"This severe pain felt as if I were being electrocuted in the leg," reports Helga K. Months ago, she had already noticed that this uncanny pain occurred during certain movements. She had already gotten used to the pain when she finally came in for a neurosurgical examination. What she couldn't get used to was en the numbness and weakness in her right leg .Helga K. Finally had to undergo surgery for a herniated disc in the lumbar spine.
"But only one in ten herniated discs really needs surgery," says neurosurgeon Astrid Takacs-Tolnai.
A herniated disc can put prere on nerves, cause great pain and ultimately paralysis. In some cases, however, a small herniated disc even goes unnoticed and causes no significant problems.
Intervertebral discs as shock absorbers for the lower back
The intervertebral discs lie like shock absorbers between the vertebral bodies of the spine. They flexibly connect the vertebrae with each other. Provide in conjunction with the small vertebral joints for appropriate mobility. Each intervertebral disc consists of a fibrous ring of connective tie. A water-rich gelatinous core inside the ring.
Like gel cushions, the intervertebral discs distribute the prere on the spine evenly over the vertebral bodies and thus ensure the enormous load-bearing capacity of the human spine In the course of the day, each person shrinks by up to three centimeters due to the strain of standing and walking. The intervertebral discs then expand again during sleep.
When walking, a prere of 3.6 bar (comparable to the prere in a car tire) weighs on the intervertebral discs . In a sitting position, however, this prere is just over 22 ba
How does a herniated disc develop?
Low back pain is a common complaint. If the pain radiates into the leg, a damaged intervertebral disc may be the cause.
When the connective tie ring of the disc tears and the gelatinous core bulges outward, disc protrusion occurs. If the gelatinous core breaks through the connective tie ring, this is a herniated disc.
In most people, herniated discs are the result of age-related wear and tear. Over the years, the elasticity of the intervertebral discs decreases. They lose water, become brittle and cracked.
Incorrect loading and overloading promote intervertebral disc problems. Years of heavy lifting using the wrong technique, such as bending forward, put as much strain on the spine as sitting at a desk for hours on end .
Most intervertebral disc problems occur between 30 and 60 years of age.
Often those people who have a weakly trained trunk musculature also have damaged intervertebral discs, because the muscle tension necessary to stabilize the spine is missing. Severe overweight promotes premature wear of the intervertebral discs. Pregnant women and women after pregnancy can also suffer from it. Smoking is another significant risk factor. High-performance athletes are also more often affected by intervertebral disc damage
"Most intervertebral disc problems occur between 30. and 60. With precise diagnostics (MRI), signs of wear and tear on the spine can already be detected in many people over the age of 30.
However, some people have worked hard physically all their lives without experiencing major low back pain. An individual genetic disposition to premature wear and tear also plays a role
Surgery for a herniated disc?
"When a herniated disc causes numbness and paralysis in the arms or legs and threatens permanent nerve damage, surgery is usually required. Bladder problems, numbness in the pubic area – these are real alarm signs that require urgent consultation with a neurosurgeon and surgery.
In the absence of paralysis symptoms, conservative therapy can be fully utilized. In the case of very severe and long-lasting pain, which can be relieved by pain medication, physiotherapy and, if necessary. If infiltrations do not improve, surgery can be considered.
In up to 90 percent of patients, the symptoms improve with conservative therapy and not infrequently the herniated disc is reduced in size and the symptoms even disappear completely after a few weeks. Years ago, patients with a painful herniated disc were confined to bed for long periods of time, but nowadays early exercise training is used to treat pain. The consistent development of the trunk muscles in the form of often only small exercises, which are carried out consistently and every day, are the key to long-term success. If we humans did our back and abdominal exercises as consistently as we brush our teeth, which we were taught to do as children, we would have far less low back pain. In most cases, insufficiently trained trunk muscles in conjunction with poor posture and overloading are responsible for the development of disc damage.
The location and size of a herniated disc are not the sole criteria for the need for surgery. As long as there are no signs of paralysis, it is possible to wait.