7. Further on, the prevalence is followed by C4-C6 and, as the rarest, C7-T1. The peculiarity of the intervertebral discs of the cervical segment consists in their insignificant size and in the vicinity of the adherence to the spinal nerve, which indicates the possibility of clamping the nerve and the appearance of severe pain even with a slight protrusion.
With a hernia in the cervical level 4-5, where the root of the nerve is located near the 5th disc, there is a weakness in the deltoid muscle region located in the upper part of the arm. Also, the patient faces significant pain, localized in the shoulder area. With a hernia in the cervical 5-6 level with the location of the root of the nerve near the 6th disc, the patients have weakness of the biceps, as well as weakness in the muscles of the wrist. Symptoms such as pain, numbness and tingling in the direction of the thumb on the hand are noted.
In the case of a hernia in the cervical level 6-7 with the location of the root of the nerve near the 7th disc, the triceps suffer from weakness in the subsequent spread to the forearm, in addition, the weakness affects the muscles of the extensor fingers. Pain, numbness and tingling extend to the middle finger of the hand.
With the formation of a hernia in the cervical 7-T1 level with the location of the root of the nerve near the 8th disc, weakness occurs when trying to squeeze hands. The patient experiences the previously listed manifestations in the form of pain, numbness and tingling, the spread of these manifestations occurs from the shoulder to the little finger of the hand.
The intervertebral hernia of the cervical spine, the symptoms of which we have considered, are only general manifestations that may indicate the presence of a hernia. Each case is subject to consideration, because different variations of the symptomatology are possible depending on those features that are inherent in the organism as a whole. For this reason, I would like to warn the reader of hasty conclusions about his own condition, the type of disease that is relevant to him, and, of course, independent attempts at treatment based on possible assumptions.
As a rule, the intervertebral hernia that appears in the thoracic region is accompanied by painful sensations, concentrated in the back (upper part), and the increase in these sensations is observed during sneezing and coughing. It should be noted that the emerging pain is not at all a manifestation peculiar to hernia alone — in this case it is necessary to differentiate lung, heart and kidney diseases, as well as gastrointestinal disorders and diseases that may be relevant for the musculoskeletal system. In particular, the mass of various diseases of the spine, which are characterized by a similar symptomatology: a tumor, infection, fracture of the spine against the background of osteoporosis, certain metabolic disorders, etc.
In the formation of a hernia in the area of the spinal cord, it becomes possible the appearance of myelopathy (spinal dysfunction of the brain), which causes serious sensory disorders, imbalance in walking and movements, weakness of the lower extremities, problems with the intestine or bladder.
Directly symptomatology of the disease is determined on the basis of the sizes peculiar to the hernia and from its location (central, lateral or central-lateral).
- Central location. The appearance of pain, as a rule, is noted in the area of the upper back, which subsequently leads to myelopathy. Based on the size in combination with the pressure force produced on the spinal cord, a specific degree of disease is determined. The spinal cord in the thoracic region is surrounded by a small free space. The resulting hernia on the spinal cord begins to exert a certain pressure, which, in turn, leads to dysfunction, noted in the nerve endings. Moreover, sometimes such a hernia can lead to paralysis in the lower extremities.
- The location is lateral. The effect of a hernia in the form of pressure is made on the nerve endings concentrated in the region of the back level, which manifests itself in the form of severe pains that arise in the abdominal cavity and chest wall.
- The location is central and lateral. This arrangement determines the most varied symptoms in the form of numbness, pain in various departments, etc.
Treatment of intervertebral hernia
Based on the actual size of the formation and its location in combination with the stage that determines the disease and the presence of complications that have arisen against it, the appropriate treatment is determined.
The predominantly required effect is achieved through the use of conservative therapy. It is not excluded and the need for surgical treatment, which involves the removal of a hernia. This treatment is applied in accordance with specific indications aimed at preventing the development of various severe complications, and also in the absence of proper effectiveness from the use of conservative therapies.
Diagnosis and treatment of the disease is performed by an orthopedist, a neurosurgeon and a vertebrologist.