Disc protrusion: symptoms, diagnosis and treatment methods

Low back pain is experienced by most people after 35 years of age. At one point, excessive pressure on the intervertebral discs, combined with degenerative destruction, do their job. And the disc nucleus moves out of its normal position, resulting in protrusion.

The intervertebral disc is an element of the spinal column that cushions the pressure that appears during a person's movement and during other physical exertion. He correctly fulfills his function only if he takes a position clearly defined by nature. Degenerative processes change the location of the intervertebral disc, which at best leads to discomfort, and at worst - to severe pain and immobilization of the patient.

The displacement of the load on the intervertebral disc causes two conditions - protrusion and hernia. They are often confused, since the same causes lead to the development of diseases. However, the answer to the question “protrusion is a hernia or not” is unambiguous - no.

In this material, together with specialists Bersenev Medical Center we will consider their differences, as well as talk about the symptoms, diagnosis and treatment methods.

Bersenev Vladimir Andreevich - Honored Doctor of Ukraine, neuropathologist of the highest category, founder of the Bersenev Medical Center.

Protrusion and hernia: what is the difference

Protrusion is, in fact, the first stage in the formation of a herniated disc. Under the influence of degenerative processes, the disc shifts slightly, but does not break the annulus fibrosus in which it is located. It is extremely important to seek help from a doctor at this stage, because during protrusion, you can use the whole range of therapeutic measures, and in 95% of cases they produce the desired effect. It is not possible to restore the normal state of the disc during protrusion only in rare cases: for example, after serious injuries.

Usually the protrusion is 1-4 mm in size, but more severe protrusions occur. According to statistics, it occurs in 50-60% of men after 40 years. In women, the disease is less common, probably due to less physical activity. Most often, protrusion affects the lower part of the lumbar spine.

There is an opinion that protrusion is uncritical, and it does not always need to be treated. It is not true. Protrusion is an indicator that a degenerative process has started in the spine, which in most cases is progressive. Simply put, protrusion develops and subsequently leads to a hernia, and it is much more difficult to treat it.

As mentioned above, during protrusion, the disc is displaced, but the annulus fibrosus remains intact. If the patient is not treated, the protrusion develops into extrusion, that is, the ring breaks, and the intervertebral disc protrudes outward. This is a hernia.

Can the protrusion become a hernia? Yes. But not always a herniated intervertebral disc is a consequence of protrusion. The annulus fibrosus can rupture due to injury, fall, sudden lifting of a heavy object. In this case, it is imperative to see a doctor, and not only because this condition reduces the quality of life. The formation of a hernia triggers an autoimmune process: the contents of the disc are perceived by the immune system as a threat, so the production of antibodies begins. The inflammatory process develops, and healthy intervertebral discs suffer.

If the annulus ruptures completely, sequestration occurs. This is a prolapse of a disc fragment that is no longer associated with the nucleus pulposus. This condition poses a particular danger to humans. The element can pinch the nerve roots, which will lead to very severe pain, as well as permanent damage to the corresponding structures.

Causes of protrusion and herniated intervertebral discs

• Genetic predisposition. Due to this factor, a hernia can even occur in a child. This is due to a defect in the proteins that make up the disc.
• Age-related changes. At a young age, the intervertebral disc is elastic and soft. Over time, the tissue ages, the disc “stiffens”. It loses moisture, becomes less elastic. Cushioning capabilities are impaired and the risk of disc injury increases.
• Injuries. A destructive mechanical effect can lead to protrusion or hernia. Particularly dangerous are blows to the spine and strong falls on the buttocks (there is an instant compression of the discs). This also includes injury to the annulus fibrosus as a result of sudden heavy lifting.
• Physical inactivity. Interestingly, the intervertebral discs suffer more if a person is inactive than when there is physical activity. This applies to the sitting position, in which most modern people spend a lot of time. The intervertebral discs are under severe stress, which negatively affects the shock-absorbing properties. In addition, the intervertebral disc does not receive moisture from the surrounding muscles, as they are under the influence of spasm due to the static position. This leads to tissue wear and tear.
• Going in for sports, which involves a heavy load on the discs. We are talking, for example, about golf, hammer throwing. The athlete "twists" the body, resulting in a hernia or protrusion.
• Excess weight. Excessive pounds increase the stress on the spine.
• Smoking. Rather, this is not a reason, but a catalyst. Smoking decreases the amount of oxygen in the blood, which negatively affects the condition of the tissues.

Protrusion symptoms

• Spine pain: from mild whining to severe pain.
• Pain extending to the limbs.
• Tingling sensation around the spine, arms and legs.
• Numbness of the limbs.
• Weakness in the arms or legs.
• Restriction of neck mobility (if the cervical spine is affected);
• Pain between the shoulder blades.
• Rarely - urination disorders (with lesions of the lumbar spine).

Symptoms depend on the size of the protrusion and its location. If the fibrous ring is strong, protrusion can reach up to 10 mm without going into extrusion. Be that as it may, any regular back or limb pain should be a reason to visit a specialist.

Hernia symptoms

• Intense pain in the lower back or limbs, chest, neck.
• Periodic attacks of severe pain, which can only be stopped with the help of medication.
• Inability to perform some types of work due to very strong painful sensations during physical exertion (for example, lifting things from the floor, cleaning).
• Numbness in the fingers.
• Headache, dizziness.
• Blood pressure surges.

As with protrusion, symptoms can vary depending on the location, cause, and size of the hernia. There are three types of hernias most commonly encountered. Let's consider them.

• Ventral (frontal). The intervertebral disc bulges forward, affecting the anterior ligament of the spine.
• Lateral (foraminal). Such hernias compress the spinal nerves.
• Rear (dorsal). Spinal cord tissue is compressed.

A hernia can form in any direction, and symptoms differ from case to case. It is possible to establish the type of intervertebral hernia after an MRI scan.

Diagnosis of protrusion and intervertebral hernia

The most effective diagnostic method is MRI. Tomography allows you to find out the localization of protrusion or hernia, the degree of damage to tissues and nerves. If there is a hernia, MRI makes it possible to find out its direction and size.

Computed tomography provides information about the state of the bones, but this method is ineffective in diagnosing the state of soft tissues. It can be used as an auxiliary method if necessary. Radiography and ultrasound are also used.

Protrusion treatment

Treatment of both diseases is carried out in a comprehensive manner. The doctor develops therapy after conducting a thorough diagnosis, because you need to take into account the many features of a hernia or protrusion, as well as the patient's body as a whole.

To relieve swelling and inflammation, a therapeutic massage is prescribed. Physiotherapy treatments such as magnetotherapy are performed. To restore the full-fledged work of the musculoskeletal system, the patient can be assigned to work on simulators. Exercise therapy helps to strengthen the muscular corset of the back, restore muscle tone. To eliminate pain, relieve tension, neutralize the inflammatory process, drug treatment is used.

Metameric methods of treatment have proven to be effective.

Metameric massage eliminates spasms and pain, improves blood circulation, normalizes the nutrition of intervertebral discs with useful substances and fluids. Metameric injections are also used, which allow you to directly affect the affected areas.

There are many effective methods. It is important to correctly develop a treatment regimen by choosing the correct combinations. What is protrusion, and how to treat it, they know at the Bersenev Medical Center. The clinic's specialists will conduct a thorough diagnosis, after which they will develop a therapy taking into account the individual characteristics of the patient. Between courses of metameric injections, treatment can be carried out at home. If the patient adheres to the doctor's recommendations, the function of the intervertebral disc can be restored.

Hernia repair

If necessary, the patient is assigned to bed rest for the duration of the treatment. Medical treatment consists in the use of the drugs described above. Patients are prescribed acupressure, acupuncture. Metameric methods of treatment are used: massage, injections.

After removing the pain syndrome, you can start exercise therapy, other motor treatment methods.

If a patient seeks help soon after symptoms are detected, conservative treatment is successful in about 85% of cases. If it does not produce the desired effect, you have to resort to surgical intervention. The operation is carried out only as a last resort.

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Conclusion

To avoid the operating table, it is important to monitor the condition of your spine by listening to the "signals". This is especially true for people over 40. At the stage of protrusion, it is easiest to fix the problem, but a hernia is not a sentence either. It is important to find an experienced doctor who has access to modern diagnostic and treatment methods. A protrusion or hernia is a relatively benign disease if properly treated. Experts know how to do this. Bersenev Medical Center.

• You can find out more about the prevention and treatment of intervertebral discs at a consultation at the medical center doctorbersenev.ua.
• Kiev, st. Boulevard-Kudryavskaya, 10-B.
• Contact center number: (044) 238-22-31