Among the main complications associated with a back injury or existing progressive osteochondrosis, a hernia of the intervertebral discs is distinguished . The development of severe pain, limitation of the mobility of a certain part of the spine and disturbance of posture, paresthesia, periodically occurring numbness of certain parts of the body can become one of the most striking symptoms. Most often, hernias are detected in the lumbar region, less often they affect the chest or cervical. This complication, typical of adults, in childhood, such problems are extremely rare, usually are congenital.
What is considered a herniated intervertebral disc?
From the point of view of anatomy, a hernia formed in the region of the intervertebral disc means a sharp displacement towards a certain part of the pulpous nucleus (the internal contents of the disc). The output of the content occurs due to rupture of the tissues forming the fibrous ring, which surrounds the intervertebral disc. This is possible as a result of a back injury (rarely) or as a complication of the degenerative degenerative processes that accompany osteochondrosis of the spine. Against the background of the latter, initially the core of the disk loses part of its moisture (dehydrates), loses the necessary elasticity, and becomes fibrous. The disk is compressed by neighboring vertebral bodies, its partial bulging to the side is formed, but there is no rupture of the fibrous ring. This is called disc protrusion. Further progression of the pathology leads already to the development of a hernia, which has a sharper and more pronounced symptomatology.
Causes of development: trauma, osteochondrosis, hereditary abnormalities
Often, the cause of a hernia formed in the intervertebral disc can be metabolic disorders or infectious lesions of the spine. In addition, the influence of hereditary anomalies in the structure of the vertebrae or their disks, which progress against the background of age-related changes, is possible. Acute or chronic trauma, localized in the back or sighting area of the spine, plays a certain role. This may include injuries such as a fall on the back, vertebral fractures or strokes in the lumbar region. In addition, chronic injury to bones and discs is possible, which occurs when professional factors are involved – vibration, static load (heavy lifting, sharp inclines). But one of the main reasons that provokes hernias is considered to be progressive osteochondrosis of the spine, with changes in the structure of the discs themselves, their fibrous rings and vertebral bodies.
Postural changes, progressive deformities
As changes in the structure of the intervertebral discs and surrounding tissues are formed, they are continuously compressed by the bodies of neighboring vertebrae, which leads to an increase in pressure inside. With a changed structure, if the disk is dehydrated, part of its contents may be squeezed out to the side. A hernia can form in the direction of the spinal cord or spinous processes, or it protrudes to the left or right. Contribute to this violation of posture, if certain areas are under increased load, or changes in metabolism, leading to excessive loss of moisture and dehydration of the discs. Correct posture is supported by a strong muscle corset. If the back is weak, there is hypotension of the muscles, it is disturbed, which can accelerate the changes initiated by osteochondrosis.
Pain is one of the leading symptoms
Depending on the type of hernia, the manifestations can be from minimal to pronounced and strong. With lateral, anterior or Schmorl’s hernia (a hernia in the vertebral body), the symptoms may be mild. If this is a posterior or dorsolateral hernia, which has a protrusion in the intervertebral space, severe painful pain is possible . It occurs due to irritation and partial compression of the spinal cord itself or the outgoing roots, as well as inflammation of their membranes and thickening of the ligaments.
Changes are staged, and therefore the nature of sensations changes. At the first stage, pain in the affected area is associated with degenerative and dystrophic processes affecting the disc. It dehydrates, cracks, becomes fibrous, which reduces its depreciation functions and strength. The pulpous nucleus in the center of the disk may protrude (protrusion), nerves and blood vessels may be irritated, swelling of the tissues is formed, which provokes pain in the affected area. To protect the spine, the muscle corset generates tension of the fibers, which changes the posture and leads to compensatory curvature of the vertebrae in other areas. Prolonged muscle spasm upsets the blood circulation and innervation of the affected area, provokes pathological changes in the joints and ligaments of the spine.
Numbness and pain, paresthesia
At the second stage, due to progressive changes, a typical change in the nature of the pain syndrome, the appearance of numbness or paresthesia is typical. Part of the disc sticks out more and more, it presses on the nerve roots, and can lead to tension. If inflammation of the nerve roots or edema occurs, severe pain and numbness along the trunk occurs with radiation to the shoulder, arm or leg. Together with them, motor disturbances with muscle fiber weakness, numbness of certain areas or a feeling of creeping creeps, a change in sensitivity may occur.
The formation of vegetative disorders is also possible – a decrease in skin temperature, dryness and swelling of the skin, sweating disorders. To alleviate pain, patients often take a forced position, lie or sit for a long time. Additional manifestations are typical for certain types of hernia – in the lumbar, cervical or thoracic.
Why are hernias dangerous?
The formation of a hernia of the intervertebral discs can lead to specific complications without adequate treatment. Among them, the most serious are paresis or paralysis of the extremities, both upper and lower. Also possible disorders of skin sensitivity and movements, muscle tone. This threatens with disability, up to the failure of the lower body.