Hernia: Causes, treatments, and diagnosis

Hernia is a common problem. It causes a localized bulge in the abdomen or groin.

It can often be harmless and pain-free, but at times it can bring discomfort and pain.

In this article, we investigate what a hernia is, the common causes of hernia, and how they are treated.

Fast facts on hernias

• Hernias often produce no troublesome symptoms, but abdominal complaints may signal a serious problem.
• They are usually straightforward to diagnose, simply by feeling and looking for the bulge.
• Treatment is a choice between watchful waiting and corrective surgery, either via an open or keyhole operation.
• Inguinal hernia surgery is more common in childhood and old age, while the likelihood of femoral hernia surgery increases throughout life.

Was this helpful?

A hernia occurs when there is a weakness or hole in the peritoneum, the muscular wall that usually keeps abdominal organs in place.

This defect in the peritoneum allows organs and tissues to push through, or herniate, producing a bulge.

The lump may disappear when the person lies down, and sometimes it can be pushed back into. Coughing may make it reappear.

Hernias can commonly be found in the following areas:

Groin: a femoral hernia creates a bulge just below the groin. This is more common in women. An inguinal hernia is more common in men. It is a bulge in the groin that may reach the scrotum.

Upper part of the stomach: a hiatal or hiatus hernia is caused by the upper part of the stomach pushing out of the abdominal cavity and into the chest cavity through an opening in the diaphragm.

Belly button: a bulge in this region is produced by an umbilical or periumbilical hernia.

Surgical scar: past abdominal surgery can lead to an incisional hernia through the scar.

With the exception of an incisional hernia (a complication of abdominal surgery), in most cases, there is no obvious reason for a hernia to occur. The risk of hernia increases with age and occurs more commonly in men than in women.

A hernia can be congenital (present at birth) or develop in children who have a weakness in their abdominal wall.

Activities and medical problems that increase pressure on the abdominal wall can lead to a hernia. These include:

• straining on the toilet (due to long-term constipation, for example)
• persistent cough
• cystic fibrosis
• enlarged prostate
• straining to urinate
• being overweight or obese
• abdominal fluid
• lifting heavy items
• peritoneal dialysis
• poor nutrition
• smoking
• physical exertion
• undescended testicles

Risk factors for hernia

The risk factors can be broken down by hernia type:

Incisional hernia risk factors

Because an incisional hernia is the result of surgery, the clearest risk factor is a recent surgical procedure on the abdomen.

People are most susceptible 3-6 months after the procedure, especially if:

• they are involved in strenuous activity
• have gained additional weight
• become pregnant

These factors all put extra stress on tissue as it heals.

Inguinal hernia risk factors

Those with a higher risk of inguinal hernia incude:

Share on PinterestSmoking tobacco increases the risk of inguinal hernias.

• older adults
• people with close relatives who have had inguinal hernias
• people who have had inguinal hernias previously
• males
• smokers, as chemicals in tobacco weaken tissues, making a hernia more likely
• people with chronic constipation
• premature birth and low birth weight
• pregnancy

Umbilical hernia risk factors

Umbilical hernias are most common in babies with a low birth weight and premature babies.

In adults, the risk factors include:

• being overweight
• having multiple pregnancies
• being female

Hiatal hernia risk factors

The risk of hiatal hernia is higher in people who:

• are aged 50 years or over
• have obesity

In many cases, a hernia is no more than a painless swelling that presents no problems and needs no immediate medical attention.

A hernia may, however, be the cause of discomfort and pain, with symptoms often becoming worse when standing, straining, or lifting heavy items. Most people who notice increasing swelling or soreness eventually see a doctor.

In some cases, a hernia needs immediate surgery, for instance, when part of the gut becomes obstructed or strangulated by an inguinal hernia.

Immediate medical attention should be sought if an inguinal hernia produces acute abdominal complaints such as:

• pain
• nausea
• vomiting
• the bulge cannot be pushed back into the abdomen

The swelling, in these cases, is typically firm and tender and cannot be pushed back up into the abdomen.

A hiatal hernia can produce symptoms of acid reflux, such as heartburn, which is caused by stomach acid getting into the esophagus.

For a hernia without symptoms, the usual course of action is to watch and wait, but this can be risky for certain types of hernia, such as femoral hernias.

Within 2 years of a femoral hernia being diagnosed, 40 percent result in bowel strangulation.

It remains unclear whether non-emergency surgery is worthwhile for hernia repair in cases of an inguinal hernia without symptoms that can be pushed back into the abdomen.

The American College of Surgeons and some other medical bodies consider elective surgery unnecessary in such cases, recommending instead a course of watchful waiting.

Others recommend surgical repair to remove the risk of later strangulation of the gut, a complication where blood supply is cut off to an area of tissue, which requires an emergency procedure.

These health authorities consider an earlier, routine operation preferable to a more risky emergency procedure.

Types of surgery

Share on PinterestBelly button following hernia surgery.

Although surgical options depend on individual circumstances, including the location of the hernia, there are two main types of surgical intervention for hernia:

• open surgery
• laparoscopic operation (keyhole surgery)

Open surgical repair closes the hernia using sutures, mesh, or both, and the surgical wound in the skin is closed with sutures, staples, or surgical glue.

Laparoscopic repair is used for repeat operations to avoid previous scars, and while usually more expensive, is less likely to cause complications such as infection.

Surgical repair of a hernia guided by a laparoscope allows for the use of smaller incisions, enabling a faster recovery from the operation.

The hernia is repaired in the same way as in open surgery, but it is guided by a small camera and a light introduced through a tube. Surgical instruments are inserted through another small incision. The abdomen is inflated with gas to help the surgeon see better and give them space to work; the whole operation is performed under general anesthetic.

Hernia in children

Inguinal hernia is one of the most common surgical conditions in infants and children.

A 2014 systematic review of 20 years of data on conventional open hernia repair (herniorrhaphy) and laparoscopic hernia repair (herniorrhaphy) in infants and children found that laparoscopic surgery is faster than open surgery for bilateral hernias, but that there is no significant difference in operating time for unilateral inguinal hernia repair.

The rate of recurrence is similar for both types of procedure, but complications, such as wound infection, are more likely with open surgery, especially in infants.

Read the article in Spanish

Hernia: Causes, treatments, and diagnosis

Hernia is a common problem. It causes a localized bulge in the abdomen or groin.

It can often be harmless and pain-free, but at times it can bring discomfort and pain.

In this article, we investigate what a hernia is, the common causes of hernia, and how they are treated.

Fast facts on hernias

• Hernias often produce no troublesome symptoms, but abdominal complaints may signal a serious problem.
• They are usually straightforward to diagnose, simply by feeling and looking for the bulge.
• Treatment is a choice between watchful waiting and corrective surgery, either via an open or keyhole operation.
• Inguinal hernia surgery is more common in childhood and old age, while the likelihood of femoral hernia surgery increases throughout life.

Was this helpful?

A hernia occurs when there is a weakness or hole in the peritoneum, the muscular wall that usually keeps abdominal organs in place.

This defect in the peritoneum allows organs and tissues to push through, or herniate, producing a bulge.

The lump may disappear when the person lies down, and sometimes it can be pushed back into. Coughing may make it reappear.

Hernias can commonly be found in the following areas:

Groin: a femoral hernia creates a bulge just below the groin. This is more common in women. An inguinal hernia is more common in men. It is a bulge in the groin that may reach the scrotum.

Upper part of the stomach: a hiatal or hiatus hernia is caused by the upper part of the stomach pushing out of the abdominal cavity and into the chest cavity through an opening in the diaphragm.

Belly button: a bulge in this region is produced by an umbilical or periumbilical hernia.

Surgical scar: past abdominal surgery can lead to an incisional hernia through the scar.

With the exception of an incisional hernia (a complication of abdominal surgery), in most cases, there is no obvious reason for a hernia to occur. The risk of hernia increases with age and occurs more commonly in men than in women.

A hernia can be congenital (present at birth) or develop in children who have a weakness in their abdominal wall.

Activities and medical problems that increase pressure on the abdominal wall can lead to a hernia. These include:

• straining on the toilet (due to long-term constipation, for example)
• persistent cough
• cystic fibrosis
• enlarged prostate
• straining to urinate
• being overweight or obese
• abdominal fluid
• lifting heavy items
• peritoneal dialysis
• poor nutrition
• smoking
• physical exertion
• undescended testicles

Risk factors for hernia

The risk factors can be broken down by hernia type:

Incisional hernia risk factors

Because an incisional hernia is the result of surgery, the clearest risk factor is a recent surgical procedure on the abdomen.

People are most susceptible 3-6 months after the procedure, especially if:

• they are involved in strenuous activity
• have gained additional weight
• become pregnant

These factors all put extra stress on tissue as it heals.

Inguinal hernia risk factors

Those with a higher risk of inguinal hernia incude:

Share on PinterestSmoking tobacco increases the risk of inguinal hernias.

• older adults
• people with close relatives who have had inguinal hernias
• people who have had inguinal hernias previously
• males
• smokers, as chemicals in tobacco weaken tissues, making a hernia more likely
• people with chronic constipation
• premature birth and low birth weight
• pregnancy

Umbilical hernia risk factors

Umbilical hernias are most common in babies with a low birth weight and premature babies.

In adults, the risk factors include:

• being overweight
• having multiple pregnancies
• being female

Hiatal hernia risk factors

The risk of hiatal hernia is higher in people who:

• are aged 50 years or over
• have obesity

In many cases, a hernia is no more than a painless swelling that presents no problems and needs no immediate medical attention.

A hernia may, however, be the cause of discomfort and pain, with symptoms often becoming worse when standing, straining, or lifting heavy items. Most people who notice increasing swelling or soreness eventually see a doctor.

In some cases, a hernia needs immediate surgery, for instance, when part of the gut becomes obstructed or strangulated by an inguinal hernia.

Immediate medical attention should be sought if an inguinal hernia produces acute abdominal complaints such as:

• pain
• nausea
• vomiting
• the bulge cannot be pushed back into the abdomen

The swelling, in these cases, is typically firm and tender and cannot be pushed back up into the abdomen.

A hiatal hernia can produce symptoms of acid reflux, such as heartburn, which is caused by stomach acid getting into the esophagus.

For a hernia without symptoms, the usual course of action is to watch and wait, but this can be risky for certain types of hernia, such as femoral hernias.

Within 2 years of a femoral hernia being diagnosed, 40 percent result in bowel strangulation.

It remains unclear whether non-emergency surgery is worthwhile for hernia repair in cases of an inguinal hernia without symptoms that can be pushed back into the abdomen.

The American College of Surgeons and some other medical bodies consider elective surgery unnecessary in such cases, recommending instead a course of watchful waiting.

Others recommend surgical repair to remove the risk of later strangulation of the gut, a complication where blood supply is cut off to an area of tissue, which requires an emergency procedure.

These health authorities consider an earlier, routine operation preferable to a more risky emergency procedure.

Types of surgery

Share on PinterestBelly button following hernia surgery.

Although surgical options depend on individual circumstances, including the location of the hernia, there are two main types of surgical intervention for hernia:

• open surgery
• laparoscopic operation (keyhole surgery)

Open surgical repair closes the hernia using sutures, mesh, or both, and the surgical wound in the skin is closed with sutures, staples, or surgical glue.

Laparoscopic repair is used for repeat operations to avoid previous scars, and while usually more expensive, is less likely to cause complications such as infection.

Surgical repair of a hernia guided by a laparoscope allows for the use of smaller incisions, enabling a faster recovery from the operation.

The hernia is repaired in the same way as in open surgery, but it is guided by a small camera and a light introduced through a tube. Surgical instruments are inserted through another small incision. The abdomen is inflated with gas to help the surgeon see better and give them space to work; the whole operation is performed under general anesthetic.

Hernia in children

Inguinal hernia is one of the most common surgical conditions in infants and children.

A 2014 systematic review of 20 years of data on conventional open hernia repair (herniorrhaphy) and laparoscopic hernia repair (herniorrhaphy) in infants and children found that laparoscopic surgery is faster than open surgery for bilateral hernias, but that there is no significant difference in operating time for unilateral inguinal hernia repair.

The rate of recurrence is similar for both types of procedure, but complications, such as wound infection, are more likely with open surgery, especially in infants.

Read the article in Spanish

Non-surgical treatment of herniated discs | Artromedcenter

Intervertebral hernia is a consequence of degenerative-dystrophic processes in the musculoskeletal system. This disease is characterized by slow development. Left untreated, there can be serious consequences for a person’s health. Treatment involves the use of conservative and radical methods. It is important not to ignore the symptoms of the disease and consult a doctor as soon as possible. This will stop the development of the disease in the early stages.

Features of the course of the disease

With constant overloads, uneven loads on the spine, softening of the pulpous nucleus occurs. It is forced out from the center to the side. If movement occurs as a result of compression, the tissue sheath will swell. Then, when unloading occurs, the core returns to its previous position.

At the first stages of such a pathological process, the membrane is capable of recovery. After a certain period of time, if nothing changes, shell recovery slows down. In this case, the disease begins to develop more actively, an intervertebral hernia is formed with accompanying symptoms.

The clinical picture of a hernia is determined by the stage of its development and localization. In some cases, there is more than one such education. The more nerve bundles, ligaments and muscles are involved in degenerative processes, the more intense the symptoms.

There are certain stages in the development of an intervertebral hernia:

1. Prolapse. At this stage, the disk is displaced by no more than 3 millimeters.
2. Protrusion. At this stage, the disc has moved more than 4 millimeters, but it has not yet gone beyond the retaining ring.
3. Extrusion. The fibrous capsule loosens, the nucleus protrudes from it.
4. Sequestration. The ring breaks, the nucleus completely protrudes beyond it.

The direction of the hernia can be different. If its formation occurs on the anterior or lateral part of the disc, damage to the surrounding structures does not occur. With the formation of a hernia in the back, nerve bundles are compressed, soft tissues are damaged. With timely treatment, it is possible to stop the development of the disease.

No symptoms at the initial stage of development. Sometimes there may be slight pain or discomfort in the area where the bulge develops. As the disease progresses, pain occurs, over time it becomes more intense. With the simultaneous development of several hernias, the clinical picture is layered and becomes pronounced.

Characteristic signs of the development of the disease include:

• Pain syndrome. Pain is a key sign of education formation. Initially, the pain is not pronounced, it goes away on its own. As the pathological process develops, the pain does not go away even if the person is at rest. Most often, the pain is aching. Often it is supplemented by numbness of the limbs, paresthesia, or loss of sensation.
• Muscle tension. When pain appears, a person instinctively tries to spare the sore spot, begins to limit motor activity. Thus, muscle tension arises, in which a distortion of the spinal column can form. In the future, in this position, the discs are injured.

Symptoms may appear depending on the location of the mass.

In case of cervical hernia:

• fingers become numb;
• attacks of vertigo occur;
• attacks of headaches appear;
• nausea or even vomiting occurs;
• jumps in blood pressure;
• pain in the neck, in the shoulder girdle, in the upper limbs.

For thoracic hernia:

• chest discomfort;
• difficult to swallow;
• when sneezing or coughing the pain gets worse;
• there is pain similar to an attack of angina pectoris, there is also pain in the stomach;
• dyspepsia.

Most often, hernias of the lumbar spine are formed. They are accompanied by the following symptoms:

• pain in the lumbar region;
• toes become numb, muscle tone decreases;
• some reflexes are lost;
• have difficulty with bowel or bladder function;
• difficulty walking.

Principles of conservative therapy

Conservative treatment of a hernia of the lumbar spine without surgery involves the use of complexes that will help restore paravertebral tissues and intervertebral discs. The main task of conservative therapy is:

• elimination of tension from the muscular system;
• strengthening of muscle tissue;
• even distribution of the load on the spinal column;
• getting rid of the disease without the use of radical methods.

It is unacceptable to use any means on your own in the presence of such a diagnosis. This is fraught with the development of complications. It is also impossible to do exercises, since it is difficult to calculate the load on the spine on your own. When the first symptoms appear, it is important to consult a doctor in time, undergo the prescribed diagnostics and clearly follow all medical recommendations. In each case, individual therapy is prescribed.

Medical treatment

When the disease worsens, pain becomes intense, movements are limited. In this case, the patient is prescribed drug therapy.

With the help of drugs, you can get rid of the clinical signs of the disease, improve the general condition of a person. These drugs include anti-inflammatory, decongestant, hormonal, enzyme, muscle relaxants. With the help of these drugs, the severity of symptoms can be reduced.

It is important to understand that such treatment is effective, but in order to completely get rid of the disease, it is necessary to eliminate the cause of its development. Otherwise, after a certain time, the disease recurs. When undergoing treatment for a lumbar disc herniation without surgery, certain side effects may occur. In parallel, gastroprotectors, hepatoprotectors are prescribed.

Non-steroidal anti-inflammatory drugs

Most often, these drugs are prescribed for the development of degenerative processes in the joints or spine. Such drugs have analgesic, antipyretic and anti-inflammatory effects, eliminate pain. The predominant number of agents that fall into this category are non-selective inhibitors of the cyclooxygenase enzyme. This enzyme is directly involved in the production of mediators of the inflammatory process.

With the help of non-steroidal anti-inflammatory drugs, the inflammatory focus in the area of ​​the location of the intervertebral hernia is reduced. Medicines relieve swelling, relieve pinching of the spinal nerve bundles, anesthetize, improve motor activity. Most often, selective agents are prescribed in the treatment. After taking these funds, there is no negative effect on the mucous membranes of the intestines and stomach. These drugs include Nimid, Movalis, Celecoxib.

If the above drugs do not bring the desired result, doctors prescribe non-steroidal anti-inflammatory drugs of the non-selective group. These include Diclofenac, Dicloberl, Ibuprofen, Ketoprofen. In this case, gastroprotectors are necessarily prescribed – Omez, Zolopent, Nolpazu.

Muscle relaxants

The main task of these drugs is to reduce muscle tone, get rid of contractures. These drugs include Movalis and Mydocalm.

Glucocorticosteroids

These preparations contain hormonal substances. Long-term use of these drugs should not be prescribed, as they can adversely affect articular cartilage. These medicines are used for a short time.

Biogenic stimulants

Aloe extract is used to accelerate tissue repair. This drug is given by injection. Also, Fibs medicine is used to activate regeneration processes. These drugs are administered every day for one month.

Drugs to improve blood flow

These drugs include Pentoxifylline. With its help, blood microcirculation improves, tissues are better supplied with oxygen. This drug is given by injection or taken orally.

Enzymes

Hydrolytic enzymes reduce inflammation, improve the body’s natural resistance. Drugs relieve swelling and help reduce the severity of pain.

Vitamin preparations

To help the body in the treatment of a disease, vitamins A, B1, B6, B12, C, D, E are used. With the help of group B vitamins, the intensity of symptoms decreases, normal tissue sensitivity is restored, and the severity of painful sensations decreases. These drugs are taken orally or by injection.

In parallel, vitamin D with calcium is prescribed. They help restore bone density, strengthen ligaments. Vitamin A, tocopherol, ascorbic acid act as antioxidants. They remove free radicals, enhance recovery processes.

Painkillers

Medicines are used to relieve acute inflammation. These include Ibuprofen, Tempalgin, Spazmalgon, Solpadein.

In the presence of an intense pain syndrome that cannot be stopped with non-steroidal anti-inflammatory drugs, blockades are prescribed using Novocaine, Lidocaine, Kenalog, Celeston, Metipred. Such drugs help to quickly get rid of acute pain, stop the focus of inflammation.

Chondroprotectors

In the presence of an intervertebral hernia, the nucleus pulposus is destroyed. It cannot recover on its own. The patient is prescribed chondroprotectors. With the help of these drugs, metabolic processes in the tissues of the spine are improved. They are a good prevention of the formation of hernias and the development of diseases of the musculoskeletal system. These drugs include: Don, Artra, Chondroitin, Chondrolon, Elbon. Such drugs are taken in a course of up to six months, then they take a break of one month and repeat the course of treatment.

Manual therapy

Manual therapy is one of the most effective methods of prevention of herniated discs. This is a combination of impact on soft tissues along with correction of the articular apparatus. In this case, blood circulation and motor activity of the spine resume. It is recommended to combine manual therapy with spinal traction, Cypress simulator.

During the procedure, the chiropractor warms up the muscles in the desired area. Then he gently presses, trying to eliminate the displacement of the disk, release the pinched nerve, and eliminate pain. In each case, the approach is individual.

In the first sessions of therapy, the specialist performs a gentle stretching of the spine. The result is the release of the pinched nerve bundle, as a result, the pain becomes less pronounced. Further therapy sessions help restore destroyed cartilage and muscle tissue.

Results of manual therapy sessions:

• improvement of blood microcirculation in tissues;
• improved nutrition of cartilaginous tissues, oxygen access to them;
• return of the intervertebral disc to the desired position;
• pain relief;
• getting rid of increased muscle tone and spasm;
• return of normal mobility of vertebral structures.

This method is universal in the treatment of hernia. It is effective if drug therapy does not bring the desired results. With a regular course of manual therapy, you can prevent the development of complications of the disease, restore joint mobility, get rid of the unpleasant symptoms of the disease.

Therapeutic gymnastics

Therapeutic gymnastics strengthens the muscular frame of the back, stabilizes the lumbar region. The classes include exercises that are selected by the doctor in each case individually. With the help of regular training, you can prevent surgery, restore mobility.

Doctors often prescribe a course of therapy, which includes conservative and physiotherapy, as well as massage. Therapeutic exercises are an additional method of rehabilitation. With regular performance, you can prevent the further development of the disease and complications.

Regular exercise results in:

• improvement of blood microcirculation;
• elimination of spasm;
• removal of nerve bundle clamps;
• improved access to oxygen and active drug preparations;
• restore mobility.

Physiotherapy

Physiotherapy treatments are effective. They are used to quickly restore lost body functions. The impact occurs by waves, rays, pressure, water.

Physiotherapy is used for the following purposes:

• reduce the severity of pain in the area where the inflammatory process develops;
• improve blood microcirculation;
• reduce the intensity of cartilage and bone destruction;
• eliminate puffiness;
• speed up the metabolic processes.

The therapy algorithm is compiled by a doctor after a preliminary diagnosis. There are different types of physiotherapy procedures that will bring good results after completing the prescribed course:

• laser treatment;
• magnetotherapy;
• pressure therapy;
• electrophoresis;
• EHF;
• UHF;
• ultrasound;
• reflexology;
• exposure to heat;
• massage;
• radon baths;
• balneotherapy;
• ozokerite;
• paraffin therapy.

Magnetotherapy

It is a modern type of physiotherapy treatment. The impact occurs due to a static magnetic field. It can be constant or pulsed. When using this procedure, you can get rid of pain, reduce swelling, restore damaged tissues.

EHF

The procedure consists in exposure to high-frequency current. This is a point stimulation, as a result of which there is an improvement in blood microcirculation, the elimination of edema, and a slowdown in inflammatory processes.

Electrophoresis

Electrophoresis is the most popular method. Assumes the effect of low-frequency current pulses. Under its influence, the active substances of drugs penetrate deeply into damaged tissues.

Ultrasound

The result of the course is the regeneration of damaged cells, getting rid of pain. It also activates metabolic processes.

Paraffin therapy

The procedure improves blood circulation. It relieves swelling and reduces the severity of the inflammatory process.

Radon baths

Such procedures are carried out mainly in sanatoriums. Surgery is a contraindication.

Acupuncture

The procedure is a traditional oriental practice. It involves the impact on biologically active points of the body.

Electrical stimulation

The procedure involves exposure to low-frequency impulse currents. With the help of this procedure, the severity of symptoms is reduced, the cause of the development of the disease is eliminated.

Results after the course of procedures:

• improved blood circulation;
• prevention of further tissue destruction;
• splitting of salt deposits;
• getting rid of nerve bundle clamps;
• improved nerve conduction;
• pain relief.

Bernard currents

Insertion of electrodes takes place with further action of pulses. After the procedure, tissue nutrition is restored, degenerative processes are inhibited, and pain sensations are eliminated.

Shock wave therapy

This therapy helps to get rid of pain and swelling, increases the speed of tissue repair. After completing the course, there is an expansion of blood vessels, activation of blood flow, elimination of puffiness.

Diagnostics must be performed before procedures can be performed. The complex of therapy is prescribed only by a doctor.

Folk remedies

It is important to remember that alternative therapy is not an alternative to conservative treatment, it is only an addition to the main course of treatment.

How to treat a hernia of the lumbar spine with folk remedies:

• Tincture from the cinquefoil root. Used internally and externally. For cooking, you need to grind the cinquefoil root, pour a liter of vodka or alcohol. Insist for three weeks in a dark, dry place. Next, the remedy must be filtered. Use for compresses, lotions and applications. It is recommended to combine with Dimexide.
• Comfrey root ointment. Grind raw materials, add melted pork fat, pour vodka or alcohol. After hardening, rub into the sore spot.
• St. John’s wort and sunflower oil solution. Used for lotions and applications.
• Garlic is crushed and poured with alcohol. Strain after 10 days. Use for compresses.
• Kalanchoe pulp is used for compresses.
• Red clay cake.
• Shilajit is mixed with honey and used as a compress.

Always consult your doctor before using any non-traditional treatments. Folk remedies are especially effective in the early stages of the development of the disease.

Treatment of a hernia of the lumbar spine in Moscow at the Dikul clinic: prices, appointments

As a rule, conservative therapy is the first line of treatment for degenerative diseases of the lumbar spine.

But non-surgical treatment of lumbar spinal herniation is not always successful, and in the presence of sequestration or persistent neurological symptoms, it is possible to use surgical techniques to remove the disc herniation. Surgical treatment is performed under general anesthesia. Operations can be both minimally invasive using endoscopic techniques, and open type with fixation and the use of instruments. Long-term results after surgical treatment depend both on the quality of the operation and the availability of full rehabilitation in the postoperative period.

Treatment Methods

Acupuncture: This treatment method is based on the Chinese theory of the presence of vital energy in the human body – a decrease or blockage of the circulation of Qi energy leads to various diseases.

The modern explanation of the mechanisms of action of acupuncture is based on the stimulation of biologically active points on the human body.

Acupressure: is similar in mechanism of action to acupuncture, as there is a compression effect of the fingers on active points, but without violating the integrity of the skin.

However, this treatment, like acupuncture, has certain contraindications (eg pregnancy or decompensated somatic diseases).

Massage: Regular massage treatments can significantly reduce back pain. Massage allows you to increase blood flow in the tissues and improve the supply of oxygen to the tissues.

Although massage is not considered an effective treatment for herniated discs, it is nevertheless a safe tissue treatment method with virtually no side effects.

But it must be taken into account that massage is contraindicated in the presence of thrombosis of the veins of the lower extremities, the presence of infections or osteoporosis.

Chiropractic

Chiropractic manipulation often helps relieve symptoms of a herniated disc in the lumbar spine. Before performing the procedure, the chiropractor must review the patient’s medical history, imaging data, and perform orthopedic and neurological tests.

For each individual patient, the chiropractor selects an individual program of manipulations and other chiropractic methods.

Manual Therapy Procedures with Pain Relief

Manual therapy under light anesthesia, which lasts only a few minutes, is used to treat certain spinal conditions. The procedure is carried out in an outpatient center or hospital and the duration of sleep and session is short, about 6 minutes. While the patient is under anesthesia, the chiropractor stretches and manipulates the affected area while the patient’s body is in a relaxed state. This procedure is usually carried out 1-3 times, with intervals of 2-4 weeks between them.

Exercise therapy

Exercise is the main component of the treatment of lumbar spinal hernia. A proactive approach to patient recovery through exercise will reduce pain and help ensure long-term spinal health.

As a rule, 1-2 days of bed rest is sufficient for pain caused by a herniated disc. The temptation for the patient to stay in bed for several days interferes with the treatment, as the muscles need movement and this is necessary for the healing process. Refusal of physical exercises reduces the chances of the effectiveness of conservative treatment.

Exercise effectively strengthens and stabilizes the muscles of the lumbar spine and prevents further injury and pain. Strong muscles support the weight of the body and bones, relieving unnecessary pressure on the spine.

Active therapies help improve flexibility, strength, spinal stability and joint movement.

To achieve optimal results, it is necessary to choose an exercise program with a physiotherapist who will select the necessary set of exercises depending on the symptoms and characteristics of a particular patient.

Active Treatment Goals:

• Trunk Stability: Many people don’t realize the importance of a musculoskeletal system for spinal health. For example, the abdominal muscles help the back muscles support the spine. When the trunk muscles are weak, it puts extra pressure on the back muscles. The physical therapist can teach the patient basic stabilization exercises to strengthen the back
• Flexibility: Teaching proper stretching techniques prepares the patient for aerobic and strength training.
• Hydrotherapy: Unlike just being passive in a hot tub, active hydrotherapy can include water aerobics, which helps to exercise the torso without undue stress.
• Muscle Strengthening: Strong muscles are a great way to support your spine and reduce pain.

Stretching exercises such as yoga and Pilates increase strength and flexibility and help relieve acute back pain.

Moderate aerobic activity, including walking, cycling, and swimming, also helps relieve pain. Some aerobic activities may be better suited for a particular condition.

Passive Physical Treatment for a Herniated Disc

• Deep Tissue Massage: There are over 100 types of massage, but deep tissue massage is ideal if there is a herniated disc because it uses a lot of pressure to relieve deep muscle tension and spasms that block movement in the area of ​​​​localization of a herniated disc.
• Hot and cold therapy: Both hot and cold therapy have their own benefits, and the physiotherapist can alternate between them to get the best results.

A physical therapist can use heat to increase blood flow to the target area. The blood helps repair the affected area by providing additional oxygen and nutrients.

The blood also removes by-products from muscle spasms.

Conversely, cold therapy (also called cryotherapy) slows down circulation. It reduces inflammation, muscle spasms and pain. A physical therapist may place an ice pack on the target area or use special equipment to cool inflamed tissues.

• Hydrotherapy: As the name suggests, hydrotherapy uses water. As a passive treatment, hydrotherapy may involve simply sitting in a whirlpool bath or warm showers. Hydrotherapy gently relieves pain and relaxes muscles.
• Transcutaneous Electrical Nerve Stimulation (TENS): The TENS machine uses electrical current to stimulate muscles. Electrodes attached to the patient’s skin send a weak electrical current to key points along the nerve’s path. TENS reduces muscle spasms and is generally considered to cause the release of endorphins, which are the body’s natural painkillers.
• Traction: The purpose of traction is to reduce the effect of gravity on the spine. Gentle traction reduces the impact of a herniated disc on the roots. Traction can be performed in the cervical or lumbar spine.

Medicines and spinal injections for lumbar herniation

• Acetaminophen: Acetaminophen (Tylenol) is a first-line drug for pain management. However, this drug is not suitable for everyone. While acetaminophen is a good pain reliever, it does not reduce inflammation.
• NSAIDs relieve pain and reduce inflammation, which makes them different from acetaminophen. Examples of NSAIDs include aspirin, ibuprofen (eg Advil) or naproxen (eg Aleve). Some NSAIDs are not suitable for those who have coronary artery disease or stomach ulcers.
• Muscle relaxants: Spinal muscle spasms often accompany a herniated disc. In such cases, a muscle relaxant may provide relief from pain.
• Oral steroids: (also called corticosteroids) may be effective in reducing swelling. These drugs are prescribed for short-term use. Multiple side effects are usually due to long-term use of steroids.
• Opioids (narcotics): Narcotic pain relievers relieve acute and/or severe pain and are only given cautiously in severe pain. It must be taken into account that many patients develop tolerance to opioids and require higher doses to reduce pain. These pain medications can also be addictive and should only be used under close supervision.
• Antidepressants: These drugs block pain information in the brain and increase the effects of endorphins, which are essentially natural pain relievers. Another added benefit is that antidepressants help the patient sleep better.

Spinal Injections

• Epidural Injections: Injections into the epidural space of steroids, which are powerful anti-inflammatory drugs, help to quickly relieve pain from root compression. Injected into the epidural nerve space, steroids can significantly reduce pain after the first injection, but it may take several days for the full effect to develop. During the year, no more than 3 injections are usually administered.

Drug warning

• Drugs usually have side effects that need to be taken into account when taking them
• It is advisable to check with your doctor about any medications, even if they are over-the-counter and do not pose any obvious danger.
• It is also important to note that a patient should not rely solely on painkillers and injections to treat pain from a herniated disc.
• Incorporating physical therapy and exercise into treatment will give the best results.

Surgery

Surgery for a herniated disc in the lumbar spine may be recommended if non-surgical treatments such as medications, exercise therapy and physical therapy fail to relieve symptoms. Surgery is considered only in cases where doctors can find out the exact source of pain manifestations.

Spine surgery can be either open or minimally invasive. Minimally invasive methods allow to reduce tissue damage and recover faster.

Visualization during spinal surgery

Imaging-guided surgery (CT and intraoperative fluoroscopy) allows the surgeon to more accurately perform the intervention and stir the instruments (screws, rods).

Main operations:

• Discectomy or microdiscectomy: removal of a herniated disc and elimination of the compression effect on the root.
• Laminectomy: removal of a thin bony plate on a vertebra to increase space within the spinal canal and relieve compression.
• Laminotomy: Removal of part of the spinal arch (lamina) that covers the spinal cord. A laminotomy removes less bone than a laminectomy.
• Foraminotomy: Removal of bone or tissue in the spinal canal where the nerve roots originate from the spinal cord and exit the spine.
• Disk Replacement: As an alternative to fusion, a damaged disk is replaced with an artificial one.
• Spinal Fusion: A surgical technique used to fuse two vertebrae. Spinal fusion may involve the use of a bone graft with or without instrumentation (eg, rods, screws).