If you have a herniated disk, a disk located between the vertebral vertebrae has broken and curves towards the spinal canal. It is common and often does not hurt. But if the disc presses against the spinal cord or nerve roots, you may get back pain or sciatica, which is a radiant pain in the leg. Usually, the pain goes away by itself after a certain amount of time, but sometimes surgery may be needed.
You can have disk hernias in the entire spine, but the most common is to have it in the lower part of the back called the lumbar spine. The second most common is to have disc hernias in the upper part of the back called the neck spine. It is more uncommon to have disc hernias in the chest.
The pain can come very quickly or develop over a long period of time. It is unclear what causes disk hernias, but there is a greater risk of having hernias if someone in the family has it.
Back pain does not have to depend on a hernia. There may be several other reasons for your back pain.
Symptoms of herniated
If you have a hernia, it is common with any of the following symptoms:
- Back hurts.
- Pain radiating into one leg.
- Numbness and tingling in the legs.
- Weight sensation in the legs.
- Difficult to control the movements of the legs.
- Bad feeling in the leg and foot.
- Hard to control urine and faeces.
- Neck pain.
- Pain radiating to the arms and fingers.
- Pain radiating into the chest.
When and where should I seek care?
Usually the hassles get better within a couple of weeks. Within a couple of months, most people no longer have pain. But in some cases you may have more severe symptoms of herniated. Then you may need to be operated quickly.
Seek medical care directly at a medical center or emergency room if you have back pain and any of the following symptoms of herniated:
- You have difficulty controlling urine and faeces.
- You have numbness or decreased sensation around the rectum or genitals.
- You have numbness, tingling or weakness in your legs or arms.
Also, contact your health care center if your back pain or sciatica pain does not improve within a couple of weeks or if painkillers do not help. This is especially important if you are in middle age.
Physical therapists, also called physiotherapists, naprapaths and chiropractors can sometimes advise.
What can I do for myself?
If you have had a hernia, you may be very sore and difficult to walk. But it usually takes longer to get good if you lie in bed more than any day.
Things you can do to feel better:
- Do the everyday chores you feel you can handle.
- Go back to work as soon as you can. If you have a sedentary job, you can try to get up and work if you can. If you have a physically demanding job, you may need to retire for a while.
- Try to exercise as best you can. Easier exercise strengthens your back and leg muscles.
- If you have a herniated disc in the lower back, try putting a pillow under your legs when lying on your back so that your hips and knees bend.
- Try to lie on the side in the fetal position.
- Relieve the pain with pain pills if needed. It does not cure the hernia but can help you get started with everyday activities. Prescription-free drugs are available at the pharmacy.
The doctor examining you wants to check that you have no serious illness that causes you back pain.
For example, if you have low back pain or sciatica, the doctor examines the following:
- was in the back the pain sits.
- was on the body the nerve pain spreads.
- reflexes in the legs.
- the sensation of the legs and the sensation of the abdomen.
The doctor also examines the rectal ring muscle by feeling if you can pinch the muscle in the rectum, in men, prostate is also examined.
You may also raise your legs when lying down to control the sciatica.
If your doctor thinks you may have herniated disc in your neck, you will be examined:
- was in the neck it hurts
- reflexes in the arms
- feeling in the arms and fingers.
If you have never had a back pain or sciatica, some laboratory tests are usually taken. The samples are taken to exclude diseases that can be serious. If you have a hernia, these tests are usually normal.
Examples of samples you may take are:
- blood count
- urine sample
X-ray and imaging examinations
If the back pain or sciatica pain does not get better after four to six weeks, the doctor will usually either order a lumbar spine computed tomography or a magnetic camera examination.
A computed tomography , also called layer X-ray, means that a computer creates two- or three-dimensional images by imaging thin slices, layers, of the back. With the help of X-rays, soft parts such as herniated disc in the lumbar spine can be made visible.
A magnetic camera examination , MR, is a study in which thin layers of the back are imaged. Here, a magnetic field is used to create the images instead of X-rays. A magnetic camera examination gives very good pictures of soft parts, such as counters and nerve structures.
Treatment of herniated
In some cases it does not help to just move around and take prescription drugs. Then you may need stronger, prescription drugs.
Muscle relaxants can also help, but are not recommended in the first place because you may get drowsy by them. There is also a risk of becoming addicted even if you only use the drugs for a short time.
Visit a physiotherapist, naprapat or chiropractor
They can help you set up a workout program so you can get started and train your muscles and fitness. No referral is needed, you can contact your physiotherapist, naprapat or chiropractor yourself.
There you can get help with:
- Reduce the pain.
- Get back the normal mobility and function of the muscles and joints.
It is important that the treatments of herniated are evaluated. If you do not get better after three to four times, it is good to rethink the treatment and think about some other way to treat the problems.
There are also other methods that can alleviate. For example, acupuncture , corset, cold, heat, ultrasound and transcutaneous electrical nerve stimulation , also called tens. These methods can alleviate the problems, but there are no scientific studies to confirm that the methods help cure the hernia.
Sometimes an operation is needed
If you have a lot of pain and feel that you cannot live a normal active life again, you can discuss with your doctor if you may need surgery. Most people get better or very good after an operation.
You may need an operation if:
- You have nerve root pain in the bone caused by hernia and the pain has not diminished after two to three months, despite various treatments of herniated. You will then be operated on the lower back or neck to get rid of the pain that radiates into the leg or arm. If you have a lot of pain, the hernia will usually operate within a week.
- The hernia presses nerves to the bladder or rectum and you cannot control urine or faeces.
- You become paralyzed in the leg or arm.
Lumbar hernia surgery
When operating a herniated disc in the lumbar region, the doctor makes a skin cut and creates a small opening to the disc between two vertebrae. The doctor holds the nerve root aside and removes the hernia.
You do not need to prepare yourself in any particular way. You get the information you need from your doctor before you are to be operated on.
The operation usually takes an hour and you are anesthetized when you are operated on. Sometimes you have to go home the same day but usually the day after the operation.
Afterwards you can touch the body as usual. But be careful about straining your back in the beginning. You may need some form of rehabilitation and each clinic has specific programs for how the rehabilitation is going.
How quickly you get back to work depends on the tasks you have. Usually, the period of sick leave after surgery varies from a few weeks to three months.
Surgery – usually in the case of herniated disc in the neck
During a surgery, the doctor usually removes the disc between two vertebrae. Then the doctor takes one leg, usually from the hip comb, and places it between the vertebrae. You also make a fixation with titanium implants. This means that a small part of the spine becomes immobile, but it should not affect the total mobility of the spine.
You do not need to prepare in any particular way for the operation. You get the information you need from your doctor before you are to be operated on.
The operation usually takes between one and a half and two and a half hours. You are anesthetized when you are operated on. You may come home from the hospital after one or a few days.
After the surgery you may need some form of rehabilitation, each clinic has special programs for how the rehabilitation is done. How long you need to be on sick leave afterwards depends on what work you have.
It is unusual for you to have a disc herniation at the same place after an operation, but new disc hernias may occur between other vertebrae. In the case of a new disc herniation, you go through a new investigation.
What happens in the body?
The spine is made up of twenty four vertebrae. The upper part is called the neckline, and is followed by the chest and down the lower back. The vertebrae at the bottom of the pelvis form the sacrum and the tibia.
The counters are important for the mobility of the spine
In order for the spine to hang together, but still be movable, there are joints between the vertebrae. The joints are held together by ligaments and short muscles. Between the vertebrae are disks, intervertebral discs. The discs are important for the mobility of the back and at the same time act as shock absorbers. The core of the counter consists of a soft mass while the outer part is a firmer, hard cartilage mass.
When a portion of the soft core mass in the disk penetrates through the outer firmer portion of the disk, it becomes a disk hernia. Then the disk bulges out against the spinal canal. It can happen throughout the spine but most commonly it happens in the lumbar spine and then the spine.
Nerve roots exit from the spinal cord between the vertebrae
The spinal cord runs enclosed in the spinal canal within the spine. The spinal cord serves as an important switching station for the nerve pathways that are on their way to and from the brain. Between each vertebra, nerve roots extend from the spinal cord through holes on each side. Each nerve root contains both nerve threads that convey information from the brain and spinal cord to the body, and nerve threads with sensory information from the body to the brain.
Magnetic camera examinations of the back of healthy people show that you can have a hernia without symptoms. But a disc herniation in the lower back can cause back pain and sometimes so-called nerve root pain that radiates into the leg, sciatica. A herniated disc that presses nerve roots in the back of the neck can cause radiating pain in the arms and sometimes pain in the neck.
In some cases, the hernia may become sciatica
If the nerve roots are affected by a herniated disk, you may eventually have radiating pain in one leg, sciatica. Many times the back pain decreases as the sciatic pain begins.
Sciatica is a nerve pain that radiates into the bone in the sciatic nerve area. The large sciatic nerve to the bone is formed by several different nerve roots that originate from the spinal cord canal in the lower back, the lumbar spine.
The pain is usually caused by a combination of pressure against one of the nerve roots that form the sciatic nerve and inflammation around this root. An affected nerve root becomes swollen and it leads to pain signals, impaired sensation and impaired muscle power. When a nerve root is affected to send pain signals, the brain interprets it as pain in the area that the nerve supplies, that is, in the leg or arm and hand.
Symptoms can vary widely between people, from almost no symptoms of herniated at all, to more or less disabling pain. Then you may need hospital care. Sciatica is often exacerbated in situations where the leg is stretched and at the same time the body bends from the hip forward.
You may have sciatica due to a herniated disc, but sciatica may also have other causes.
Other complications of herniated discs in the lumbar region are numbness and tingling in the legs as well as muscle weakening. The sensation in the leg and foot can also be affected.
Similar aches can occur in the arms and trunk of the herniated disc in the neck, but are not called sciatica.
The pain gradually goes away
If you have had a hernia, pain and other problems can either come very quickly, or gradually over days or weeks. The pain then usually progresses gradually. During the time that the pain subsides, it is important that you, although it hurts, try to be physically active, whether you have sciatica or back pain.
You usually feel better after a few weeks and after two to three months most are trouble free. The rupture of the dishes themselves, or the bulging of the dishes, may remain even though the symptoms have disappeared.
You can get herniated discs for no particular reason
It is difficult to pinpoint what can increase the risk of hernias, but heredity seems to have some significance. Possibly repeated or excessive bending and simultaneous twisting of the body can also cause disc hernias, or a disc herniation that already exists causes severe problems.