Always take lower back pain seriously: herniated discs can be a medical emergency

Always take lower back pain seriously: herniated discs can be a medical emergency

Back pain has been experienced by almost everyone. These are often due to tension and disappear after a while. But a herniated disc can also hide behind the symptoms. Therefore, persistent pain and symptoms such as Symptoms of paralysis should be taken seriously and medical issues clarified. In an interview with the news agency "dpa", experts explain how to recognize a herniated disc and which treatment options are available.

Back pain is one of the most common reasons for absenteeism
Almost every adult has had back pain at least once in their lifetime. According to a current evaluation of DAK health, these are among the three most common reasons for sick leave; every fifth day of absence (20.6 percent) was caused by such a musculoskeletal disease. In most cases, the symptoms are caused by muscle tension or e.g. causes a blocked vertebra and go back within a few weeks. However, if the back or lower back pain persists for more than four weeks, a doctor should be urgently consulted to clarify whether the intervertebral discs may be affected. Because a herniated disc often remains undetected, especially if the complaints are only occasional e.g. occur after long periods of sitting.

Pain can spread to the arm or leg
The acute herniated disc usually occurs very suddenly. Sometimes a simple turn or lifting a crate of drink is sufficient if there is appropriate damage. Because the 23 intervertebral discs, which serve as a buffer and suspension between the vertebral bodies, have a gelatinous, soft core in the middle and are surrounded by a hard but elastic "fiber ring" ("anulus fibrosus") for stabilization. Arises e.g. When the water box is lifted, the fiber ring can tear, causing material to escape from the core and press on the surrounding nerves.

As a result, severe, stabbing back or neck pain often develops, which can radiate up to the arm or leg. Depending on which part of the spine is affected, further symptoms such as neurological deficiency symptoms (tingling, furry feeling in the leg, "ant walking") or a loss of reflexes can occur. In the event of symptoms of paralysis, a doctor should be consulted as soon as possible, explains Reinhard Schneiderhan, President of the German Spine League and Orthopedist in Munich, in an interview with the news agency.

Uncontrolled loss of stool or urine is an urgent warning signal
In addition to this, there are other important alarm signs that indicate an emergency and must therefore be taken seriously: "If the affected people lose urine in an uncontrolled manner or can no longer hold their stool, surgery must be carried out within six hours," added Prof. Bernd Kladny. The expert acts as deputy general secretary of the German Society for Orthopedics and Trauma Surgery (DGOU) and is also the chief physician of the Orthopedics and Trauma Surgery department at the m & i specialist clinic in Herzogenaurach. Even if the symptoms of paralysis are very severe and there is an increased risk of falling, an operation is recommended, Kladny continues.

According to the expert, all other cases can be treated conservatively, e.g. by the patient anti-inflammatory and pain relieving medication or injections and infusions. Protection is also important - but that doesn't mean avoiding any movement. Instead, normal everyday movements should be trained under the guidance of a physiotherapist and stability in the trunk area should be improved, says Kladny.

Conservative measures are often sufficient

The problems can often be remedied in this way - but in some cases the measures described are not sufficient. "When it comes to how long conservative treatment should take place, the patient should be included," Kladny continues. Patients who e.g. If you have to be fit quickly for professional reasons, you can initially try intensive treatment for two weeks in a conservative manner. If this does not lead to the desired success, the person affected should answer the question "Surgery for a herniated disc: yes or no?".

Exist in one patient e.g. Increased health risks from an operation, according to Kladny, the therapy period could also take longer. However, a critical size was reached after six weeks at the latest, says Schneiderhan. "Then questions have to be asked such as: Can the person concerned move normally again? Is he still in pain? Can he sleep through? ” If the patient is still severely limited, various options can be considered. With minimally invasive procedures, for example, incidents and bulging of the intervertebral discs are shrunk using laser energy and the gap created is welded again. The surgeon can remove the escaped tissue of the intervertebral disc either directly or through a kind of “hollow tube”, the expert explains. However, it is important in any case to get a second medical opinion before an intervention. "You shouldn't make hectic decisions or be persuaded," the expert points out.

Beware of abdominal exercises such as sit-ups
Schneiderhan explains that the risk of a herniated disc is increased in people who sit a lot, put unilateral or incorrect strain on their bodies or generally have too little movement. Likewise, the protective fiber ring becomes more susceptible to cracks with age and can therefore tear faster.
But it doesn't have to come to that, because according to Michael Preibsch, a herniated disc can be prevented by the German Association for Physiotherapy. In many cases, muscular problems have existed for a long time, e.g. the hip flexor muscles are poorly stretchable or the abdominal muscles are too weak to be able to offer the back sufficient stability. However, according to the expert, such "muscle imbalances" could be compensated for by targeted training. But caution should be exercised here, because widespread exercises such as Sit-ups would primarily affect the hip flexor and would rather exacerbate the problem. "This is why instructions are particularly important at the beginning of preventive training," recommends Preibsch.

Do not clamp the handset between your ear and shoulder
In addition, incorrect loads should be avoided if possible, e.g. by getting up and walking around more often during work. Weaning off a few “quirks” can also help prevent a herniated disc. This includes, for example, holding the telephone receiver clamped between the ear and shoulder or constantly stretching your head close to the monitor due to an incorrectly adjusted visual aid, explains Preibsch. Movement is also indispensable in the context of prevention, because "it often affects people who don't usually do much and then renovate a house," emphasizes the expert. Activities such as e.g. Jogging, walking or cycling, alternatively yoga could be the right thing. (No)

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