Herniated discIf it hurts in the lower back, this can have many causes. Most people immediately think of lumbago or irritation of the sciatic nerve. However, a herniated disc (disc prolapse) is often responsible for the back pain. If this is the case and additional symptoms occur, such as paralysis, rapid action is required to prevent consequential damage. If it is not such an acute emergency and the herniated disc is detected early enough, the symptoms of disc prolapse are in most cases treatable without surgery. Measures such as physiotherapy and medical bandages or orthoses to support the spine provide pain relief and, in the best case, prevent the disease from becoming more pronounced. Many sufferers live for years with one or more herniated discs relatively pain-free, without surgical intervention.
Intervertebral discs – the shock absorbers of the spine
Between two vertebrae of the spine there is an intervertebral disc (out of a total of 23), which acts as a buffer to cushion vibrations, friction and shocks and ensures that the prere load is distributed evenly throughout the spine. Each intervertebral disc contains a core with a viscous mass that is surrounded by solid tie. In the course of life the intervertebral discs wear out. they lose height and gradually lose their Buffer function, so that at some point the disc tie gradually escapes laterally and in the worst case hits the spinal cord.
If the intervertebral discs cause noticeable problems, the disc tie either bulges out or comes out completely. In the case of a simple protrusion, the doctor speaks of a protrusion – an Prolapse of the intervertebral disc. The medical term for the complete leakage of the disc tie is prolapse – herniated disc. However, the actual protrusion or prolapse of the disc itself does not cause severe pain. For this reason, problems with the intervertebral discs can initially go completely unnoticed for a long period of time. Only when the leaking disc tie presses on the surrounding nerve roots does extremely unpleasant pain occur, which often makes any movement unbearable.
Certain areas of the spine are affected more frequently than others by a bulging or bulging disc. For example, herniated discs occur much more often in the lumbar spine than in the cervical or thoracic spine. Above all, risk factors such as obesity, poor posture, heavy physical strain or lack of exercise are usually responsible for intervertebral disc problems.
Herniated disc – lumbar spine symptoms
The area in which the back pain occurs in the spine usually already provides information about where the herniation of the intervertebral disc has occurred. If, for example, the leaking disc tie presses on the nerves in the lumbar spine, those affected complain of pain in the lower back. If the complaints occur more in the neck and neck area, it may be a herniated disc of the cervical spine.
However, the pain is not necessarily limited to the site of the herniation: it can also radiate to other areas of the body. In the case of a herniated disc in the lumbar spine, the pain often extends to the legs or even to the toes. Usually the complaints increase when coughing, sneezing or pressing. If the prere on the nerve roots of the lumbar spine persists over a long period of time or is particularly strong, sensory disturbances such as tingling and "formication" as well as paralysis of the legs may occur. If the affected person involuntarily loses urine or stool, it is an emergency and a quick operation is inevitable.
The herniated disc and the treatment
Many people are convinced that every herniated disc must be treated surgically. In fact, however, surgery is rarely necessary, since many courses of the disease can already be improved by a suitable, conservative therapy have a sufficient influence. Physiotherapy, pain-relieving medication as well as medical aids such as orthoses or bandages play an important role here. In the end, only five percent of all herniated discs in Germany are operated on. While some time ago strict bed rest and the so-called step positioning were recommended in the case of a herniated disc, today doctors increasingly advise the continuation of normal, light everyday activity. But in order to make movement possible again for those affected in the first place, painkilling and anti-inflammatory medications are used. Heat applications such as mud, mud or red light support the effect of painkillers.
As soon as an almost pain-free movement is possible again, the medicinal treatment is accompanied by physiotherapeutic exercises and, if necessary, by massages or movement therapy in water. In the case of a herniated disc that progresses without complications, physiotherapy is carried out over a period of about six to eight weeks. In addition, a rehabilitation measure of several weeks may be necessary afterwards.
During this period, medical bandages or orthoses can provide powerful support for the spine during both physiotherapy and everyday movements, thus helping to relieve pain. If the symptoms do not improve after several weeks of conservative therapy, the treating physician will probably recommend surgery after all.
However, surgery always carries risks. For example, surgery on the intervertebral discs in the lumbar spine can result in an incisional hernia, abdominal wall hernia or intestinal paralysis. During disc surgery on the cervical spine, nerve irritation can occur, among other things. In rare cases, permanent hoarseness may occur. In addition, there are the general complications that can accompany surgery, such as wound healing disorders or thrombosis.