THE‘Ernia del Disco is one of the Most common causes of back pain and sciatica. It often affects adults between 30 and 50 years oldboth men and women (with a predilition for women, below we explain why) causing pain, numbness and limitations in movements. Fortunately in most cases, you can intervene with non -surgical treatments that relieves symptoms and improve the quality of life. We talked about it with the Dr. Luigia Bruglieraphysiatrist doctor in neurorying and pain therapy, is responsible forSpecialized motor rehabilitation unit of the IRCCS San Raffaele Hospital of Milan
What is the hernia of the disc?
Among the vertebrae of the column there are gods Intervertebral discs that work as shock absorbers. When one of these records damage or moves, it can compress spinal nerves causing pain. The hernia can form In the cervical, thoracic or lumbar area, the latter the most frequent.
“It is such a frequent pathology that there are often many approaches,” explains Dr. Luigia Brugliera. «The incidence between men and women is superimposable, but it must be said that the woman often has a greater fragility of muscles and joints. So, if not trained and if prepared, it can incur this disorder. The disc is the “shock absorber” placed in the vertebrae. Yes creates an hernia when the central part of the disc, the pulpy nucleus, comes out of its intervertebral physiological space. There are many risk factors, etiology is multifactorial: mechanical overload, poor physical training, muscle fragility. Cause pain because it exerts mechanical compression against adjacent tissues and meets the nerve, arousing pain ».
What are the most common symptoms?
The most common signs of the Arnia on the disc are: localized back or radiated back pain with legs and arms, tingling or muscle weakness, reduced mobility. Nin each case, for a correct diagnosis, the doctor’s evaluation is always necessary.
In which cases can you or is it better to avoid surgery for a disc hernia?
The surgery for the hernia of the disc can be avoided or it is better to postpone it in the following cases identified and evaluated by the physiatrist doctor:
1. If the pain is manageable: When the pain is moderate and controllable with drugs, physiotherapy or other conservative therapies.
2. Absence of serious neurological deficits: if there are no signs of paralysis, loss of the control of bladder or intestine, or serious muscle weakness.
3. Positive response to conservative therapy: If after 4-8 weeks of non-surgical treatments (rest, physiotherapy, anti-inflammatory) the symptoms improve.
4. Contained hernia or protrusion: In cases where the disc is moved but not completely leakage, physical and postural therapies are often enough.
5. Presence of surgical risk factors: Advanced age, chronic pathologies (heart, diabetes, coagulation) that make the operation risky.
In summary, it is preferred Avoiding intervention when the symptoms are not disabling, respond to conservative treatments, and there is no obvious neurological damage. Surgery is a solution only if all other roads fail.
What are the most effective non -surgical treatments to relieve pain or improve the hernia of the disc?
«Therapy is initially conservative, pharmacological. Anti -inflammatories are prescribed, in some cortisone cases, muscle relaxants, neurotrophic and sometimes also analgesic therapy. Cortisone is the drug with the most powerful anti -inflammatory effect, but it can have contraindications. Better to use it in the second joke. It tends to raise blood sugar, to tie osteoporosis. In addition, it can be opt for focal therapy, infiltrative with cortisone. It is an important physiotherapy path for the course of the disc -arnia, “specifies the physiatrist.
And the most innovative ones?
«There are the most avant -garde treatments including there Disclosed with Ozono Ecoguidattoin correspondence with the Harnia. The Epidural infiltrations or radio frequency.
The Infiltrations with PRP and Mesenchimal cellscompletely free from collateral effectsthe. A normal blood sampling is made which is then centrifuged, plasma is obtained with a large concentration of platelets. Then it is reinfiltered on a disc level and from there the regenerative process begins. The prp born for treatment of joint sectors, of the knee for example », specifies Dr. Luigia Brugliera.
“The Superinductive system with electromagnetic field Instead, it is indicated above all for the skeletal muscle pathology (SIS), it is sometimes prescribed also for neuropathic pain therefore for hernia. It has a good miorilaxant effect, improves joint mobility but not so much on hernia.
There Tecar therapy It is optimal but above all as an adjuvant of other therapies. It can modulate my fasciale muscle pain, it improves the vascularization of the tissues but above all muscle », explains Dr. Luigia Brugliera.
Can physiotherapy help to regress hernia or just manage pain?
«Physiotherapists are divided by specialty, therefore For the hernia of the disc, those who treat orthopedic patients, skeletal muscle must be chosen. The rehabilitation program must always be tailor -made of the patient », recommends Dr. Brugliera. «The key point for those with the hernia of the disc provides Trunk reinforcement exercisesOf mobilization of the columnAnd Fundamental stretching of the muscle kinetic chains of the trunk and the lower limbs ».
Good habits to prevent the disk hernia
Tackling the hernia of the disc without surgery is possible in most cases. The early, personalized and constant treatment can avoid complications and restore mobility and well -being. If you suffer from persistent back pain, it is good to contact a specialist for an accurate diagnosis and a targeted therapeutic path. Surgery becomes necessary only if, after months of conservative therapy, the symptoms do not improve or worsen, or if there is a serious nervous compression. Losing weight, avoid sedentary lifestyle and improve ergonomics at work are fundamental aspects to prevent recurrence.
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