Symptoms of a herniated disc. How to identify signs of intervertebral hernia

A person can walk upright thanks to the elasticity of the intervertebral discs, which are located between the main vertebrae.

The spine is divided into three sections, consisting of the cervical, thoracic and lumbar vertebrae. Their total number is 24 pieces. The spine ends with the sacrum, which passes into the coccyx. A healthy intervertebral disc is a nucleus pulposus enclosed in a fibrous ring. When this disc is deformed, the nucleus ruptures and its inner part protrudes outward. This is how the process of developing an intervertebral hernia begins. At first this creates a feeling of discomfort, but later it develops into intense pain. When a hernia protrudes, nerve endings are affected, which cause pain.

When the pain becomes more severe and is felt in the arm or leg, this indicates a large prolapse of the nucleus from the disc.

Types of hernias

Since the spine consists of three parts, a hernia in these areas manifests itself differently. In medicine today, intervertebral hernias are divided into three subtypes:

• hernia of the cervical spine. With this disorder, rupture of the fibrous ring occurs in one of the seven cervical vertebrae. Occurs in 20% of cases of the total number of people who came to the clinic with such a problem;
• hernia of the thoracic spine. When a ring falls out in one of the twelve thoracic vertebrae, the symptoms coincide with ordinary osteochondrosis, so it can be difficult to establish an accurate diagnosis. A hernia in the thoracic region is extremely rare. Of the total amount, this figure is no more than 1%;
• lumbosacral hernia. Seen most often. Doctors make a similar diagnosis in 79% of cases.

When the hernial sac falls out of the disc, the nerve ending is pinched. When the size of the intervertebral hernia becomes threatening, the spinal canal is blocked and the nerve endings passing through it are compressed. In this case, urgent surgical intervention is required. The disease is called “Cauda Equina Syndrome” and can only be cured by surgery. Failure to contact the clinic in a timely manner can result in damage to the spinal cord and complete paralysis.

Symptoms of intervertebral hernia

The main signs of the presence of intervertebral disc damage caused by a protruding hernia can manifest themselves as follows:

• pain radiating to the leg, especially to the knee, a little lower and to the foot area;
• a feeling of numbness in the lower or upper limb, the appearance of goosebumps on the skin;
• reaction to changing weather. During periods of temperature changes, a nagging, persistent pain appears in the affected part of the back;
• pain in the chest area that cannot be relieved by using heart medications;
• “lumbago” in the lower back. This may indicate both the manifestation of radiculitis and the beginning of the development of an intervertebral hernia. A distinctive feature is persistent pain for a long period of time (sometimes more than three months), even after all the necessary manipulations for radiculitis. The pain is strong, especially when trying to make a slight movement;
• insensitivity of the skin, peeling and dryness, decreased sensitivity in the affected nerve ending (knee, elbow, shoulder or other part of the body);
• disturbances in urination, this can be either incontinence or blockage of the urethra due to strangulation;
• increased pain when trying to turn around, bend over, cough, sneeze, or turn your head;
• change in gait, weakness in the leg, trembling in the knee, pain in the foot;
• increased blood pressure;
• headache caused by poor circulation due to a pinched nerve in the cervical spine.

Origin of pain

The pinched nerve, depending on which part of the spine the hernia appears in, generates pain, spreading throughout the body.

If the patient’s cervical spine is affected by a hernia, the pain will radiate to the head, neck, and all parts of the arms, including the shoulders. Possible migraines, “floating” consciousness, dizziness, ringing or noise in the ears, numbness in the fingers, the tonometer shows elevated numbers, and sometimes hearing and vision disorders are observed.

If hernial breakthroughs occur in the thoracic spine, then the pain can radiate to the chest, the heart area, there is a feeling of heaviness in the side, the person cannot bend, the drooping of the shoulders causes physical suffering, and it is difficult for the patient to breathe deeply.

When the nucleus prolapses from a disc in the lumbar back, the patient experiences severe pain in the lower spine. The pain migrates to the leg, causing numbness in the limb. It is difficult for the patient to bend over or turn the body to the side.

Causes of hernias

In recent years, this disease has become significantly younger. If previously the diagnosis of intervertebral hernia was given to people over 30 years old, now a similar entry in a medical card can be found in 20-25 year old people. The most common cause of herniation in intervertebral discs is improper distribution of the load on the spine.

The vertebrae are connected to each other by intervertebral discs, with the help of which shock absorption occurs, returning the vertebrae to their place after stress. If the load was stronger, the fibrous ring ruptures. Through the crack, the pulpous part of the nucleus falls into the spinal canal, which, in turn, can provoke compression of the spinal cord, lead to impaired blood circulation, urination, the development of scoliosis, and paralysis of the limbs.

This disease is not as harmless as it might seem at first glance. Therefore, if you find any signs of an intervertebral hernia, go to the doctor immediately.

How to determine the disease

Visually, it is rarely possible to notice prolapse of the nucleus; only in exceptional cases does the hernia appear in the form of a barely noticeable pea at first, and as the disease progresses, the size of the tubercle increases and becomes the size of a nickel.

Most often, doctors determine the presence of the disease during an examination. After carefully listening to the patient’s complaints, the doctor studies the symptoms and prescribes an x-ray of the area of ​​the spinal column where the problem may be located. Neurologists use tapping with a hammer to check the reaction of nerve endings for the presence of a lesion.

The doctor may also prescribe an MRI (magnetic resonance imaging) or computer diagnostics. When performing an MRI, the likelihood of establishing an accurate diagnosis increases significantly, since this research method allows you to more accurately determine the condition of the back, spine, tendons, blood vessels and surrounding tissues. In addition, there is no harmful radiation inherent in radiography.

Manifestations of intervertebral hernia can be confused with radiculitis, coronary heart disease, inflammation of the pancreas, arthrosis, pneumonia and other serious diseases. Therefore, you should not self-medicate; if symptoms are detected, you should immediately contact a specialist.

In the early stages, the disease can be completely cured, therefore, it is possible to do without the intervention of a surgeon.

How to accurately identify an intervertebral hernia? An experienced person can recognize an intervertebral hernia, distinguish it from a common exacerbation of radiculitis or the consequences of an old lumbar injury, and also find out the exact location of the pathology in the spine after examining the patient and conducting additional examinations. Most often, intervertebral hernia is a complication of osteochondrosis, which is manifested by disruption of the vertebral disc ring and displacement or protrusion of the nucleus.

The causes of pathology can be:

• constant incorrect position of the back when performing daily duties, for example, when working at a computer;
• insufficient water and drinking ration;
• pathological metabolic disorder in the body or excessive physical activity.

Hereditary factors also play a significant role in the development of the disease. People over 30-35 years of age who are fairly tall (above 175 cm) and overweight, especially women, are at risk.

Symptomatic manifestations

How to determine intervertebral hernia? Symptoms of intervertebral hernia have certain criteria and depend on the type of pathology. Hernia of the lumbosacral region is quite common. This is one of the most common types of disease. The disease is accompanied by sharp pain in the lower back and groin area, pain can be in the buttock or leg. often causes numbness in the lower extremities.

The cervical region is also susceptible to the development of pathology, although it is less common. Symptoms of this pathology are expressed in painful sensations in the head, shoulders or neck. The patient constantly complains that he is dizzy and his fingers are numb. The patient may experience increased blood pressure and tinnitus. The development of pathology leads to almost complete loss of hearing and vision, the patient’s coordination of movements and balance are impaired.

A herniated disc causes chest pain that cannot be relieved by heart medications. Painful sensations can also appear in the hand, often causing it to become immobile. Such a hernia is quite rare, but nevertheless brings a lot of suffering to the patient.

If some of the listed symptoms are detected, the patient should immediately contact a competent neurologist.

A hernia of the spine is quite dangerous; without timely treatment it leads to serious complications:

• disrupts the functioning of the cardiovascular system;
• causes pathologies of the gastrointestinal tract;
• leads to the development of practically incurable radiculitis;
• aggravates the course of chronic bronchitis.

Due to poor circulation, oxygen starvation of the brain occurs, resulting in an increased risk of stroke. In an advanced stage, the pathology leads to irreversible changes in the pelvic organs, loss of sensitivity and even paralysis of the upper and lower extremities. By making the correct diagnosis and prescribing competent treatment, it is possible to almost completely get rid of the problem or minimally reduce the development and manifestation of unpleasant symptoms.

Methods for determining intervertebral hernia

If a person suddenly develops so-called “lumbago” in the back (sharp pain appears quickly and goes away just as quickly), stiffness is constantly felt in the body and intestinal disturbances appear (diarrhea or, conversely, constipation), then it is necessary to urgently seek help from a specialist . A neuropathologist diagnoses the presence or absence of an intervertebral hernia during examination based on certain criteria, the presence of which helps to accurately detect the pathology. Among them are the following:

• sensitivity disorder, especially in the area of ​​nerve root injury;
• the presence of vertebrogenic syndrome, which is manifested by limited movement in a certain part of the spine and constant muscle tone;
• failure to compensate for movements and decreased natural reflexes.

Some studies can help identify a spinal hernia:

• CT scan;
• MRI of the spinal region.

Doctors have a sufficient range of accurate studies at their disposal, the results of which help to reliably detect and verify the presence of an intervertebral hernia. When carefully examining the patient, palpation of the problem area helps to find the location of the pathology and the degree of its development. The final diagnosis is made based on the patient’s complaints, determining the localization of the pathology, its nature based on specific tests to study muscle strength and reflex reactions.

It is almost impossible to independently determine a spinal hernia at home: research must be accurate, deep and comprehensive. Moreover, you cannot diagnose yourself and prescribe treatment, because the symptoms of this pathology often coincide with the signs of other diseases.

There is one symptom that you should definitely pay attention to - the appearance of unnatural reflexes when trying to sit down or stand up. Very often, a patient with an intervertebral hernia is forced to take positions that are uncomfortable at first glance, but this is how he stops experiencing pain and can slightly relax muscle tone. At the same time, all movements of a person suffering from a spinal hernia are always smoother and quite accurate.

Untimely and incorrect treatment or its absence lead to the development of quite serious complications, including the patient’s disability: injured nerve fibers cease to function over time and cause paralysis of one or another part of the body.

The most common consequence of intervertebral hernia is radiculitis. The affected nerve fibers of the spine in the pathological area become inflamed and cause sharp pain when walking or lifting heavy objects. Pain may also appear when making sudden and awkward movements.

Treatment of the disease

When such a pathology occurs, surgical intervention is most often used. There are many types of such therapy, and they are selected individually for each patient, taking into account all the characteristics of the body. The postoperative period for a patient with a spinal hernia lasts quite a long time - up to six months. Rehabilitation therapy includes:

• constant use of medications;
• physiotherapy;
• compulsory therapeutic exercises;
• manual therapy methods.

Separately, we should talk about the methods of traditional therapy.

Having noticed the first even minor symptoms of an intervertebral hernia, you should immediately contact a professional doctor: a therapist, surgeon or neurologist to find out an accurate diagnosis. Only a doctor will be able to make the correct diagnosis and select the optimal effective treatment, which will help the patient maintain working capacity and restore health.

When you experience back pain, you need to know how to identify a spinal hernia at the initial stage of the disease. Not only older patients, but also quite young people began to turn to the doctor. Early diagnosis of the disease is the key to successful therapy.

What is a hernia?

The discs between the vertebrae provide full motor activity to the spinal column and also act as shock absorbers during physical stress. In the middle they have an external fibrous ring and a nucleus pulposus.

Intervertebral hernia is a disease in which the fibrous ring ruptures and part of the nucleus protrudes, compressing the spinal cord and nerve roots.

This phenomenon provokes the appearance of an inflammatory process and painful sensations.

When the fibrous ring ruptures, but inflammation and infringement do not appear, a person may not even suspect the presence of the disease.

Often, if the hernia of the spine is not strangulated, special therapy is not necessary.

Stages of the disease

• Doctors distinguish the following stages of disease development:
• first stage. A disc crack appears between the vertebrae, the hernia protrudes two to three millimeters. Local blood flow is disrupted, swelling and hypoxia appear. The patient experiences sharp pain in the spinal column, especially with movements affecting the affected area.
• Second stage. The protrusion can already range in size from four to fifteen millimeters. A person's limbs go numb and dull and aching pain appears.
• Third stage. The nerve root atrophies and osteophytes begin to form, preventing the disc from depreciating.

Fourth stage. The surrounding tissues atrophy, pain disappears. The spine becomes almost motionless.

Causes

There are a huge number of factors that provoke the development of a herniated disc. Often, it appears as a complication of other diseases: osteochondrosis, scoliosis, lordosis, excessive kyphosis. Also, the development of a hernia can be triggered by a fall on the back, a strong blow, or insufficient nutrition of the discs, which lack blood vessels. Their nutrition is carried out through the motor activity of the deep spinal muscles. If the load on them is insufficient, the power supply of the disks becomes inadequate, as a result of which their strength is lost.

The annulus fibrosus becomes vulnerable and may rupture. The appearance of a herniated disc is dangerous because prolonged compression of the nerve fibers affects areas of the spinal cord. This can lead to disability and, in the worst case, death.

Factors that increase the risk of developing intervertebral hernia:

Symptoms

To understand how to identify an intervertebral hernia located in the cervical spine, you need to know its characteristic symptoms:

• the appearance of painful sensations in the upper extremities;
• frequent dizziness;
• unstable blood pressure;
• pain in the shoulder area;
• migraine;
• numbness of fingers;
• problems with visual and auditory functions;
• loss of balance.

In the thoracic region

It is important to know how to recognize a spinal hernia that is located in the thoracic region. She is characterized by the following symptoms:

• severe pain in the chest area;
• painful sensations that radiate to the upper limbs.

In the lumbar region

An existing hernia in the lower back can be recognized by the following characteristic symptoms:

• groin area goes numb;
• pain in the lumbar region, lower leg, lower extremities;
• periodically my toes go numb.

Diagnostic methods

To find out if there is a hernia in the spine, you need to consult a doctor. The neurologist will conduct an anamnesis, take general tests, and also carefully examine the spinal column. Accurate diagnosis of intervertebral hernia is impossible without conducting hardware studies of the problem area.

Self-diagnosis

There are symptoms by which you can identify an intervertebral hernia yourself. Main signs of the disease:

If you experience pain that radiates to the arms and legs, you can determine the exact location of the hernia:

• if the pain spreads along the inner part of the thigh, this picture indicates that the disease is in the upper part of the lumbar region, and when it spreads along the outer part, the disease affects the sacrum area.
• Painful sensations in the shoulder joint may indicate the presence of a hernia in the thoracic or cervical region of the spinal column.

Even if a person was able to diagnose a spinal hernia at home, a trip to a specialist should be mandatory. It is worth remembering that self-diagnosis and treatment of the disease can pose a serious health hazard.

Hardware Research

A huge number of people suffering from problems with the spinal column are interested in how to recognize an intervertebral hernia and what are the features of hardware measures carried out to diagnose the disease? The most accurate methods of hardware diagnostics are:

• X-ray is radiation that can display existing damage or defects in the bones of the spinal column in the image.
• Computed tomography is a study that allows you to see the displacement of the discs.
• Magnetic resonance imaging is the most optimal examination option, which helps to determine the array of data: the state of the bone structure and soft tissues.

An accurate diagnosis of herniated discs can only be made by a qualified doctor. He will be able to see the root cause that provokes problems with the spinal column, and also choose the most effective treatment option for the disease.

Video

Home test for herniated disc

Treatment

Treatment of a vertebral hernia can be carried out in different ways.

The most important thing is to do this after consulting a doctor, strictly following his recommendations and instructions.

The most global method of treating the disease is surgery. This outcome occurs in five to ten percent of all patients suffering from a hernia. The operation may have certain risks and consequences, so it is performed in the most difficult cases that pose a danger to the patient’s life.

The purpose of surgery may be to disrupt the functioning of the spinal canal or to eliminate a hernia. In the first case, it becomes necessary to perform a laminectomy, in the second - open or endoscopic discectomy, microdiscectomy.

If the hernia is completely removed, then it becomes necessary to install an implant that fixes the spine.

Herniated intervertebral discs provoke acute pain, so first of all, therapeutic actions are aimed at relieving the aggravation and relieving painful sensations. For this purpose, non-steroidal anti-inflammatory drugs and muscle relaxants are used, having various release forms.

To restore the strength and elasticity of the discs between the vertebrae, experts recommend using preparations containing hyaluronic acid.

It is very important that the back is completely relaxed, so it is better to limit physical activity for one to three days.

After the acute stage has passed and the disease is in remission, it is recommended to perform exercise therapy, which is developed by a specialist. Gymnastics helps to achieve good results, the main thing is to perform the movements slowly, without sudden movements and jumps. The goal of physical therapy is to stretch the spinal column and also activate blood flow. At first, you can practice with trained people who check the correctness of the exercises.

Forecast

Half of the patients with intervertebral hernia, having undergone adequate conservative treatment, forget about the painful sensations after a month. Sometimes, a longer period of treatment is required (from two months to six months), and up to two years to fully recover.

In the most difficult cases, it is possible to completely relieve pain only after a year, and full treatment is delayed for five to seven years.

The prognosis for patients suffering from myelopathy is poor. Neurological deficits are present even if the hernia is removed surgically and result in the person becoming disabled.

Treating an intervertebral hernia is quite problematic, but it is not easy to identify it, especially in the early stages. At the same time, problems with diagnosis arise with a vertebral hernia of any part of the spine: cervical, thoracic, and lumbar.

How to determine that a patient has a hernia and not a protrusion or other diseases? You obviously won’t be able to do this on your own “by touch,” but if you diagnose the disease using special techniques, then finding and describing it will not be difficult.

1 How to identify a spinal hernia: diagnostic methods

To detect a herniated disc and determine its characteristics, only imaging diagnostic techniques are used. In simple cases, one effective method can be used; in complex cases, a combination of methods may be required.

List of visualization techniques:

1. (ultrasound examination) is the least informative procedure of all, in the vast majority of cases it does not tell any details about the disease.
2. - one of the simplest visualization techniques, it is usually used at the patient’s initial appointment. With its help, it is possible to make a diagnosis in 50-60% of cases.
3. and (magnetic resonance and computed tomography) are the best examination methods that allow not only to find the disease, but also to evaluate its characteristics (size, location) in detail.
4. - a technique for studying the spinal cord ducts. It is most effective for detecting severe herniated intervertebral discs, which lead to compression (squeezing) of the spinal canal.

1.1 Ultrasound

Is it possible to find out using ultrasound that a patient has a herniated disc? In the vast majority of cases, no. The fact is that ultrasound is excellent at scanning soft tissues, but is not suitable for scanning hard bodies (like bones).

Ultrasound can reveal indirect signs of the disease. Such, for example, as the presence of hernias of the muscle fascia due to their constant overstrain. And chronic spasm of the back muscles is most often observed either with an intervertebral hernia or with osteochondrosis of the thoracolumbar segment.

No other signs of the disease can be detected using ultrasound, so it is not used to diagnose back hernias, even in combination with other techniques. But with its help you can analyze the condition of the pelvic and abdominal organs.

This may be useful for severe hernias that cause compression (squeezing) of the abdominal or pelvic organs. Such situations are relatively rare, and are usually confirmed using magnetic resonance imaging.

1.2 X-ray

X-ray is the gold standard for basic (initial) diagnosis of herniated disc. The simplicity, cheapness and accessibility of the technique (it is done in almost every clinic) are the main reasons to start diagnostics with x-rays.

X-rays can reveal even relatively small hernias of the spine, but there is a nuance here too. X-rays can detect the disease, but will not show the results in sufficient detail.

This is important when you need to determine whether the hernia is compressing the vertebral vessels or the spinal canal. Unfortunately, if the hernia is small or has a specific structure, x-ray is powerless - it will simply show that it is there, but will not even be able to accurately assess its size.

1.3 MRI and CT

The most informative and accurate methods for identifying and determining the characteristics of a back hernia are MRI and CT procedures. You can read about it separately, but in general there is no definitive answer.

The differences are:

1. MRI is safer, and also perfectly shows soft tissues, in addition to bone.
2. CT creates a radiation load, but at the same time visualizes bone tissue better (it can also visualize soft tissue).

There should be no problems finding a computed tomograph, while powerful MRI machines (from 1.5 Tesla, which are needed when diagnosing such diseases) are not available in every city.

It is recommended that children and pregnant women be diagnosed using MRI, while computed tomography is also suitable for everyone else. Both of these methods determine the presence of a hernia, its location, exact dimensions, and the presence/absence of complications (including compression).

When treating severe spinal hernias, a series of MRI or CT scans may be required to monitor the disease over time. This does not affect the patient’s health in any way (even if a series of CT images is taken).

1.4 MRI diagnosis of spinal hernia (video)

1.5 Myelography

Myelography is a relatively rare diagnostic technique (than MRI and CT). The procedure is not available in every clinic, or even in every city. With its help, through X-ray examination using contrast, the spinal cord fluid-conducting tracts are examined.

Myelography is good in cases where there is a suspicion of complications of a spinal hernia, in the form of damage or compression of the spinal canal. In general, MRI or CT diagnostics do an excellent job with this task, so myelography seems superfluous against the background of these procedures.

Another disadvantage is that it is an invasive procedure with quite unpleasant side effects (they are observed quite often). It is also possible to be allergic to iodine-containing drugs administered as contrast during the procedure.

Less commonly, ordinary air is used to replace the contrast agent (pneumomyelography), but this procedure is even rarer than the classic one. Myelography can detect complications of intervertebral hernia, but in fact, both CT and MRI can cope with this, and no worse.

2 Which method of diagnosing a hernia is the most accurate?

A total of 5 imaging techniques were listed, which in theory can be used in the diagnosis of intervertebral hernias. Two of them are immediately removed either as unnecessary in modern medicine (myelography) or due to almost complete ineffectiveness (ultrasound).

There remain 3 methods, which, based on their effectiveness in diagnosing back hernias, can be distributed as follows:

1. The first place is deservedly given to magnetic resonance imaging. A relatively convenient, extremely safe and very informative procedure. The only downsides are the price, unavailability in some regions and the duration of the study (about half an hour).
2. In second place is computed tomography. It is practically in no way inferior to magnetic resonance imaging, but has potential harm with frequent examinations. It is similar in price and information content to MRI, but at the same time much more accessible.
3. Radiography – a well-deserved third place. The procedure is quite safe, it is performed almost everywhere, it costs very little (and is free in clinics) and accurately identifies the hernia. Although it cannot always show individual details about it.

3 Is it possible to detect a herniated disc at home?

Is it possible to detect an intervertebral hernia through self-diagnosis? With one hundred percent probability - no. However, this can be done more or less accurately based on several specific symptoms (although you will still have to make a diagnosis to confirm your guesses).

The list is:

1. Pay attention to whether you have constant compensatory spasm of the back muscles. If it is present and the muscles are constantly tense, this is one of the signs of the presence of the disease (but not the fact that it appeared precisely because of the hernia).
2. Do you experience back pain when suddenly turning or bending? If there is pain, point-like, and always occurs in approximately the same place, there is most likely a hernia. If the pain is always in different places, the cause may be other diseases.
3. Does pain or discomfort become worse when sitting or lying down for long periods of time? If yes, then this is a sure sign of either dorsopathy or intervertebral hernia. Despite the fact that this sign is correct, without imaging diagnostics it will not be possible to accurately confirm the diagnosis.

In general, even all 3 symptoms will not indicate that you definitely have a hernia. They are only a reason to go for a consultation with a doctor, who will issue a referral for diagnosis and will provide further treatment.

Abdominal hernia is a very common disease. It can occur in anyone, regardless of age and gender. This pathology develops in many mammals due to weakening of the muscle and connective tissue of the abdominal wall. Therefore, those who have pets could see a hernia on the stomach of a kitten or dog. Why does a hernia appear, and how to treat it?

Fourth stage. The surrounding tissues atrophy, pain disappears. The spine becomes almost motionless.

The abdominal wall is a complex anatomical structure formed mostly by connective and muscle tissue. Its function is to support the internal organs in the abdominal cavity. A certain balance is developed between intra-abdominal pressure and the resistance of the abdominal wall. Sometimes this balance is disrupted, and the internal organs begin to leave the abdominal cavity through weak spots under the skin, forming an abdominal hernia, the photo or appearance of which eloquently indicates the presence of the disease. It is almost impossible to confuse it with another pathology.

The causes of hernias are:

• hereditary or acquired weakness of the abdominal wall;
• connective tissue diseases;
• age-related changes;
• prolonged fasting;
• obesity;
• ascites;
• pregnancy;
• physical stress;
• pushing during childbirth;
• chronic cough;
• constipation;
• lifting weights.

Injuries and postoperative scars can also contribute to the development of a hernia. A hernia can appear as a result of surgery if mistakes are made during suturing of the surgical wound. Therefore, postoperative consequences are often factors influencing the development of hernia formation, especially if they are purulent in nature. The cause of internal hernia is anomalies of embryonic development and chronic perivisceritis.

Types of abdominal hernias

Depending on which weak hernial point, unable to withstand intra-abdominal pressure, allowed the internal organs to go beyond the abdominal wall, the following are distinguished:

• - pathological protrusion of organs under the skin through weakened muscles in the groin. Most often found in medical practice. As a rule, men over 40 years of age are susceptible to this type of hernia. In this case, in a man, the spermatic cord or intestinal loop may extend beyond the limits; in women, the uterus, ovary or bladder.
• Crotch- located in the pelvic floor with protrusion under the skin. Passing through the muscle tissue, the hernia can protrude into the anterior wall of the rectum or vagina, the perineal fossa, or the lower part of the outer labia. This type of hernia is most often diagnosed in women.
• - exit of the omentum and other internal organs of the peritoneum through an opening that is formed along the midline of the abdomen. The pathology originates at the pubis and passes through the navel to the chest area. The disease is rarely asymptomatic.
• Femoral- occur in women over 30 years of age. Such a hernia reaches impressive sizes, although they are less likely to be strangulated. In most cases, its contents are the omentum or a loop of intestine. Provoking factors for the occurrence of a femoral hernia are excessive physical activity, pregnancy and chronic constipation.
• - occur when internal organs leave the abdominal cavity beyond the umbilical ring. The cause of this pathology is a decrease in the tone of the abdominal muscles. Umbilical hernia is quite rare and occurs mainly in women, more often in women who have given birth.
• Lateral- can appear in the vaginal area, and in case of injury - anywhere. The cause of their occurrence is obesity, impaired muscle innervation, and inflammatory processes. Fat penetrating into the openings of blood vessels promotes their expansion, which creates excellent conditions for the development of hernia formation.
• - are a congenital anomaly. In this case, the vertebrae are not able to close at the location of the spinous processes, thus forming a gap. It is into this that the spinal cord and its membranes penetrate. If there are too many unfused vertebrae, the disease will be serious.

Signs of an abdominal hernia

The clinical picture of an abdominal hernia is nonspecific, but quite recognizable. The most obvious sign of the disease is pain, which is accompanied by a bursting sensation. There may also be cramping pains that vary in severity and frequency.

Soreness can only appear during physical activity, after which it subsides a little. Constipation, nausea and vomiting are common concerns. The resulting hernia is clearly visible to the patient and may initially disappear when the body assumes a horizontal position.

The most obvious symptoms and signs of the disease are nagging pain and protrusion. Therefore, the question of how to determine an abdominal hernia is not particularly difficult. Often patients make this diagnosis on their own.

Pathological swelling in the early stages bulges more strongly when straining, coughing, sneezing, and can disappear at rest. Later, when the hernial orifice is further expanded, the hernia increases significantly in size, and there is a risk of strangulation and the development of various complications. Therefore, any hernia is considered dangerous and requires treatment.

Diagnosis of the disease

If a hernia is suspected, detailed diagnosis is very important, which can only be achieved with a comprehensive examination of the body. In such a situation, an X-ray examination of the bladder, chest, gastrointestinal tract and liver will be mandatory. The procedure is carried out using barium, which allows you to see the location of the hernia in the image.

If there is a displacement of the small intestine, then this sign indicates the development of a hernia. Additionally, differential diagnosis or irrigoscopy may be prescribed.

Ultrasound is also an effective examination method. With its help, you can distinguish irreducible protrusions from benign ones and lymph nodes in the groin area. Ultrasound allows you to study the anatomy of the cavity in which the hernia is found and plan an appropriate method for its removal.

Computed tomography makes it possible to recognize the nature and size of the defect with high accuracy.

Possible complications with a hernia

The main danger posed by an abdominal hernia is strangulation. This condition can occur when a loop of intestine gets into the hernial sac. The process of pinching is associated with contraction of the abdominal muscles, which helps to reduce the hernial ring. Ultimately, a deterioration in blood circulation occurs, against the background of which intestinal necrosis can form - tissue death. When a hernia is strangulated, the following complications are possible:

• serious intoxication of the body;
• intestinal obstruction;
• peritonitis - inflammatory process of the abdominal cavity;
• disruption of the kidneys and liver.

How to treat an abdominal hernia

In very rare cases, a hernia can be treated conservatively and corrected with physical therapy and massage. More often it requires surgical intervention. And if infringement of vital internal organs has already occurred, then the operation is performed as an emergency.

The choice of surgical methods for removing a hernia today is quite wide. Depending on the type of hernia and the technical complexity of the operation, the doctor may recommend open or laparoscopic hernioplasty, using tension or implantation of a mesh implant to close the hernial orifice.

There are categories of patients for whom surgery is contraindicated or is prescribed only in emergency cases, when the risk associated with hernia complications significantly exceeds the dangers of the operation. Such patients include children under 1 year of age, pregnant women, people suffering from chronic or infectious diseases, diseases associated with metabolic disorders, such as diabetes.

Often, if the development of an abdominal hernia is associated with a general weakened state of connective or muscle tissue, then surgery does not guarantee that after some time the hernia will appear again, but in a different area. Therefore, preventive measures to strengthen the abdominal muscles, adjusting nutrition and lifestyle are recommended to all patients.

Hernia surgery

No matter how easy the situation with a hernia may seem, the only way to cope with such a problem is to have surgery. Such pathologies do not disappear on their own. Over time, the size of the protrusion only increases and creates a danger to human health and life.

Moreover, if the hernia is in the body for too long, deformation of neighboring tissues occurs. And this, in turn, can have a direct impact on the result even after surgery. Even a special bandage and reduction are not able to solve hernia problems. Wearing a support bandage will not reduce the likelihood of strangulation at all.

There is only one type of hernia that can disappear on its own - an umbilical hernia in a child under five years of age. In other cases, surgery cannot be avoided.

You should contact a specialist immediately at the first suspicion of a hernia. The sooner the patient is operated on, the greater the chance of an easy recovery without complications. Once the diagnosis is confirmed, the patient will have to undergo additional examination, including tests. These measures are necessary to assess a person's overall health. A detailed analysis of all the patient’s indicators and the presence of concomitant diseases allows the surgeon to determine the appropriate treatment option, adapted to the characteristics of a particular person’s body.

Preoperative examination includes:

• blood test (biochemical and clinical);
• blood on RW;
• HIV test;
• analysis to detect hepatitis;
• blood type;
• Analysis of urine;
• chest x-ray;
• examination by a gynecologist or andrologist;
• therapist's conclusion.

Modern possibilities of medicine are simply amazing. Surgery to remove a hernia today is performed in a low-traumatic manner through laparoscopy. In the appropriate area of ​​the body, the surgeon makes small incisions into which the laparoscope is inserted along with the necessary instruments. This device allows the doctor to control every action on the monitor, and the presence of miniature surgical instruments allows you to remove the hernia without damaging nearby tissues.

During the operation, a kind of patch made of mesh material is placed on the hernia. Subsequently, it will grow into the tissue, which will further prevent the appearance of a hernia. The percentage of recurrent hernias in this case is minimal.

The operation is performed under local or general anesthesia. It all depends on the severity of the disease and the condition of the patient. But surgeons accept intravenous anesthesia, since in this case all the patient’s muscles are relaxed. This makes it easier for the doctor to carry out the necessary manipulations. Under local anesthesia, the patient is tense, which only aggravates the surgical process, and this can negatively affect the outcome after surgery.

The duration of the surgical intervention is 1.5-2 hours. Moreover, after the operation the patient does not lose the ability to move independently, and within a day he can go home.

Hernia prevention

The main cause of hernias in the abdominal area is weakness of the connective tissue. A similar complication occurs after surgery, especially if the person is obese. People who have had to undergo abdominal surgery in the abdominal area must adhere to the following recommendations: for 2 months after surgery, be sure to wear an elastic bandage, avoid sudden turns and bends of the body, and do not lift weights over 8 kg.

Up to a certain point, a person may not even suspect the presence of a hernia in his body. But sooner or later the protrusion will become visible when the muscle mass is tense or pressed. Even a quiet hernia can cause complications if it becomes strangulated, which is caused by pressure on the blood vessels. Just a couple of hours of poor blood circulation can result in the development of gangrene. The only solution in such a situation is surgery. To exclude such serious health problems, you should think about disease prevention. The main thing is to avoid excessive loads with heavy lifting. It is very important to normalize stool, since constipation often provokes the appearance of hernias. If there are disturbances in the functioning of the gastrointestinal tract, then a special diet rich in fiber will help restore its functions. At the same time, it is imperative to monitor your weight and maintain body parameters within acceptable limits.

Don't forget about physical education. A stretched and weakened abdominal wall is a common cause of abdominal hernia. But you can strengthen your muscles with the help of special exercises, in particular the abs and the “bicycle” exercise. Daily exercises of 7-10 minutes will bring good results and increase abdominal muscle tone. You should also strengthen your pelvic floor muscle tissue. To do this, you need to alternately relax and then tense the muscles of the anus.

To prevent the appearance of a hernia, it is necessary to promptly treat diseases that provoke an increase in intra-abdominal pressure:

• cold accompanied by cough;
• lung problems;
• chronic constipation;
• urological disease with impaired urination.

While pregnant, a woman should eat properly to avoid constipation. Fitness classes won't hurt. This will help increase muscle tone and improve blood flow.

To minimize the occurrence of a hernia in a newborn baby, it is necessary to ensure proper care of the navel area and ligation of the umbilical cord in the first days of his life. You need to feed your baby according to a schedule, excluding the possibility of overeating. If you have constipation, be sure to review your baby’s diet and make certain adjustments. It is recommended that infants be placed on their tummy 3 times a day, which allows them to strengthen their abdominal muscles. It is not advisable to swaddle an infant tightly and often throw it up.