Herniated disc is a disease characterized by protrusion of a fragment of the intervertebral disc or its complete loss. Most often it develops as a result of osteochondrosis. In recent years, the disease has become much younger and already occurs in people over 25 years old. Along with the spread of the intervertebral hernia, it has acquired various myths about treatment. So how do you treat a herniated disc? How long do you need to do gymnastics, and when is it time to go to the surgeon?
Minute of anatomy
The intervertebral disc (IVD) consists of the nucleus pulposus and the annulus fibrosus; it performs a shock-absorbing function and ensures the mobility of our spine. Osteochondrosis and a herniated disc is a payback for upright walking, because every day throughout our lives we load our spine, walk in heels and carry weights. From such loads, the nucleus pulposus begins to press on the annulus fibrosus from the inside. At first, it resists the nucleus, but the lack of nutrients and exhaustion due to osteochondrosis do their job, and the annulus fibrosus begins to protrude into the spinal canal. This initial manifestation is usually asymptomatic and therefore goes unnoticed. Depending on the degree of disc protrusion, IVD prolapse and protrusion are distinguished. Since the load on the spine remains the same, the annulus fibrosus still experiences constant pressure from the nucleus pulposus. And at some point - with an awkward turn, with a jerk of weight lifting, with sports zeal - the nucleus pulposus breaks through the annulus fibrosus - this is a herniated disc.
The clinical manifestations of the disease depend on the part of the spine in which the hernia is formed. Most often, the most mobile parts are affected: the lumbar and cervical. Depending on the location of the hernia, the patient is worried about pain in the neck or lower back, radiating to the corresponding limb. Along with the pain comes a feeling of "woodiness" of the lower back or neck - the body strains the muscles to limit movement in these parts and not provoke pain. But sooner or later, tense muscles get tired and begin to hurt themselves. Often the limb becomes numb, there is a feeling of creeping. This occurs when the hernia begins to compress the nerve roots and fibers.
Types of treatment
For hernias, treatment can be conservative or operative. Conservative treatment includes:
- anti-inflammatory drugs - they relieve inflammation, swelling and, as a result, pain;
- muscle relaxants - designed to relax tense muscles and reduce pain;
- vitamins of group B - improve the conduction of nerve impulses, which is very important for nerve roots squeezed by hernias;
- consultation with a chiropractor who can also recommend spinal traction and post-isometric relaxation;
- physiotherapy - in the non-acute period, physiotherapy procedures help relieve muscle-tonic tension and relieve pain;
- Physical therapy is probably the most important component on this list. After all, all medications bring relief only temporarily, and if you do not engage in exercise therapy, the pain will definitely return. Physiotherapy exercises strengthens the muscular frame of the back, helps to maintain the spine in the correct position. Thanks to muscular work, nutrients are more actively delivered to the intervertebral discs.
There are several types of surgical treatment. All of them can be reduced to common denominators: either during the operation, the intervertebral disc is removed along with the hernia, or a laser is supplied to the IVD, which evaporates the liquid from the disc. Traumatic surgery is a thing of the past: now neurosurgeons work at the microsurgical level using microscopes, endoscopes and lasers.
Indications for surgery
Many people are afraid of surgery, afraid of anesthesia, fear of pain and complications of surgery. Therefore, they often delay to the last visit to the doctor and miss the opportunity of conservative therapy. You need to understand that at the first visit to the doctor, you are unlikely to be sent directly to the operating table, because the operation requires indications. If there are no such indications, then the treatment will be conservative.
Indications for surgical treatment:
- the progression of weakness in the limb, when, despite the prescribed conservative treatment, weakness and numbness do not go away for a long time;
- ineffectiveness of conservative treatment, when no drugs and procedures relieve constant pain, do not remove restrictions on movement in the neck or lower back;
- dysfunction of the pelvic organs, when with a hernia of the IVD in the lumbar spine, urination, defecation and erection are disturbed;
- sequestered hernia, when it undergoes destruction and forms a necrotic focus.
If these symptoms have arisen, then the question of conservative treatment is no longer worth it, because their appearance means that the internal organs are beginning to suffer, and this cannot be allowed.
Therefore, you should not be afraid of the operation: if the doctor prescribed it for you, then this is the best way out to keep you healthy!