How to understand that a protrusion has turned into a hernia. Video - What is protrusion and herniated disc? Treatment of intervertebral hernia

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. Spinal diseases, which are becoming increasingly common due to sedentary lifestyle life, stress on the 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 a weakening of the bone skeleton, a decrease in motor activity, a weakening of the muscle corset, which goes hand in hand with it, a lack of minerals in the bones, impaired blood supply, and insufficient supply nutrients, in tissue, incorrect, pathological water metabolism. 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 we will have to treat the pathological changes, but it would be 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. And this means that intervertebral disc Elasticity has decreased significantly, 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, a sudden stressful situation, sports training, and even during associated disorders water-salt metabolism that were already in the body. 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. At the protrusion on last stage There may be the same threatening symptoms:

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 along the nerve fibers, and will be equally unpleasant.
Protrusion is characterized by dizziness, headache, differences blood pressure, but a herniated disc can also give such symptoms.
Only the disruptions differ significantly internal organs. For protrusions this is not yet so pronounced, but functional impairments are already clearly visible.
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.

That's why they are appointed various studies: to determine how close the transition from a severe stage to a very severe one is looming. Because treatment of protrusion is still possible without surgical intervention, and treatment of the hernia is unlikely.

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, therapeutic exercises, physiotherapy, massotherapy, V certain cases- manual therapy. At an early stage of diagnosis. In case of late presentation - limited mobility, in some cases - bed rest, at 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 conservative treatment, but, as a rule, surgical intervention is required. 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.

Spinal problems are not uncommon today. For example, if patients complain of back pain, the doctor in 90% of cases diagnoses osteochondrosis, the consequences of which are protrusion and hernia.

Many people consider these diseases to be identical, but in fact they are clearly different from each other. It is extremely important to understand how protrusion differs from herniated intervertebral discs, because each of the pathologies has a number of features that must be taken into account during treatment.

In the human spine, between the vertebrae, there are discs whose function is to reduce pressure on the spinal column, as well as to ensure its overall flexibility and strength. The disc consists of an annulus fibrosus and a nucleus pulposus of a gelatinous structure.

Disc protrusion - pushing it out spinal column, the so-called protrusion. The fact is that the fibrous ring has a certain strength limit, and when it is exhausted, the disc begins to deform.

A protrusion not exceeding 5 mm is called “protrusion”. The nucleus in this case is still located within the annulus fibrosus. It is important at this stage to have time to take measures to eliminate the disease in order to prevent degenerative processes from developing further. Otherwise, the pressure on the disc will continue and intensify, resulting in a herniation.

Causes and symptoms of pathology

Protrusion is almost always a consequence of osteochondrosis. Degenerative processes develop due to a deficiency of mineral elements in bone tissue. Also, the reason lies in the lack of physical activity, which is especially important in the modern world.

A passive lifestyle, sedentary work, lack of even morning exercises and especially regular warm-ups weaken the muscle corset. Problems with water metabolism and impaired blood supply can provoke protrusion, due to which nutrients cannot easily flow into bone and cartilage tissue.

Depending on the part of the spine affected by protrusion, the symptoms of the disease vary:

Cervical sector. Manifested by a tingling sensation in the arms and neck, paresthesia. Physical exercise are difficult to tolerate, and there are periodic surges in blood pressure.
Chest area. Pain in the intercostal area when turning the body. There is occasional discomfort during deep inhalations and exhalations. The pain radiates to the heart, simulating angina attacks.
Lumbar region. Pain occurs with prolonged sitting or physical activity. The sensations may be insignificant, and patients often miss such a manifestation, not paying attention to it and blaming it on ordinary fatigue.

What is a herniated disc?

A hernia is a pathology in which the fibrous ring ruptures due to constant trauma. Often, through cracks and breaks, the nucleus pulposus leaks into spinal canal, and this is fraught with pinched nerves.

If the hernia occurs in the cervical sector of the spine, the blood supply to the brain will deteriorate. This will cause dizziness, as well as memory pathology. The disease can provoke the development of cervical radiculitis, and even paralysis if pinching occurs spinal cord.

A hernia formed in the thoracic region can cause intercostal neuralgia, and in the lumbar region it can cause pathologies of the pelvic organs. IN in some cases It may be difficult for a person to walk and even sit due to severe pain and numbness in the legs.

Not correct treatment protrusion or its complete absence is the main cause of the formation of a spinal hernia. Pathology can also develop against the background of trauma. Factors that increase the risk of developing a hernia include a passive lifestyle, crooked posture, excessive physical activity (especially if it is rare and the body is unprepared), the presence excess weight, as well as prolonged driving (due to vibrations and body position).

If you don't do the right thing and timely treatment, intervertebral hernia can cause even more serious health problems. The disease has a detrimental effect on the functioning of the heart, causing radiculitis, gastritis and even bronchitis. A hernia also disrupts blood circulation in the brain, which can lead to strokes.

What is the difference between protrusion and herniated intervertebral discs?

Understanding the difference between protrusion and hernia, you need to understand that the latter is a consequence of the former. Metabolic disorders contribute to the depletion and further destruction of the annulus fibrosus.

As a result, the ring loses its firmness and elasticity and acquires many defects. With protrusion, despite the defects, the integrity of the ring is not compromised, but with a hernia, it ruptures and the protrusion begins to exceed 5 mm.

Differences in the diagnosis of pathologies

Diagnosis of both pathologies is carried out in the same way. The doctor collects anamnesis, after which he carries out visual inspection patient. Next, magnetic resonance imaging (MRI) is performed, which makes it possible to find out the location of the protrusion and its size.

An x-ray is then taken to rule out the presence of other probable pathologies. The doctor makes a diagnosis only after receiving and analyzing all the data, and determines whether a protrusion or hernia is bothering the patient. To do this, he needs to know what symptoms distinguish a hernia from a protrusion. The difference is clearly demonstrated in the photo below:

How quickly does a protrusion turn into a hernia?

The rate of transition of intervertebral disc protrusion into hernia depends on many factors. It is impossible to indicate exactly how long this will happen. The development of degenerative changes in the absence of treatment will accelerate, especially if the patient does not change his lifestyle and ignores all signs of the disease. Poor nutrition, an inactive lifestyle, sedentary work, occasional injuries - all this will only aggravate the situation and hasten the development of intervertebral disc herniation.

Treatment tactics

In both cases, as soon as the disease is diagnosed, the patient should limit any physical activity, replacing it with massage and therapeutic exercises. If the case is particularly advanced, the doctor will prescribe injections, the main function of which is to improve the quality of cartilage, increase its resistance to pressure and enhance elasticity.

Treatment of protrusion

Treatment of the disease primarily requires a reduction in physical activity. It is important to follow this rule at least for the period of therapy. Next, you can proceed with conservative treatment, which is prepared by the attending physician.

This includes exercise therapy, swimming and gymnastics, massage sessions and procedures manual therapy. Will have a beneficial effect on health and general health patient physiotherapy, kinesitherapy, acupuncture.

Doctors almost always prescribe the patient to take chondroprotectors, since such drugs are among the most effective for protrusion. Among other things, hardware traction of the spine is performed and symptomatic therapy, which involves the use of analgesics and NSAIDs.

Hernia treatment

Since the disease can cause complete or partial limitation of mobility, and in some cases even disability and paralysis, its therapy must be comprehensive and timely. It is important to understand that conservative action here will no longer be effective enough.

Such treatment will only partially improve well-being, stopping the progression of the disease, and it is thus impossible to return the disc between the vertebrae to its original condition and shape, restoring its functionality.

For a complete cure, it is necessary to involve surgical intervention, but both before and after surgery, at the rehabilitation stage, the patient mandatory they prescribe procedures that fall into the category of conservative: massage, exercise therapy, swimming and others. If a person suffers from unbearable pain syndrome, the doctor may prescribe him injections that provide a novocaine blockade.

Exercises for hernias and protrusions

Physical exercises will be equally useful for both protrusion and hernia. Gymnastics in this case is aimed at strengthening the patient’s muscles and will also give good result. The complex is compiled by a doctor or exercise therapy instructor. It includes traction and extension of the spine through:

stretching the arms along the body in a lying position, first with bent and then straight legs;
pulling your knees to your chest alternately while lying on your back;
stretching the back and arms while sitting on the heels, etc.

It is very important to train avoiding various kinds twisting exercises, as well as sudden movements and jolts during fitness, which cause pain.

Folk remedies in the fight against illness

It is impossible to treat protrusion and hernia only with traditional methods, as they will not cope with the problem on their own. They will be effective when used in combination with basic traditional treatment. Several popular recipes for healing potions are given below.

Garlic compresses

Grind 300 grams of garlic, add 150 milliliters of vodka to the pulp and leave in a dark room for 10 days. Use the resulting mixture for compresses, spreading it in a thin layer on the affected area of the body. Be sure to cover the composition with a film and a warm cloth to create a greenhouse effect.

It is advisable to remove the compress after 45 minutes, but if discomfort occurs, finish the procedure earlier; do not hold it forcefully, as a burn may remain. It is recommended to carry out this procedure every other day, and take turpentine baths in between.

Turpentine baths

Only people who do not suffer from problems with the cardiovascular system are allowed to resort to the procedure. Take 10 grams baby soap, previously crushed using a grater, dilute it with one liter hot water and a glass of turpentine.

Add 30 milliliters there salicylic alcohol(1%). Mix all this so that the components are completely combined and place in the refrigerator for storage. Add three spoons of this composition to the bath, after filling the container with water at a temperature no higher than 45 degrees. Lie in this water for 10 minutes.

Kalanchoe compresses

The plant is often called indoor ginseng, which is not surprising, because its juice can penetrate the skin and have therapeutic effect. Remove a few leaves from the plant, cut off the thin top peel with a knife and apply it to the affected area of the spine, securing it with a plaster on top.

What is worse and more dangerous: protrusion or hernia?

Since a hernia is a consequence of protrusion, it would be logical to assume that it is considered more dangerous. But in reality, everything is not so simple. Not only the stage and level of protrusion is important, but also the location of the lesion, for example:

Extrusion of the intervertebral disc towards the intervertebral canal, if it is 4 mm in size, will be noticeably more dangerous than a median type hernia measuring 5 mm.
A hernia in the lumbar sector is less dangerous than a disc protrusion in the cervical area.
A Schmorl's hernia, even if it reaches 10 mm, may not bother a person at all, but protrusion very often turns out to be extremely painful.

As it becomes clear, the degree of danger of illnesses is relative and to determine it, several factors must be taken into account. But still, all other things being equal, that is, if we compare a hernia and a protrusion that arose in the same section, directed in the same direction, then a hernia is certainly more dangerous.

Conclusion

Protrusion intervertebral discs differs from a hernia primarily in the degree of protrusion and the integrity of the fibrous ring. Strong muscular frame and correct posture will help protect the body from such diseases.

It is important to adhere to preventive measures by playing sports, avoiding excess weight and consuming healthy food. As soon as the first symptoms become noticeable that even remotely resemble problems with the spine, you must immediately visit a neurologist to begin the fight against the disease at an early stage of its development.

Are protrusion and hernia the same disease or is there a difference between them? How to cure a protrusion so that it does not become a hernia? Methods of safe, non-surgical therapy, massage exercises. Where to start treatment and which doctor to contact?

An article for middle-aged people

Protrusion or hernia is usually experienced by people aged 20 to 45 years who are engaged in heavy work in production. Both diseases have unpleasant symptoms and limit physical activity person. Protrusion and hernia - what are they and is there a difference between them?

What it is?

Both diseases affect intervertebral discs and occur against the background of osteochondrosis, mechanical damage or other diseases of the spine. The intervertebral disc consists of a nucleus and an annulus fibrosus. With both ailments, it is compressed and protrusion occurs. Over time, the disc loses water, the shell dries out, cracks and finally breaks, releasing the contents out.

Protrusion and herniation of the intervertebral (intervertebral) disc

What is the difference?

What is the difference between protrusion and herniated intervertebral discs? The main difference is that with protrusion the protrusion is small (up to 5 mm), the fibrous ring is still intact, and the disease is considered a hernia when the ring ruptures and the contents of the nucleus protrude. Roughly speaking, protrusion is the initial stage of a hernia, which, if left untreated, progresses to the next stage.

How to distinguish them?

As noted above, the first criterion is size. If the protrusion is up to 5 mm, then it is not a hernia. This can be determined using hardware diagnostics: MRI or CT. The doctor injects a contrast agent and takes pictures of the spine, which allow you to accurately see the location, size, and shape of the protrusion.

Symptomatically, both diseases are similar: back pain, dizziness, numbness of the limbs (if localized in cervical spine), difficulty in movements (turns, bending of the body). However, with a hernia, the symptoms become more pronounced and there is a risk of pinching the protrusion.

A protrusion is characterized by a small protrusion, and a hernia is a rupture of the disc ring with the formation of a large protrusion

If you ask “Protrusion or hernia, which is worse?”, then the answer is clear – a hernia, since with protrusion of the spine there is no tissue rupture and there remains the possibility of treatment without surgery. The hernia requires surgical intervention, and in case of pinching - urgent.

Causes

In 90% of cases, the main cause of protrusion is osteochondrosis, its consequences:

lack of minerals in bones;
decrease in motor activity, as a result of which the muscle corset is weakened;
impaired blood supply and, as a result, insufficient supply of nutrients;
decreased elasticity, impaired water metabolism in tissues.

Hernia

If treatment is not started at the protrusion stage, the disease develops, developing into a hernia. main reason such a transition – lack of therapy, increased load on the spine during illness.

Diagnostics

For both diseases, diagnosis is carried out according to the same scheme. The doctor begins by collecting an anamnesis, during which the patient needs to describe in detail the symptoms of the disease, their duration, and intensity. It is important to provide the doctor with complete, reliable information, otherwise making a diagnosis may be complicated.

To diagnose the disease, you should definitely consult an orthopedist or chiropractor.

Then comes a visual examination, during which an orthopedist or chiropractor They examine, feel the back, and may ask the patient to perform some actions (bending, turning).

To confirm the diagnosis, hardware tests are performed:

Magnetic resonance imaging is the most informative method of hardware diagnostics; it provides accurate data on the size, shape, and location of the protrusion;
computed tomography creates a three-dimensional model based on images of the affected area, but this method is inferior to MRI in terms of information content;
X-rays are performed to rule out other diseases.

Based on the data obtained, the doctor makes a diagnosis - protrusion or hernia, and prescribes appropriate treatment.

Treatment

How to cure these diseases? In general, the treatment of both ailments follows a similar scheme, but some points have significant differences. We will describe them in separate sections, and we will devote this one to a description of the general stages.

To treat the disease, in some cases the patient is prescribed therapeutic exercises

In both cases, when an illness is detected, patients must be provided with rest and reduced physical activity. Almost all patients are prescribed physiotherapeutic procedures: massage, therapeutic exercises.

In addition, chondrolone injections are prescribed for hernias and disc protrusions. This drug belongs to the group of chondroprotectors that improve the condition cartilage tissue, increase its elasticity and resistance to pressure. Their cost on average is 600 rubles.

How to relieve pain? For this purpose they use medications, which are presented in the table.

To relieve tension and discomfort in the spine, massage courses and exercises are performed, which we will discuss below.

Massage

A gentle mechanical effect on the back stimulates blood flow to the cells, and with it nutrients. Tactile influence relaxes, strengthens muscles, removes tension, normalizing motor activity, relieves pain, eliminates discomfort. The procedure is carried out only as prescribed by a doctor in the office of a professional massage therapist with medical education.

As a rule, massage is prescribed to relieve tension and discomfort in the back.

Despite the benefits, the procedure has its contraindications:

severe pain;
inflammatory process;
damage to the skin: unhealed wounds, moles, papillomas;
the first days after surgery.

Important! Do not prescribe a massage for yourself without consulting a specialist; you may not take into account contraindications, harming your health.

Various types of massage are used to treat both diseases:

Thai - in addition to mechanical effects on the back, includes elements of yoga, physical exercise;
cupping is performed using small jars that are suctioned to the patient’s back and moved along certain lines;
spot is carried out by exposure varying intensity, duration on specific points of the back;
segmental – works on a specific area of the body;
classic – the entire back is worked, but Special attention given to the affected area.

What specific type of procedure will be prescribed is decided jointly by the patient and the doctor based on the severity of the disease, the needs, characteristics of the patient, and his financial capabilities.

Physiotherapy

It is a set of exercises aimed at restoring the natural position of bones and cartilage, working out, strengthening the muscle corset, increasing mobility and elasticity of the vertebrae. There are different sets of exercises aimed at various degrees diseases, physical abilities patients.

Protrusion

The main goal of therapy is to eliminate the cause that became the catalyst for the development of the disease. Most often it is osteochondrosis, so in addition to the treatment of protrusion, therapy for osteochondrosis is prescribed. In addition, your doctor may prescribe painkillers and/or anti-inflammatory drugs to relieve symptoms.

Spinal traction is another method of therapy that can be performed on a special table with an orthopedist or under water. In the first case, the patient is fixed on the table using special belts, stretching the spine. During the underwater procedure, special weights are attached to the patient’s body and the body is placed horizontally on the water. This ensures the most natural position of the body, and due to the buoyant force of water, traction occurs gently and painlessly. In addition, water, acting on the body, massages the tissues and relaxes them. Therapeutic effect traction is achieved by increasing the intervertebral space, which fills the protrusion. The procedure is carried out in a special bath under the supervision of a doctor.

Hernia

The only one known today effective method The treatment for a hernia is surgery. The patient, depending on the size of the protrusion and the stage of the disease, is prescribed one of the types of surgical intervention:

Laminectomy – removal of part of the protrusion and vertebra in the area nerve root which is under pressure. Allows you to relieve pain. It has significant disadvantages - a large postoperative wound, long recovery period during which the muscle corset is weakened.
Endoscopy is minimally invasive (i.e. with minimal tissue trauma and skin) method, but because of this it has some limitations due to which application is not always possible. The patient is discharged from the hospital within 2-4 days.
Laser therapy involves vaporizing the protrusion with a laser beam. It is considered a high-risk procedure because the beam is difficult to control.
Microsurgery is performed using a microscope or a special operating head loupe, which allows you to significantly enlarge the visible area. With the help of microsurgery, the doctor gains access to any part of the spine and removes a hernia of any density. The incision after the intervention is no more than 5 cm, the recovery period is short.

Rehabilitation period

The first time after surgery occurs rehabilitation period during which the patient needs to take care of his health and carefully follow the doctor’s instructions. The duration and severity of recovery depends on the surgical method used for treatment. Microsurgery, laser therapy and endoscopy allow the patient to rehabilitate in a short time; tissue healing occurs quickly, since the postoperative injury is minor. Discharge occurs no later than 5 days.

After laminectomy, patients undergo a more difficult, longer recovery period. Discharge from the hospital is carried out on 7-14 days.

To restore the body after surgery, exercise therapy sessions are prescribed.

In all cases, for the first month after surgery, patients are not allowed to lift objects heavier than 5 kg or give themselves intense physical activity. Instead, massage, exercise therapy, and swimming are prescribed. After a month, patients are allowed to gradually return to their normal lifestyle and exercise.

Answers on questions

Is protrusion a hernia or not? It is the same? No, that's two various diseases, which are based on similar reasons. Often a hernia becomes a complication of protrusion, which develops in the absence of therapy or high physical stress on the musculoskeletal system.

Does a protrusion always turn into a hernia?

No not always. If you start seeing a doctor in a timely manner, then in 90% of cases the disease is completely cured. It is important to comply preventive measures after treatment and do not overload the body, so as not to provoke a relapse.

Prevention

The best way to cure a disease is to avoid it. For this it is recommended:

Avoid strong regular load on the spine.
Strengthen the back muscles with light physical exercises, gymnastics (squats with a weight on outstretched arms, slopes).
Try to compose balanced diet to provide tissues with sufficient nutrients.
Do not delay contacting a doctor if you notice symptoms.
Conscientiously and completely follow all the doctor’s recommendations, do not interrupt the course of treatment without first consulting the doctor.
Do not overload the body with physical activity, do not lift heavy objects, observe safety precautions when carrying heavy things (lift them from a squatting position).
Avoid injuries and other mechanical damage to the back.

It is not difficult to follow these preventive measures, but they significantly reduce the likelihood of the occurrence and development of the disease.

Let's sum it up

In the article we talked about 2 diseases: protrusion and hernia. The main differences between them are: the size of the protrusion, the severity of symptoms and damage to the disc tissue. Let us remember that a hernia is a complication of protrusion that develops due to lack of treatment and can only be eliminated through surgery, while protrusion can be successfully treated with massage, gymnastics and traction. Pay attention to preventive measures - they will help you avoid the development of the disease. Share your experience in treating both diseases in the comments, effective methods, ask any questions you may have.

Problems associated with spinal pathology in Lately become one of the main reasons for applying for medical care. Therefore, it is important that people receive timely and reliable information about how to properly handle the main element of their body, which ensures the movement of the body in space. Knowing why protrusions occur and understanding how they differ from each other can become the basis for reducing spinal morbidity.

In most cases, a hernia is a consequence of untreated protrusion, next stage degenerative lesions of the intervertebral disc, usually osteochondrosis.

Protrusion is the protrusion of a disc beyond the level of the vertebral margins. At the same time, the fibrous ring surrounding the elastic nucleus pulposus remains intact.

It is distinguished by its presence - it ceases to hold the core and its parts begin to protrude beyond the boundaries of the intervertebral space.

Degenerative processes in the intervertebral discs lead to the fact that they lose elasticity, their shock-absorbing function decreases, and when the spine is loaded with weight lifting, microtrauma, sports training, the discs are unnecessarily compressed. Microtears of the fibrous ring occur, and if the load does not stop, the nucleus pulposus is squeezed out. The localization and size of the protrusions determines the presence of pain and neurological symptoms throughout almost the entire body.

Ability to distinguish 2 related pathologies

According to the clinical picture.

Diagnosis of hernias and protrusions begins with clinical symptoms, since these are exactly what the doctor encounters when a patient seeks help.

Protrusions, as a rule, give local painful sensations- paresthesias that do not extend far along the innervation of the spinal roots that are in the area of interest.

Hernia small size in terms of symptoms it differs little from protrusion - the pain can also only bother you in the area of the back, neck or lower back. If the protruding part is large enough, then pain appears in the corresponding limbs, paresthesia, and even dysfunction of the innervated organs when the hernia begins to compress the spinal cord.

Using instrumental diagnostics.

The “gold standard” in diagnosing vertebral disc diseases is magnetic resonance imaging (MRI), which should be performed in different projections to reliably determine the location of protrusions and the proximity of anatomical structures that may be subject to compression.

In the photographs you can see that the structure of the protruding part of the intervertebral disc during protrusion differs from that during a hernia. The same applies to sizes - 5 mm is considered the maximum size for protrusion, larger sizes are regarded as hernias.

Are there differences in treatment methods?

In terms of therapeutic measures, the management of patients with osteochondrosis is uniform and is aimed primarily at relieving the patient of pain. The most important part of therapy is unloading the affected segment of the spine, eliminating muscle tension, as well as measures to promote a speedy recovery - improving microcirculation and metabolic processes in the pathological zone.

However, therapeutic measures for large sizes hernias or a narrow spinal canal may be insufficient and surgical treatment will be required. This is also the difference between a hernia and protrusion.

The prognosis of these two pathologies largely depends on the patient’s behavior. Following the doctor's recommendations, a complete transition to correct movements that do not harm the spine, maintaining active healthy image life can limit the disease at the stage of protrusion.

These measures will allow the body to independently “patch” damage to the fibrous rings and improve the health of the discs themselves.

However, often people who get rid of pain at the first stage of treatment forget about doctors’ recommendations and return to their previous lifestyle: improper movements, traumatic work or training. In this case, the undertreated spine, having lost all reserves for recovery, will “respond” with the occurrence of a hernia and can put the patient in a hospital bed for a long time and lead to disability.

Both protrusion and hernia– this is a lesion of the intervertebral disc against the background of osteochondrosis, degenerative-dystrophic changes.

Relatively speaking, a protrusion is a small hernia in which the fibrous ring has not yet ruptured. Since the division is relatively arbitrary, it is generally accepted that disc protrusion up to 5 mm- This protrusion, more – already a hernia.

Of course, a herniated disc is worse, but there are some peculiarities here too. There are many types of disease locations. A foraminal protrusion of 4 mm is much worse than a median hernia of 5 mm, and a central hernia (Schmorl’s hernia) of up to 10 mm may not bother the patient at all. There are ventral hernias that may not bother a person at all, do not manifest themselves in any way, and do not need to be treated.

Or another example, a protrusion in the cervical region is much more dangerous than a hernia in the lumbar region.

But if we take the same protrusion and hernia in the same place, in the same direction of protrusion, then the hernia is definitely worse.

Protrusions are much more common and tend to develop into a hernia.

Diagnosis is carried out on the basis of MRI or, extremely rarely, CT (harmful).

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Hello. I did an MRI. What does the diagnosis mean? Pain in the lower back and legs.

Sorry for not attaching two photos at once, it doesn’t work

Photo number 2

This could be the reason for the pressure

Hello!

How serious is this diagnosis?

Foraminal protrusion of L4/5 disc up to 2.5 mm?

Hello. My name is Tatyana. I had 3 surgeries. They removed the hernia and put in an implant. Then they squeezed it out, they removed it, and they put another one in. And a year later they removed it, it was in the way. there's nothing there now. It's been 3 years already. Now the MRI shows right-sided median protrusion and central protrusion. I had weakness in one arm. Now I have weakness in my right hand too. Pain in my neck, headache, dizziness. what should I do? what treatment is needed?

Nutrition for degenerative dystrophic disease with protrusion of vertebral discs in the cervical, thoracic and lumbar spine.

Eat meat, beets, legumes, sea and river fish, pomegranates, seaweed, nuts. You need foods rich in protein, vitamins B and C, calcium, phosphorus.

Hello! Please tell me if there is permanent disc protrusion in the spine It's a dull pain in the left side, radiating to the buttock. After treatment for spinal pain gone, but the pain remains on the left. Maybe it is necessary to examine other organs? Doctors do not prescribe any examinations.

Good evening. Tell me, in my case, I can choose support and treatment.

Good evening! I had an MRI. What does my diagnosis mean? Is it curable? Pain in the lower back and legs. Headache

Hello. Subchondral sclerosis as well as marginal osteophytes are detected in the vertebral bodies L3-S1. Intervertebral discs with signs of dehydration, height reduced at the L3-S1 level. At the L3-L4 level, a circular protrusion of the intervertebral disc is determined with dimensions of up to 0.20 cm, the spinal canal at this level measures: ventrodorsal 1.99 cm, width - 1.69 cm. At the level of L4-L5, a circular protrusion of the intervertebral disc is determined with dimensions of up to 0.26 cm, the spinal canal at this level measures: ventrodorsal 1.60 cm, width – 2.05 cm. At the L5-S1 level, against the background of a circular protrusion of the intervertebral disc up to 0.16 cm, the dorsal central accent of the protrusion measures 0.36 cm with the main one measuring 0.53 cm, and the spinal canal at this level measures 0.53 cm. : ventrodorsal 1.63 cm, width 2.71 cm. The cerebrospinal fluid space can be traced throughout, without pathological MRS. The anterior and posterior are detailed, the yellow ligaments are without features. The facet joints are not changed. The spinal cord (at examination level) is located in the center of the spinal canal, not sure if the structure is typical. The cone of the spinal cord is located at the level of L1-L2 and is divided into the radicular filaments of the cauda equina, the latter without features. In the area of the sacroiliac joints there is fatty degeneration. Please explain what this actually means and what to do. Thanks a lot. What exercises?

Hello. MRI conclusion: osteochondrosis lumbar region spine, protrusion of intervertebral discs L3-S1 with compression of the dural sac. Please tell me what this means and what recommendations? What exercises should you do? Thank you.

Hello! According to the conclusion, do I have a protrusion or a hernia? The doctor said it was the same thing. I am 22 years old. Please tell me, is it possible for me to do three things: in the gym, floor dancing (pole dancing) and attend regular human stretching (not a special one with a slope)? Only in the gym with breaks for 4 months. Pain in the lower back slightly radiates to the right leg, pulling, aching. After the gym I felt relieved. Stretching with bending and everything else can’t hurt your back like half-dancing?
All doctors speak differently. Thank you very much for your answer!

Hello, I have a very interesting question, recently two fingers on my left hand, the ring and little fingers, have started to go numb, almost every day, don’t tell me what this means, I’m very worried about this. Thank you.

Good afternoon. I am 39 years old. Tell me, is it possible to treat my sore with medication or is surgery inevitable? After all, the hernia will not decrease over time, but will only increase? And what about sedentary work, will you need to change or even quit?

L4-5 Intercanal hernia (central up to 7.0 mm, canal width 21.0
L5–S1 up to 6.0 mm (central hernia.
compaction of the posterior ligament and extracanal marginal growths of the articular bodies of the vertebrae.
.Hello.
Is an intracanal hernia a Schmorl's hernia? And what are the prognosis? Are massage, exercise therapy, Ascurutin, glucosamine and manometric therapy suitable in such cases?
No, this is not a Schmorl's hernia, but an ordinary foraminal hernia. The effect of the described methods is doubtful.
Hello, a little earlier I asked a question about dorsal protrusion in the lumbar region, so far there has been no answer and I am sending you the MRI results, is it possible at my 24 years old to reduce the size of this protrusion? What do you think about stretching the vertebrae? And what if I get pregnant? Will this protrusion develop into a hernia?

Hello, I am 24 years old, according to MRI, I was found to have a dorsal protrusion in the lumbar region L5S1 0.35, question! Isn’t this a hernia yet? Tell me, what is the probability that it will develop into a hernia? I don’t do anything particularly difficult, only if gym I give it a workout and go snowboarding. I put it on chondroguard, I put it on compligam, Now I’m going to see a monastic therapist and then massage and physiotherapy.

Hello! I had an MRI, please tell me is it curable or is it for the rest of my life? I should not lift anything, I mean weights (they swing). In my case, how can I cure it by doing sports and how many kg can I lift weights? Thanks in advance!

Mojte mne pomoch.chto eto

Hello! I am 16 years old. Height – 171 cm, weight – 47 kg. I have physiological protrusions of the L3-S1 discs, up to 0.2 cm in size, with pain in the lumbar region, hip bone, sometimes radiating to the leg (most of all to the left). In winter, I fell hard on my pelvic bone (slipped on ice). I also have x-rays showing scoliosis (thoracic) - 2nd degree (the angle of curvature of the spine is 13 degrees, incorrect posture), while I have pain in the thoracic region, mildly, but it hurts (namely between the shoulder blades, sometimes the shoulder blades and under them (shoulder blades)) and if you are not clever, do some exercise. There is heaviness in the lower back in the morning (after sleep), and heaviness also appears after sitting for a long time. So it’s been two months now, soon the third month of my torment will begin, my back hurts every day from morning to evening.
Where I had an MRI, the doctors said that everything was fine, there was no reason to worry...
And I also want to ask, could the ribs (back problems) hurt because of this? I feel like my ribs are aching.
Could all these changes in your back cause pain every day?
Should I also do an MRI of the thoracic region and an x-ray of the ribs?
At the bottom I will attach the result of the lumbar MRI -sacral region.

What can you say about my situation???
You have an overload in the spine, most likely muscle hypertonicity on one side. Physical activity is not indicated, as it can provoke an exacerbation. You need to consult a vertebrologist who will prescribe a course of spinal correction and eliminate the cause of your problems and overload.

CT conclusion: CT signs of initial degenerative-dystrophic changes in the spine - osteochondrosis of the intervertebral discs, spondyloarthrosis of the facet and iliosacral joints, protrusion of the substance of the L2-L5 discs.
Th12-l1 disk does not extend beyond the contours
L2-L3 symmetrical circular protrusion of the disc substance up to 3.5 mm
L3-L4 symmetrical circular protrusion of the disc substance up to 4 mm
L4-L5 symmetrical circular protrusion of the disc substance up to 4 mm
L5-S1 disk does not go beyond the contours
I am 20 years old. What do you recommend and what is your opinion if you have cervical osteochondrosis?

Thank you very much, Galina Gennadievna! I live on Sakhalin. You can probably guess what the periphery is? I would like to know if there is a drug treatment for this disease? Thanks in advance for your answer!
Drug treatment is symptomatic treatment, which should be prescribed to you by a neurologist. We eliminate the cause of the problem, not the effect. But for this you need to come to Kyiv. Get well.
MRI. CONCLUSION; MP picture of degenerative changes (osteochondrosis) of the lumbosacral spine, complicated by herniation of L5/S1; protrusion of discs L2/3,L3/4.L4/5. Retrolisthesis of L4, L5 vertebrae. Signs of spondyloarthrosis at the level of L1-S1 segments Additional inclusions in the bodies of Th12-L-3, L-5 vertebrae (susp.hemangiomas). Is this a sentence??? Or can this be treated???
Hemangiomas are benign tumors in the body of the spine; they need to be monitored once every six months or a year, and a control MRI should be done. It is also necessary to examine other parts of the spine. Hernias and protrusions are not a death sentence, but a consequence of lifestyle and excessive loads on the spine. If you are bothered by pain, contact a neurologist or vertebrologist for a consultation. You also need to undergo a test for osteoporosis - x-ray densitometry, to exclude the systemic nature of the process and a decrease in bone density. Sincerely
You have strains and hernias, most likely due to overload in the spine. The cause must be found out and eliminated so that the protrusions do not progress further and new ones do not appear.

Hello! I’m 29 years old. Since childhood I had scoliosis, small between the shoulder blades. We carried heavy weights, the right shoulder blade burned... and then it fell on the tailbone. In the evening the pain intensified so that I couldn’t lie down or get up.. the right side stabbed wildly, my ribs when I inhaled and coughed I was sick, I immediately started taking ketopofen. On the third day at night, my hand went numb, it hurt to walk, there was a moment when walking my leg went paralyzed for a couple of seconds. Five days passed. The pain in the spine remained; it hurt to touch or do anything at all. Please tell me what is this?
It is difficult to answer your question - there are many complaints that are not very related to each other. Consult a doctor in person; you need to be seen to determine the problem. Sincerely
Hello. Tell me, what does this conclusion mean? Thank you!
You have protrusions and, judging by the description, one hernia that puts pressure on the left nerve root. Because of these problems, there is pain in the lower back and radiates to left leg. We need to look at the pictures, you and do treatment. To make an appointment, call the Clinic numbers. Sincerely

Hello. I have dorsal protrusions in the cervical spine up to 2 mm. There is a strong ringing in my head. Is this very dangerous? And is it possible to get rid of the ringing?

Good afternoon. please tell me the diagnosis. what are the next actions. is it dangerous?

Hello, in the L4-L5 segment I have a wide dorsal protrusion of the m/n disc with a median accent, up to 6-7 mm in size with slight caudal migration, with compression of the dural sac and root canals, with their narrowing to 1-2 mm. Dimensions of the spinal canal: sagittal – 14 mm, transverse – 19 mm. The conus spinal cord is usually located at the L1 level and is divided into radicular filaments of the cauda equina. Conclusion: initial degenerative-dystrophic changes in the lumbar region. L4 disc herniation.
A year has passed since the problem began, I underwent physical therapy. procedures. Now, as prescribed by the doctor, I am injecting Artiflex Chondro, and I am doing regular exercise therapy. Tell me if I’m on the right track, since I’m 26 years old and planning a child in the near future.

Hello! Dystrophic changes are noted in the intervertebral discs of the thoracic spine: a decrease in the height of the intervertebral discs, a decrease in the signal intensity from the intervertebral discs on T2 weighted images, unevenness of the cranial and caudal endplates of the vertebral bodies in the Th5-L1 segments (central Schmorl's grooves in the Th5-L1 vertebral bodies in depth 3-5 mm). Posterior left paramedian disc protrusion T h3-Th4 3 mm. Posterior right paramedian disc protrusion Th4-Th5 3.5 mm. Posterior circular protrusions of discs Th5-Th6, Th7-Th8, Th8-Th9, Th9-Th10 up to 1.5-2 mm. Posterior disc protrusions deform the anterior dural space. Spinal canal up to 15 mm (antero-posterior size). Conclusion of MRI manifestations of osteochondrosis, spondyloarthrosis of the thoracic spine. Posterior disc herniations from Th3 to Th10.
I have painful vertebrae in my chest area when I press on them and my back ache.
Could my conclusion lead to the following: when I take a breath, it’s as if I can’t breathe out at the end...with every breath it happens?! (Heart and lungs are excellent).
And one more thing...can I go to the gym with such a spine (I’ve been working out for 2 years)!?
The gym will aggravate the growth of protrusions. It is necessary to find out the cause and eliminate them.
Good evening! I will be very grateful to you if you answer me. About 3 years ago my legs started to hurt, they hurt from the knee to the beginning of the foot and I felt cold in the summer when it was hot, I tied my legs from the knee to the foot with woolen scarves. I had a tomography done and they told me that the 4th and 5th vertebral discs are pinching a nerve and because of this my legs hurt, but now the pain has intensified and in addition to this there has been pain in the lower back with right side where is the dimple? It’s difficult to walk when I step on my foot, the pain intensifies. Please advise what to do. All the best. Thank you.
It is necessary to see MRI images first. Sign up for a consultation at the clinic, they will diagnose you and identify the cause, then they will prescribe the correct treatment for spinal correction. Doctors will give recommendations on what you can and cannot do.
I would like to ask if there is an error in this conclusion

Good afternoon, I took a picture, they write that there is an 11mm protrusion of the intervertebral disc, and the conclusion is written that it is a hernia and extends to the left root, I showed it to the doctors, they say that there is no 11mm protrusion, now I don’t know what to think, the pain is hellish, the nerve doesn’t let me lie down, sit, do nothing, I wanted I would like to ask you how it is treated, what surgery can be done, I’m afraid

Hello, I am worried about pain in the back of my head, numbness in my arms, neck spasms, dizziness, (39 years old) I had a CT scan: straightening is determined cervical lordosis, decreased height of intervertebral discs in segments C5-C7 with moderately pronounced anterior and posterior marginal bone growths, subchondral sclerosis of the end plates of the vertebral bodies. intervertebral foramina are not narrowed. the spinal canal at the level under study is not narrowed in the sagittal direction. subchondral sclerosis of the joint spaces of uncovertebral joints. No destructive or bone-traumatic changes in the vertebrae were detected. the openings of the vertebral arteries are asymmetrical throughout. from adjacent soft tissues pathological changes not found. The C2-C3 disc does not extend beyond the contours of the vertebral bodies. C3-C4 symmetrical circular protrusion of the disc substance up to 2 mm. C4-C5 local protrusion of the disc substance, median up to 2 mm. C5-C6 local protrusion of the disc substance up to a median of 3 mm with calcification, vacuum phenomenon. C6-C7 asymmetric circulatory protrusion of the disc substance more to the right up to 2 mm. Please tell me what the prognosis of the disease is.
Forecast – at improper treatment progression of spinal osteochodrosis. The complaints are partly due to the syndrome vertebral artery. Dopplerography of the vessels of the head and neck is necessary to clarify the features. To get more detailed information It is necessary to see your MRI images and conduct an examination. Sign up for an in-person consultation. Sincerely
Good afternoon Please tell me, I did an MRI - the study of the lumbosacral spine was carried out in the sagittal and axial projection in T1 and T2 VO.
Physiological lumbar lordosis. Mild mild-sided scoliosis.
The endplates of the vertebral bodies TH11-L2 are deformed by Schmorl's cartilaginous nodes.
The height of the intervertebral discs is not reduced, the intensity of the MR signal in T2WI is reduced due to moderate dehydration of the L4-L5-S1 discs.
Dorsal prolapse of intervertebral discs are visualized:
– protrusion L4-L5 - 0.25 cm - wide medial version with an emphasis to the left, channel -1.2x1.8 cm;
– L5-S1 protrusion - 0.35 cm - wide paramedian variant with left-sided lateralization, with marginal contact of the left root, canal - 1.3x1.7 cm.
Conclusion: MR signs of osteochondrosis of the lumbar spine, complicated by disc protrusions. Schmorl's cartilaginous nodes. Scoliosis.
It hurts a lot, the doctors don’t say anything. Please tell me what should I do, I am in a lot of pain.
You have a pinched nerve root. Contact us for an in-person consultation and schedule treatment at the Clinic. We will be happy to help you.
Good night! I have constant pain in the lower back. There are two MRI reports for 2010. and from 07/15/2015 What treatment do I need?
A doctor's examination is necessary to determine treatment. An MRI report alone is not enough. You can also consult a neurosurgeon; surgery may not be ruled out.
Good day. I'm interested in this question. In 2012, I did an MRI and the conclusion was as follows: MRI signs of degenerative changes in the lumbar region with herniation at the level of L5-S1 up to 6 mm. And in 2015 The CT conclusion is as follows. CT signs of osteochondrosis of the lumbar spine. Dorsal protrusion of the L5-S1 disc up to 5 mm. I'm wondering if I have a hernia or protrusion.
You have a hernia up to 6 mm. The discrepancy is due to the error of the MRI device (error on average up to 3 mm). With respect.

Hello. It hurts very much left shoulder blade.
It started with the fact that early in the morning I woke up and felt pain in my left shoulder blade; it was slightly painful to cough, take a deep breath, and even walking was still tolerable. But after 3 days when I tensed my body and felt strong crunch the pain became even stronger when I was lying down and I couldn’t turn my neck all the way left side, it hurts to bend my neck back when I stand (walk), I pull on my collarbone and feel severe pain, when I cough slightly I feel pain in my shoulder blade, doing sharp and not sudden movements I also feel tingling + I also feel discomfort.
Please tell me what this could be and how to treat it
This is cervicothoracalgia, trapezius muscle syndrome. Perform an MRI of the cervical and thoracic regions, and with the results, sign up for an in-person consultation. At timely application The problem can be completely eliminated with a probability of more than 99%. Best regards.