When a protrusion turns into a hernia. What is a herniated disc? Treatment of protrusions and hernias: what is the difference

Many people think that protrusion and hernia intervertebral disc- these are similar states. In some ways they are right. For example, that diseases are associated with violations of the integrity of the discs.

But there are significant differences between them. What is the difference between protrusion and herniated intervertebral discs? Is there a difference in their treatment methods?

What are the differences

To determine the difference between diseases, you need to consider each separately.

Protrusion

Essentially, this is a condition that precedes the formation of a hernia. It is characterized by protrusion of the disc beyond the spine. The fibrous ring remains intact.

This happens when the metabolism inside the disc itself is disrupted. It dries out, loses size and becomes less durable.

In this regard, the distance between the two vertebrae decreases. There is enormous pressure on the disc. This leads to the fact that he seems to fall outside the space allotted to him.

There are several types of protrusion:

1. . The displacement occurs towards the spinal canal. At the same time they are compressed nerve roots, there is severe pain.
2. . Shift right or left. This type is practically asymptomatic and does not cause complications.
3. Ventral. Occurs less frequently than others. It is a protrusion in the forward direction. Like the previous species, it does not manifest itself in any way.

Symptoms vary depending on where in the spinal column the protrusion occurs. Some of the most important ones can be identified:

• Chronic or acute pain. It can spread throughout the body.
• Feeling of numbness in the limbs.
• Stiffness in movements. and promotion blood pressure.
• Disruption of internal organs.

This pathology appears for several reasons:

• changes in tissues due to age;
• sedentary lifestyle, injuries;
• curvature of the spinal column;
• hard work;
• too intense training;
• excess weight;
• metabolic disorder.

Hernia

This is a condition in which the disc between the vertebrae changes its location and the annulus fibrosus ruptures.

And protrusion of intervertebral discs occurs for similar reasons. Typically these are injuries caused by increased load or accidents, lack of traffic, lack of nutrients in the spine area, overweight bodies, etc.

There are also general symptoms, which characterize protrusion or herniation of intervertebral discs. This is severe pain in the affected area, problems in the functioning of internal organs.

How to treat

Herniation and protrusion of the intervertebral disc have similar treatment methods. The most important thing is complexity.

In most cases it is used. But it also happens that you can’t do without it.

It is impossible to completely cure this pathology. Using traditional methods, you can only slow down its development and protect against complications. TO traditional treatment can be attributed:

• procedures for ;
• reflexology;

When acute pain occurs, the use of medications is indicated. Usually medications are prescribed that relieve pain, inflammation, swelling, and spasms. They help normalize blood circulation in the affected area and metabolism.

When none of the methods described above brings results, experts suggest surgery.

It is always associated with certain risks. Therefore, it is worth resorting to this method of treatment only in critical cases.

Similar methods are used to treat hernia pathology. First of all, doctors recommend getting more rest and protecting yourself from what could trigger the development of the disease. Other methods may also be prescribed:

1. Using medications to relieve pain and inflammation. Medicines are usually used for about a month.
2. . This is the injection of drugs directly into the area where the nerve is compressed.
3. . This is a procedure in which spasm and displacement are relieved by creating traction. It can be dry, water, horizontal and vertical.

Surgical intervention is prescribed only in as a last resort. During surgery, the hernia is removed to free up space around the compressed nerve. There can be several types:

• endoscopy,
• excision,
• discectomy.

Intervertebral hernia and protrusion – two various diseases with significant differences. Despite this, they have similar treatment methods. All of them are aimed at eliminating pain, swelling and inflammation.

In both cases, operations are prescribed only after all other methods have been used.

Denial of responsibility

The information in the articles is for general information purposes only and should not be used for self-diagnosis of health problems or medicinal purposes. This article is not a substitute for medical advice from a doctor (neurologist, therapist). Please consult your doctor first to know the exact cause of your health problem.

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Protrusion and herniation of the intervertebral (intervertebral) disc are pathologies of the spine characterized by displacement of the disc nucleus pulposus beyond the fibrous membrane, which has the shape of a circle and consists of connective tissue.

In almost 90% of cases, protrusion and hernia of the spine are a complication of chronic osteochondrosis, a disease in which dystrophic changes occur in the structure of the intervertebral disc, caused primarily by impaired cartilage nutrition and a decrease in the elasticity of cartilaginous plates against the background intensive dehydration. Despite the fact that intervertebral hernias and protrusions are classified as surgical pathologies, treatment always begins with the use of conservative methods: diet correction, medication, massage, exercise therapy, manual therapy, and physiotherapy.

The human spine is the central part axial skeleton, which also includes the bones of the neck and skull, ribs and sternum. It consists of 33 (in some people - 34) osteochondral vertebrae, each of which has a body, an arch and a process.

The vertebrae surround the spinal cord, and their processes connect to muscles that fix the spine and keep it in the anatomically correct position. Between the vertebrae there are intervertebral discs - connective tissue elements filled with gelatinous pulp (nucleus pulposus), which has a jelly-like consistency.

The disc nucleus is enclosed in a dense fibrous shell, which is also called the annulus fibrosus (as it has a round shape). On the upper and lower surfaces of the disc there are white ring-shaped cartilaginous plates through which the pulp is fed.

Intervertebral discs perform important functions, on which not only human mobility depends, but also the work of some internal organs, for example, Bladder and other pelvic organs. The main ones are:

• increasing resistance to axial (vertical) load;
• softening of force and shock loads when running, jumping, walking, during shaking (shock absorption function);
• ensuring flexibility of the spine and its mobility.

Nutrients (in particular collagen), vitamins, minerals, and water are delivered to the intervertebral disc through multiple blood vessels, which large quantities pass through the vertebral body. If the nutrition of the cartilage plates is disrupted, the disc becomes dehydrated and its firmness and elasticity decreases. Over time, this leads to a decrease in the height of the intervertebral disc (normally this figure can reach 10-11 mm), deformation of nearby vertebrae, compression of the spine and crushing of the disc.

Under the pressure of the adjacent vertebral bodies, the disc is compressed, and the nucleus pulposus (along with the fibrous membrane) is displaced. A protrusion is formed, which is called a protrusion.

If the disease progresses, outer shell cracks may form. The displacement of the pulp beyond the fibrous membrane through the resulting cracks and holes is called a hernia.

If you want to find out in more detail and also consider its departments, functions and disease prevention, you can read an article about it on our portal.

Causes of pathology

The main factor that plays a decisive role in pathogenetic mechanism the formation of hernias and protrusions is osteochondrosis. Osteochondrosis refers to chronic pathologies of the spine, characterized by progressive dystrophy and deformation intervertebral discs, and in varying degrees is detected in every third person over 30 years of age.

The basis of degenerative-dystrophic changes in cartilaginous plates is impaired blood circulation in the vessels spinal cord and the spine, through which oxygen and nutrients are delivered to the intervertebral disc. The following factors may contribute to such violations:

• irrational loads on the muscles that support the spine (increased physical exercise, working in an inclined or sitting position, lack of warm-up at the beginning of sports training, etc.);

  

• unbalanced and irregular diet low in protein products (meat, fish, eggs, cottage cheese), fruits and vegetables;

  

• hormonal disorders (in women they are especially pronounced during pregnancy, in early postpartum period and until the end of lactation);

  

• diseases of the feet, in which part of the supporting load is transferred to the spine (flat feet, heel spurs, planovalgus foot deformities);

  

• excess body weight (maximum risk in patients with obesity of 3 degrees and above);

  

  

• bad habits ( toxic substances tobacco smoke and ethanol interfere with the absorption of vitamins necessary to maintain the normal functioning of cartilage tissue).

  

Protrusions are characteristic of grade 1-2 osteochondrosis, when degenerative-dystrophic processes in intervertebral cartilage can be quite easily corrected by conservative methods. At this stage, patients are prescribed injections of chondroprotectors (less commonly, glucocorticosteroid hormones), analgesics, physical therapy, and massage.

If the patient suffers pain or periodically uses painkillers (often in unreasonably high dosages), without taking any measures to restore normal blood circulation and eliminate the deficiency of essential elements, the disease will progress.

Acute degeneration of the intervertebral disc leads to a decrease in the density of the fibrous membrane and its rupture. This is how an intervertebral hernia is formed - one of the most serious complications osteochondrosis, in advanced cases requiring use surgical methods treatment.

Note! Promote education and intervertebral hernia You can also wear tight, constricting underwear and clothing, use low-hardness mattresses and pillows, and carry a bag on your shoulder (on one side). For office workers who spend most of their time at the computer, it is important to choose the right computer chair (it must have medium hardness seats and the anatomical shape of the backrest) and ensure that the dimensions of the furniture correspond to your own height and build.

Hernia and protrusion: what is the difference?

Both intervertebral hernia and protrusion of the intervertebral disc are a protrusion of the nucleus pulposus, only in one case there is a rupture of the fibrous membrane, in the other - not. Conventionally, a classification according to the size of the protrusion is also applied: if the protrusion does not exceed 5 mm, it is considered to be a protrusion; a protrusion greater than 5 mm is classified as a hernia.

Comparative characteristics of intervertebral hernias and protrusions

If you want to learn more about the types, and also consider the symptoms, causes, diagnosis and treatment, you can read an article about this on our portal.

Signs and symptoms

Hernias and protrusions have certain differences in symptoms. If the protrusion does not big sizes(no more than 1-2 mm), the patient may not notice any signs at all, and the pathology is detected by chance when performing an X-ray of the spinal column. Protrusions larger than 2 mm may appear moderate clinical signs. The most typical symptoms for this pathology are:

• pain syndrome of mild or moderate intensity, the localization of which depends on which part of the spine the protrusion is located in (pain can also radiate to other parts of the body, for example, with protrusion of the lumbar region, pain syndrome often occurs in groin area and in the legs);

  

• disturbance of sensitivity, manifested by numbness, tingling, tingling, burning, sensation of “pins and needles” (reversible paresthesia);

  

• headaches, migraine attacks, dizziness (with cervical protrusions);

  

  If protrusion in cervical spine spine, will be bothered by headaches, dizziness

• instability of arterial and venous pressure.

  

With a hernia, all these signs persist and are of higher intensity. Pain from an intervertebral hernia can be so severe that the patient is forced to limit the level of usual motor activity(in severe cases, complete immobilization is possible).

If you want to find out what they are, and also consider the causes of their appearance, prevention and treatment, you can read an article about this on our portal.

Hernia pain is caused by compression of the roots spinal nerves which are located in the spinal canal.

Gain pain syndrome also caused by spasm and swelling of the muscles, due to which the compression load on the spine in the affected segment is partially compensated.

Note! Intervertebral hernia in most cases is combined with pathological curvature spine (kyphosis, lordosis or scoliosis) and forces a person to take a certain posture during periods of exacerbation of pain. In the case of a complicated course, symptoms of a hernia (if localized in the lumbosacral region) may also be various disorders in the functioning of the pelvic organs, for example, urinary disorders or difficulty defecating. Chronic constipation of varying severity are diagnosed in 45% of patients with a hernia of the lumbar spine. For protrusions this is clinical picture in most cases it is uncharacteristic.

How to diagnose hernia and protrusion?

The standard method for diagnosing intervertebral hernias and protrusions, used in most budgetary medical institutions, is radiography. Efficiency this method compared to more modern ones diagnostic methods quite low and is about 90%.

Single protrusions small size It is not always possible to detect it when studying an x-ray image, so the preferred method of examination is magnetic resonance, computed tomography or multispiral computed tomography.

If you want to find out in more detail and also consider when a magnetic resonance examination is indicated, you can read an article about this on our portal.

If necessary, the patient is also prescribed myelography - X-ray examination spinal ducts through which cerebrospinal fluid circulates ( cerebrospinal fluid) using contrast solutions.

Treatment of hernias and protrusions without surgery

Conservative treatment of intervertebral protrusions includes treatment of the underlying disease (osteochondrosis) and prevention of further progression of surgical pathologies.

Diet

To increase the density, firmness and elasticity of the fibrous membrane and prevent its ruptures, diet correction is indicated at the initial stage of osteochondrosis. Collagen (fibrillar protein) is the main component of cartilage and connective tissue, which makes up the cartilaginous plates and the fibrous ring of the intervertebral disc. It ensures the strength and elasticity of the connective tissue disc membrane, so the patient’s menu must include a sufficient amount of protein - at least 80-100 g (in the absence of kidney problems). Protein High Quality contained in lean meat, fish, eggs, cottage cheese, dairy products.

It is also important to get enough calcium (sesame, milk), iron ( buckwheat, dried apricots, veal, apples) and phosphorus (fish).

Vitamins A, C, E, which are abundant in vegetable oils, cod liver, vegetables and fruits.

Note! From the diet of patients suffering from pathologies of the musculoskeletal system, it is better to completely exclude “empty” foods that do not provide any benefit to the body. These products include carbonated sweet drinks, sausages, sausages, smoked meats, canned food, and pickled vegetables.

Rejection of bad habits

If a patient suffers from alcohol or tobacco addiction, it is important to take measures to eliminate them. One cigarette contains more than 400 poisonous and toxic substances (for example, ammonia, arsenic, nicotine), which, like ethanol, interfere with the absorption of beneficial and nutritional elements into the systemic bloodstream.

Nutrients enter the intervertebral disc through the blood vessels of the spinal cord, so smoking and alcohol abuse increase the risk of thinning of the fibrous ring and the formation of protrusions and hernias.

Medications

This is the main part of the treatment of vertebral protrusions and hernias. To relieve pain, eliminate swelling and muscle spasms, prevent inflammatory processes The patient is prescribed the following medications:

In case of severe pain syndrome, which significantly worsens the patient’s quality of life, lidocaine blockade is indicated (in the absence of infectious diseases of the spine and malignant neoplasms any localization).

Exercise therapy

Physical therapy is one of the most effective methods of conservative treatment of protrusions. A set of special exercises for the back not only reduces the size of the protrusion due to traction of the spine (the vertebrae stop putting pressure on the damaged disc, and the pulp returns to its anatomically correct position), but also stops the progression of the pathology, preventing the formation intervertebral hernia. It is best to do exercise therapy in a specially equipped room at the base medical institution, but in the absence of such an opportunity to perform therapeutic exercises You can do it at home.

These exercises (see picture above) must be performed at least 3-4 times a week. All movements should be smooth, without jerking. Breathing is slow, calm.

Video - Exercise therapy for lumbar hernia

Physiotherapy

Physiotherapeutic methods for the treatment of hernias and protrusions are used outside periods of exacerbation and are aimed primarily at eliminating pain and normalizing blood circulation in the spine. The most effective methods of physiotherapy are:

In the physiotherapy room, the patient can also undergo thermal applications with paraffin and ozokerite.

In some clinics, at the physiotherapist's office there is a hirudotherapy room (treatment with leeches), which is also effective for the treatment of osteochondrosis, including complicated forms.

In what cases is surgical treatment indicated?

Surgical treatment of protrusions is rarely required. If the pathology is detected in a timely manner and the patient complies with the prescribed therapy and regimen, it is possible to stop the progression of the disease therapeutic methods. If the size of the protrusion increases despite the therapy, or the protrusion has turned into an intervertebral hernia, the only treatment with proven effectiveness is surgery.

Surgical removal of a hernia is carried out only strict indications, which include:

• lack of a clinically significant effect from therapeutic treatment within 3 months from the start of therapy;
• inability to relieve pain and radicular syndrome;
• severe disturbances in the functioning of the pelvic organs, developing against the background of severe compression of the nerve endings of the spinal cord (incontinence feces and urine, impotence in men, etc.).

Cases when required fast recovery the patient (for example, if it is necessary to perform several operations in a row), are considered individually at a medical council, which necessarily includes a vascular surgeon, a neurologist, a neurosurgeon and a vertebrologist.

Removal of large hernias and protrusions is carried out using the endoscopic and transfacet method. Endoscopy is considered the “gold standard” of neurosurgery when removing intervertebral protrusions, since this method avoids injury muscle tissue, which significantly shortens the recovery and rehabilitation period (in the absence postoperative complications the patient can return to work 7-10 days after surgery).

Endoscopic removal of hernias and protrusions is not effective in all cases, so the attending physician may offer more effective method surgical treatment– microdiscectomy. In most cases, microdiscectomy allows preserving the intervertebral disc, and its complete excision is performed quite rarely. The main advantage of this treatment method is the ability to remove protrusions of any density, size and location, which is not always possible using standard endoscopic approaches. Proceed to physical labor after this operation it is possible in 2-4 weeks.

Important! To prevent postoperative complications (regardless of how the hernia or protrusion was removed), the use of a semi-rigid corset or bandage for a month is recommended, as well as limited sitting (no more than 10-15 minutes at a time).

Video - What is protrusion and herniated disc?

Intervertebral hernia and protrusion are pathologies of the spine, in most cases a complication of osteochondrosis. The main difference between these types of protrusions is the integrity of the fibrous ring: during protrusion, it is preserved, which explains moderate pain and neurological symptoms. If the protrusion is not treated at the initial stage, it can develop into a hernia, which in 40% of cases requires surgical treatment and can cause serious complications.

Protrusion or hernia of the spine... These diagnoses sound scary and often the patient does not understand whether these are different diseases or not. Let's try to understand each of them and consider the differences.

The structure and nutrition of a healthy disc

Many spinal diseases begin with changes in the intervertebral discs. Each of them consists of:

1. Fibrous ring.
2. A jelly-like core filling the center of the ring.

Most of the core is liquid, so it can change shape. This makes the spine flexible and allows it to soften sudden loads.

After 20-30 years, the disc is nourished exclusively by diffusion through adjacent tissues. It is during this period that serious troubles can begin.

Protrusion

Characterized by extrusion of the disc. The fibrous ring remains intact and holds back the nucleus, which breaks out.

Poor nutrition of the disc leads to its drying out. Discomfort and local pain appear. Subsequently, the protrusion increases. Numbness of the extremities may occur.

Symptoms of the disease depending on location

The direction of pain largely depends on the location of the diseased disc:

• The main load falls on the lumbar region. This is where disc bulges often occur. There is discomfort and It's a dull pain in the lower back. As the size of the protrusion increases, the pain moves to the legs and pelvic area. Numbness in the legs indicates that the disease has gone too far.
• The laziest - thoracic region. He is not very mobile and the load here is less. But if the disc is nevertheless squeezed out, then pain is felt in the area of ​​the shoulder blades and heart.
• The cervical region does not bear significant load, but is very mobile. With protrusion, pain and stiffness first appear in the neck. Later, the shoulders and arms suffer. Tingling and numbness may occur. Often diseases of this department lead to dizziness and headaches.

Types of protrusion

In its course it can be:

1. Local. Protrusion occurs in various directions. The most dangerous direction of protrusion is back towards the spinal cord.
2. Circular. Spreads throughout the entire perimeter. Usually takes a chronic course.

Causes of the disease

Except sedentary lifestyle life or constant overload, there are many reasons why this disease occurs. The main part of them:

• Rachiocampsis.
• Spinal injuries.
• Congenital diseases.
• Incorrect posture.
• Large body weight.
• Poor nutrition.
• Age-related changes.
• Weak muscles.
• Accompanying illnesses.

Treatment

Gives positive result only when integrated approach. Depending on the severity of the disease, the attending physician prescribes:

1. Nonsteroidal drugs in in various forms . Greatest effect give injections. Ointments and gels are less effective. At long-term use gastrointestinal tract suffers.
2. Hormonal anti-inflammatory drugs. Prescribed only in severe cases and when it is necessary to remove sharp pain. Discharged to short term. Lots of side effects.
3. Chondoprotectors. They act on the mechanism of tissue change itself. With long-term use, the condition of the intervertebral discs improves.

Reduces treatment time:

• Massage.
• Acupuncture.
• Physiotherapy.
• Physiotherapy.

Yoga eases the condition. The spine is viewed not as a collection of bones, but as the axis of the universe. You just need to learn to reorganize the space around it, and the spasmed muscles will relax.

Hernia

We can say that a hernia is protrusion in its extreme stage. The annulus fibrosus ruptures. The nerve roots are compressed. This process is irreversible and cannot be restored.

Why does it occur

A hernia is caused by:

• Spinal injury.
• Not fully cured protrusion.
• Self-medication.

Heavy weight, curvature of the spine, excessive loads are an additional risk of developing this disease.

Symptoms

A cervical hernia impairs blood supply to the brain. Memory suffers, dizziness increases. I have headaches and high blood pressure. May be at risk of stroke.

Disease of the thoracic region provokes the appearance of intercostal neuralgia.

Damage to the lumbar region can disrupt the functioning of the pelvic organs and lead to paresis lower limbs. Coughing and sneezing sharply increase the pain.

Treatment of intervertebral hernia

After diagnosis, the doctor makes a decision on treatment. The patient may be offered:

1. Conservative treatment. Aimed at eliminating pain and reducing inflammation. The result is achieved by using non-steroidal drugs, the effect of which is enhanced by physiotherapy. Good result gives hirudotherapy, acupuncture. During the period of remission - exercise therapy, massotherapy, swimming. At any stage of the disease, the use of orthopedic belts, collars, orthoses alleviates the condition.
2. Surgery. Aimed at quickly releasing pinched nerve roots. Prescribed if conservative treatment has not helped within 3 months. Several methods of performing the operation are used. The main ones include: endoscopic method, puncture decompression, hydrodiscectomy.

The method of surgical treatment is chosen by the doctor. He describes in detail to the patient the course of the operation, the method of anesthesia, possible risks and duration of rehabilitation. Informs the patient that successful operation- only the first step towards complete recovery.

What is the difference between a hernia and a protrusion?

The size of the protrusion and the integrity of the disc ring are the main differences between these diseases. Wherein:

• A hernia occurs when the entire layer of the fibrous ring of the disc is damaged.
• The appearance of a hernia is an irreversible process.

As long as the protrusion does not exceed 5 mm and the fibrous ring is not damaged, disc protrusion is diagnosed. In this case, the core remains within the boundaries of the disk. If the extrusion increases by more than 5 mm or the disc ring ruptures, you have to come to terms with a hernia. The nucleus goes beyond and through breaks and cracks can enter the spinal canal. The movement of particles along it leads to compression of the spinal roots.

The most important differences between these diseases are as follows:

1. Protrusion in case of improper treatment or without it at all will most likely lead to a hernia.
2. Under no circumstances will the hernia turn into protrusion.
3. Protrusion is characterized by local pain.
4. With a hernia, pain spreads along the nerves to the corresponding limbs or even internal organs.
5. A hernia can lead to dysfunction of internal organs.
6. Treatment of protrusion is most often limited to medications, physiotherapy, exercise therapy, and massage.
7. The hernia often does not respond to conservative treatment and requires surgical intervention.

The consequences of these diseases are also different. Protrusion leads to pain varying intensity, numbness of the limbs and, as a result, a hernia.

A hernia without proper treatment disrupts work of cardio-vascular system, gastrointestinal tract. It can also cause radiculitis, chronic bronchitis or cause urinary incontinence and even paralysis of the limbs.

We must not forget that hernia - a consequence of protrusion. Often requires surgery and leads to very dangerous complications. And the initial stage of protrusion can be completely cured through joint efforts with a good specialist.

Protrusions and intervertebral hernias are pathological processes that involve the discs of the spinal column. The causes and symptomatic picture of both pathologies are similar.

What is protrusion?

Protrusion of a disc beyond the line of the spinal column is a protrusion. The disease is diagnosed mainly in people over 30 years of age. Distinctive feature- maintaining the integrity of the fibrous core.

This process is the first stage of degenerative changes in the disc and precedes the appearance of a hernia. Can occur in any part of the spine. Only a doctor can distinguish whether a protrusion or hernia has formed, based on the results of a medical examination.

What is a hernia?

Intervertebral hernia is a process of rupture of the fibrous ring with further displacement nucleus and disc protrusion. It can occur on any part of the spine, but pathology is more often observed in lumbar region.

This is explained by the fact that on lumbar region involves a high degree of physical activity. The first symptoms of the disease are back pain localized at the site of development hernia formation, limited movement.

What is the difference between protrusion and hernia?

The difference in the nature of the manifestation of both processes is minimal. The main difference between a protrusion and a hernia is that in the first case, the protrusion concerns only the disc, while it internal structures are kept intact.

When a hernia occurs, the fibrous ring first ruptures, which puts pressure on the cartilage tissue of the disc, causing it to extend beyond the spine. Initially, protrusion occurs if this pathology If left untreated, it may develop into an intervertebral hernia.

Symptoms

The first sign is back pain in the place where the pathological process is localized. The pain intensifies with physical activity and any movement, because... the bulging disc compresses the roots of the nerve endings. Getting worse general state patient due to pressure pathological formation on blood vessels. This general signs protrusion. The symptomatic picture depends on which part of the spine the disease occurs in.

What is the difference between Protrusion and Herniated Intervertebral Disc, - Dr. Lyudmila Mironyuk

Hernia, a protrusion, treatment

What is spinal protrusion and why is it confused with a hernia. Neurosurgeon Zorin Nikolai Alexandrovich

Cervical

Pathology in the cervical spine is manifested by the following symptoms:

• frequent attacks of headache;
• painful and discomfort in the neck;
• feeling of stiffness;
• limitation of motor function;
• numbness spreading to the shoulders and upper limbs, felt in the fingers;
• weakness in the hands.

With gradual development pathological process pain from the neck area gradually spreads to the thoracic region, radiating to the scapula.

Chest

Character of the symptomatic picture:

• pain and constant feeling discomfort in the upper back, between the shoulder blades;
• stiffness throughout the entire spine;
• the appearance of a feeling of numbness in the sternum.

The pain intensifies in the morning after a night's sleep, when a person long time is motionless.

Lumbar

Protrusion of this section is manifested by the following signs:

• pain in the lumbar region;
• spread of pain to the lower extremities;
• muscle weakness in the legs;
• frequent feeling of goose bumps and numbness.

As the pathological process worsens, the patient’s general condition becomes worse, putting pressure on nerve endings a bulging disc leads to work problems urinary system, which is manifested by signs of frequent, difficult and painful urination.

Causes

Protrusion of the spinal disc occurs due to the presence of the following provoking factors:

• previous injuries and spinal injuries;
• development of osteochondrosis;
• curvature of the spine - scoliosis, kyphosis, etc.;
• the presence of hemangioma - a benign formation;
• impaired metabolic process;
• passive lifestyle, lack of regular physical activity;
• osteoporosis;
• presence of excess weight, obesity;
• ankylosing spondylitis;
• rheumatoid type arthritis.

The risk group includes the following categories of people:

1. 1 Persons with a genetic predisposition.
2. 2 The likelihood of developing a pathological process increases if the patient has such bad habits like smoking and alcohol abuse.
3. 3 The risk of developing pathology increases with age. This is due to the fact that all metabolic processes in the body gradually slow down, tissue regeneration occurs more slowly.
4. 4 People who professionally engage in strength sports, in which they need to lift heavy loads, are susceptible to pathology.

In most cases, disc protrusion is caused by diseases of the spine, and bad habits, age and impairment metabolic processes are provoking factors.

Types of protrusion

Depending on the direction in which the protrusion of the intervertebral disc occurred and the nature of the pathological formation, 4 types of protrusion are distinguished. According to the type of protrusion, protrusion occurs:

• circular - extrusion (extrusion) of the disk occurs evenly over its entire surface;
• paramedian - protrusion back in the lumbar spine.

Dorsal

This type of disease is called posterior. The spinal disc bulges posteriorly from the spinal line. A hole appears in spinal canal. Dorsal protrusion can be medial or foraminal.

This is the most dangerous look diseases, because a bulging disc puts pressure on the roots of nerve endings and can cause the development of neurology with a severe symptomatic picture.

Often, due to the lack of timely treatment, sequestration occurs - the most severe form of development of hernial protrusion.

Lateral

Pathological protrusion occurs on the right or left side of the spinal column. This is the most safe look protrusion, which rarely leads to the formation of a hernial formation. But this is provided that the treatment is carried out in a timely manner. A distinctive feature is the absence or mild symptomatic picture, neurological abnormalities are not observed.

Ventral

With this type of pathology, the bulging disc protrudes in front of the spinal column. This type of disease is extremely rare. There is no symptomatic picture, which makes early detection of pathology impossible. There is no risk of complications.

Treatment

Protrusion and hernia of the spine - pathological conditions, are closely related to each other, therefore only timely treatment a bulging disc can prevent the development of a hernia, accompanied by rupture of the fibrous ring.

Therapy for protrusion is conservative, complex, including a number of therapeutic measures: taking medications, using physiotherapeutic procedures and special massagers. Acceptable use folk methods as adjuvant therapy to relieve the symptomatic picture.

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Includes treatment and dietary adherence. Heavy foods are excluded from the diet: fried and fatty dishes, spices and seasonings. The diet should contain a lot fresh vegetables and fruits, lean meat and fish. It is important to maintain the correct drinking regime and drink at least 2 liters of water per day. Alcohol is strictly prohibited.

During the treatment of protrusion, it is necessary to reduce the intensity of physical activity. Athletes are advised to temporarily give up training or reduce the degree of physical activity so as not to provoke the development of complications.

Medication

After the diagnosis has been carried out, during which the stages of development of the pathological process, the size and exact location of the formation are clarified, medications are prescribed.

Appointed medicines- non-steroidal drugs that help quickly relieve inflammation. As a result of their influence, the roots of the nerve endings are released from pressure, due to which the patient’s general condition improves. If you have symptoms such as stiffness and pain muscle spasms, drugs belonging to the group of muscle relaxants are prescribed.

Local spectrum medications - gels and ointments - are also used in treatment. Such drugs quickly relieve pain, eliminate inflammation and swelling of soft tissues, and help speed up the healing process.

In the presence of severe pain, which cannot be controlled with medication, a blockade is placed - the injection of strong painkillers (Lidocaine or Novocaine) directly into the area where the pathological process is localized.

Protrusion surgery is rarely performed. Most often, surgery is required when the pathological process is rapidly developing, intensive symptomatic picture, high risks complications and lack of positive dynamics from conservative treatment.

Conservative

Non-surgical methods for treating protrusion include performing physical therapy exercises, using physiotherapeutic techniques and training on special simulators. All this helps eliminate pain, normalize the condition and functioning of the spine, and relieve pressure on nerve endings and blood vessels.

Massage is recommended for patients, but it should only be performed by a specialist, because... any careless movement can lead to a number of severe complications. Of the physiotherapeutic procedures, preference is given to magnetic therapy, ultrasound treatment, electrophoresis with medicines anti-inflammatory action.

When selecting treatment methods, the patient mandatory neurologist consults. For pinched nerves, many conservative treatment methods may have contraindications.

Folk remedies

To eliminate painful sensations in the spine during the development of pathology, they are used the following means traditional medicine:

1. 1 A peeled head of garlic is poured into a glass of alcohol or vodka and infused for 10 days in a thick glass container. The finished tincture has a consistency similar to porridge. The product is applied to the place where the pain is localized, covered with a film on top and secured with a scarf or thick cloth. The course of treatment is 2 times a week for 1 month.
2. 2 Cut Kalanchoe leaves are applied to the back, where there is a disc protrusion, and the leaf is fixed with an adhesive plaster. It is recommended to leave this compress on all night.

Any methods of traditional medicine are only auxiliary treatment and are used only with the permission of the attending physician.

Physiotherapy

Physical therapy exercises are the most effective measures conservative treatment. Charging is first performed only under the supervision of a rehabilitation specialist. When the patient learns correct technique completed, he can study independently at home. Effective exercises:

1. 1 Lie on your back, extend your arms along your body, bend your legs. Slowly, without sudden movements lift your pelvis off the floor, resting on your shoulder blades. Stay in this position for a few seconds, lower your pelvis to the floor, repeat up to 5-10 times.
2. 2 Get on all fours, transfer your entire body weight to your palms and knee joints. Raise your left leg and right hand, hold for a few seconds. Repeat the exercise with your right leg and left arm. The number of approaches is from 5 to 10.
3. 3 Lie on your stomach, arms extended along your body. From the starting position, you need to simultaneously raise your arms, chest and head from the floor. Freeze in this position for a few seconds, lower yourself to the floor, and repeat.

Prevention

Protrusion is a pathology of the spinal column that occurs as a result of untreated diseases and poor lifestyle. There are a number preventive measures, compliance with which will help prevent the development of protrusion.

The life of every person who closely monitors their health should include regular physical activity. It is recommended to give preference to disciplines such as swimming, Pilates, and yoga. If an athlete is involved in strength sports, it is important to correctly distribute the load on the back. If necessary, use special bandages for heavy loads.

Should not be abused contact types sports and games - basketball, volleyball, in which you have to jump often and high, because this will increase the likelihood of developing degenerative-dystrophic changes in the spinal column - the most common cause of protrusion.

People faced with spinal diseases often ask how a protrusion differs from a hernia. This is a natural question that arises when a patient hears that the doctor calls the diagnosis as the same. Diseases of the spine, which are becoming increasingly widespread due to a sedentary lifestyle, stress on spinal column from incorrect permanent body position at the desk, they become younger. In people who suffer from them, damage to the musculoskeletal system appears already in at a young age, and previously they were common in the elderly and senile, as age-related changes.

Protrusion, spinal hernia, are links of the same chain, phenomena of the same order, of the same etiology, and their differences lie in the phase of the disease and the degree of damage already present in the structural structure of the bone skeleton.

This is a question for which there is no answer. Both are equally bad. The insignificant difference is that a protrusion can be treated without allowing it to develop into a hernia, while a hernia is a previous stage that has already received consequences and was not cured in time. Knowing about the presence of the previous stage, the subsequent one could have been avoided, but the main trouble is that such a condition has already appeared. This means that osteochondrosis, which in 90% of cases is the cause of the appearance of both, has already affected the spine.

And the consequences of osteochondrosis are weakening of the bone skeleton, decreased motor activity, weakening of the muscle corset, which goes hand in hand with it, lack of minerals in the bones, impaired blood supply, and insufficient supply of nutrients to tissues, abnormal, pathological water exchange. The degree of failure in the established system of the body has reached the stage where wrong image life led to malfunction body, his functional disorders, which turned into pathological phenomena. Now I have to treat pathological changes, but it would have been possible to get by with much less consequences. If only you could react in time to persistent signals from the body and seek medical help in time.

Protrusion, like a future hernia

Osteochondrosis, which has reached a certain stage in its development, has led to degenerative processes in tissues. They have lost some of the necessary moisture, resulting in their loss of the function of a natural shock absorber. This means that the elasticity of the intervertebral disc has significantly decreased, and under load it is compressed more strongly. Severe compression of the intervertebral disc can occur at the most various factors risk - prolonged position in uncomfortable position, lifting something heavy, sharp stressful situation, sports training, and even with associated disorders water-salt metabolism, which were already in the body. The intervertebral structural element consists of three parts:

• internal - nucleus pulposus (gel-like consistency);
• outer - fibrous ring (with a hard and fibrous structure);
• hyaline cartilage that separates the disc from the vertebral body.

The water that leaves the nucleus pulposus, due to disturbances, leads to the fact that the vertebra puts pressure on the fibrous ring, and the collagen that makes up its structure, under the influence of compression, is compressed and flattened. This leads to the protrusion of the ring beyond the edges of the vertebra pressing on it. As long as the protrusion is no more than 5 mm, this is still a sign of protrusion. And when the ring breaks through, then an obvious protrusion of the nucleus pulposus occurs, clearly visible on an x-ray even to a non-professional eye. This is what is called a hernia.

Symptoms and diagnosis

Diagnosis of both forms is carried out using x-rays, magnetic resonance imaging, and computed tomography. Visual inspection, palpation, squats and bending of the body will not say anything even experienced specialist. Symptoms are also not particularly different. Protrusion at the last stage may have the same threatening symptoms:

1. Pain in the area of ​​the affected vertebra, with protrusion, with a hernia, and along the nerves. Although with strong compression, depending on the affected area, both at one and the other stage, the pain will be in the localization zone, and in nerve fibers, and equally unpleasant.
2. Protrusion is characterized by dizziness, headache, and changes in blood pressure, but a herniated disc can also give such symptoms.
3. Only disturbances in the functioning of internal organs differ significantly. For protrusions this is not yet so pronounced, but functional impairments are already clearly visible.
4. The most significant sign for a doctor when collecting anamnesis and palpation is pain. Has it spread from the site of the lesion, or is it still localized in one place. But this may also be uncharacteristic if the protrusion is on a thin line, which distinguishes it from a hernia.

This is why various studies are prescribed: to determine how close the transition from a severe stage to a very severe one looms. Because treatment of protrusion is still possible without surgery, but treatment of hernia is no longer possible.

Better not to wonder

Treatment of pre-hernia condition is conservative, but intensive. Its duration depends on how quickly the patient responded to the signals sent by the spine and was worthy of visiting a doctor. These will include painkillers, anti-inflammatory drugs, physiotherapy, physiotherapy, therapeutic massage, in certain cases- manual therapy. On early stage diagnosing. In case of late presentation - limitation of mobility, in some cases - bed rest, with heavy loads at work - change of activity. The affected vertebra needs to secure the disc and relieve inflammation from it. But there will no longer be the same flexibility, mobility, mobility.

If you continue to ignore the pain, the pre-hernia condition will quickly develop into a hernia. At first, doctors will try to get by conservative treatment, but as a rule it is required surgical intervention. This may be a low-traumatic endoscopic approach, without significant damage to soft tissues, or perhaps removal of the intervertebral disc with the insertion of a titanium implant. The difference between the two concepts depends on how much the patient delayed going to the doctor, prescribing therapy, and, in fact, healing process, and what this delay ultimately led to.

With protrusion, the disc was still intact and amenable to treatment. With a hernia, it is already damaged, and this damage is very dangerous. This is what makes them different.

And with a responsible attitude towards one’s health, one would not need any such questions, nor special knowledge, nor long-term treatment, no fears about what the consequences will be. Knowledge that these are stages of the disease, the severity of which depends on how much a person thinks about himself while he is healthy.

To avoid such consequences, the advice is still the same. Balance your diet of foods, vitamins, and microelements. Lead a normal, healthy, active lifestyle, sleep the prescribed number of hours, comfortable bed. Give up bad habits, go for walks more often fresh air, exercise. Health depends on many factors. Including how responsibly you treat it.