A lumbar disc herniation is hiding the discs between the vertebrae of the spine, which work as cushions, are pressured and change shape, which can put pressure on the roots of the nerves surrounding the vertebral disc, causing symptoms such as pain, numbness or numbness. the legs.
Lumbar disc herniation is more common in people of the third age due to the natural process of aging, but it can also be produced by obesity, carrying excess weight or by weakening the muscles of the abdomen and the back that support the spine.
It is important to consult an orthopedist when the symptoms of lumbar hernia are identified so that the diagnosis is confirmed and, in this way, the most appropriate treatment can be indicated, which can be with medication, physiotherapy and, in more severe cases, with a surgery.
In most cases, lumbar pain is the first symptom of a herniated disc. This pain can be constant or worsen to carry out movements and last a few days and then improve. Other symptoms of lumbar disc herniation can be:
- Pain in the back at the end of the column, which can radiate to the buttocks or legs;
- Adormecimiento or tingling sensation in the legs and/or feet;
- Weakness in the legs and/or legs;
- Difficulty moving;
- Burning sensation or tingling in the back or buttocks.
In addition, in the most serious cases of compression of the pelvis nerves, the person can lose control of the bladder and intestine.
Although lumbar disc herniation is more frequently diagnosed due to the presence of lumbar pain, many cases are diagnosed in spinal imaging exams, without the person having symptoms.
In the majority of cases, the diagnosis of lumbar disc herniation can be performed based on the symptoms presented and on the clinical examination in which the orthopedist or neurosurgeon specialist in column evaluates the neurological reflexes, muscle strength and sensitivity las piernas and de los pies, in addition to the ability to walk.
In addition, the doctor can request imaging tests such as X-rays of the column, magnetic resonance imaging or computerized tomography to evaluate the region, type of injury and the nerves in the area that are affected.
The most common cause of lumbar disc herniation is related to the natural aging of the body, in which there is a gradual wear and tear of the discs of the lumbar spine, and as the person ages, the discs become less flexible, and can tear or rupture with more ease. In addition, people who have a very weak abdominal or back muscle, which have overweight or obesity, can develop this type of hernia, due to which the back is overloaded.
Other causes of lumbar disc herniation can be due to poor posture, using the back muscles instead of the legs or muscles to lift heavy objects, or due to abruptly turning the back, for example. In addition, smoking is also related to the development of this hernia, which reduces the amount of oxygen present in the lumbar disc, causing it to wear out more quickly.
On rare occasions, a lumbar disc herniation is caused by some trauma to the spine, such as a fall or a blow to the back.
The treatment for lumbar disc herniation must be indicated by the orthopedist or neurosurgeon with the objective of controlling and relieving the pain, and must include modification of activities to avoid movements that produce pain.
The main treatments for lumbar disc herniation include:
Treatment with medications prescribed by the doctor can be carried out with the use of oral anti-inflammatory pills such as ibuprofen or naproxen, analgesics such as paracetamol or codeine, or muscle relaxants to reduce muscle contraction that can cause more pain.
In cases where the person has not improved the symptoms with the use of oral medication, the doctor may indicate corticosteroid injections that can be applied in the area surrounding the nerves of the lumbar column.
Physiotherapy helps to alleviate the symptoms caused by a lumbar disc herniation and to recover the movements. This can be performed daily or at least 3 times a week in case of acute pain.
The physiotherapist must create a specific training program to accelerate recovery, including stretching exercises and strengthening of the abdomen and lumbar muscles, the use of devices to control pain and inflammation, in addition to treatments to be carried out at home. In this way, physiotherapy can help to resume activities and a normal lifestyle.
The time it takes to cure the illness varies, but the results can be achieved in 2 to 8 weeks or less, when measures such as proper posture, pain reduction, stretching and a strengthening program are implemented.
Depending on the patient’s health status, some Pilates and global postural reeducation (RPG) exercises can be performed under supervision. On the other hand, weight training exercises are contraindicated in most cases, at least during acute pain.
Surgery for lumbar disc herniation may be indicated by the doctor when the other forms of treatment have not been enough to improve the symptoms after six weeks, especially if the person continues to have pain that does not decrease, weakness in the legs or in them pies, difficult to be on foot or walk, the loss of bladder control or bowel control.
Various techniques can be used for the surgical treatment, such as the use of a laser or through the opening of the column, to remove soil from the part that protrudes from the lumbar disc. On rare occasions, the disc must be removed in its entirety, and in these cases, it may be necessary to unite the vertebrae using a bone graft. Find out more details about the surgery for a herniated disc.
Lumbar herniated disc surgery is always the last option of treatment and is directly related to the quality of life of the person, being performed when this quality is bad. In the postoperative period, the person must remain at rest for the first few days, avoiding efforts and starting physical therapy, which usually starts after 15 to 20 days of surgery and can last for months.
Care during treatment
Some important measures during the treatment of lumbar disc herniation are:
- Take the medications at the correct timesaccording to the orientation of the doctor;
- Carry out the exercises at home recommended by the physiotherapist to strengthen the back and abdomen muscles;
- Apply cold compresses in the lumbar area in the first days to relieve pain and inflammation;
- Apply hot compresses in the lumbar area after the first days to relieve pain and discomfort;
- Avoid staying too long in restsince being in bed can cause stiffness in the joints and weaken the muscles, which can complicate recovery;
- Rest in a comfortable position for 30 minutes and then give a short walk;
- Avoid making efforts that they can empeorar the pain like carrying heavy objects or crouching;
- Perform slow and controlled movementsespecially when bending over or standing up;
- Resume daily activities graduallyavoiding efforts that can cause the pain to appear again.
In addition, a good posture must be maintained, with a straight and aligned back, especially when sitting, which helps to reduce pressure in the spine and in the vertebral discs, in addition to relieving pain and lumbar discomfort.
It is important to follow the doctor’s instructions so that the pain improves and the recovery can occur more smoothly.
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