Hernia and complaints

Hernia is a bulge of an intervertebral disc. This can be seen on an MRI or CT scan. Various examples can be found on the internet. Note: many people have a hernia, for example, 60% of people over 60 have something that resembles a hernia. What is striking is that most people have no complaints. When do complaints arise? If the hernia presses against a nerve, or if the hernia leaks or snaps. Back pain and/or leg pain may be the result (neck hernia: neck pain and/or arm pain).

Complaints caused by a hernia disappear in about 2 out of 3 people with approximately 3 months without special therapy. In the case of severe pain or symptoms (control, feeling, strength) it is wise to seek help from an expert.

Damage and recovery

The combination of bending + lifting + turning with the lower back has been proven to cause damage to the intervertebral discs, possibly resulting in a hernia. In the past bed rest was recommended to recover. Now it is advised to be physically active as soon as possible and resume the daily routine. It seems possible to speed up the recovery of a number of people with complaints with musculoskeletal medicine and targeted exercise therapy.

See also the article on causes of low back pain.

References
Deyo RA, Mirza SK. Clinical Practice. Herniated Lumbar Intervertebral Disk. N Engl J Med. 2016 May 5;374(18):1763-72.
Broetz D, Hahn U, Maschke E, Wick W, Kueker W, Weller M. Lumbar disk prolapse: response to mechanical physiotherapy in the absence of changes in magnetic resonance imaging. Report of 11 cases.NeuroRehabilitation. 2008;23(3):289-94.

Brinjikji XW et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015 Apr;36(4):811-6.

Weber H, et al. The natural course of acute sciatica with nerve root symptoms in a double-blind placebo-controlled trial evaluating the effect of piroxicam. Spine 1993; 18: 1433-38.