waist hernias

Lumbar hernia is a very common disorder in our society, which is quite painful and can have severe consequences.
· The condition called lumbar hernia is a clinical condition that occurs as a result of cambering or tearing of the spinal cord into or out of the canal through which the spinal cord passes due to the deterioration of the pads, namely the discs, which are located between the back vertebrae and whose purpose is to absorb the load on the body and to give flexibility to the spine.
· The causes of formation are usually multifactorial. In other words, traumas, irregular postures, inappropriate movements, age-related and many other factors can be counted.
· It is more common between the ages of 30-50, but it can also be seen in the 20s and over the age of 50.
· When hernia occurs, it shows its clinic with pain. This pain is pain spreading to the buttocks, thighs and legs. Before the onset of pain, numbness and tingling may occur in the buttocks and thighs. The first sign that can be called a preliminary symptom of hernia may be a change in the way and habit of urination. Pain is usually an excruciating condition.
· Low back pain should not always be considered in favor of herniated disc. Because it should not be forgotten that only 1% of low back pain is diagnosed with a herniated disc.
· The most important feature of the pain that occurs as a result of herniated disc is the spread to the buttocks and legs. These pains can cause the person to gain a psychologically limited and sensitive structure, which affects their social life. And these events can cause the patient to gain weight and further aggravate the picture.
· When the herniated disc protrudes into the canal, it puts pressure on the spinal cord. And this pressure shows itself as pain, and this pressure causes a decrease in strength and loss of function in the muscles of the nerve it affects and in the areas it stimulates, depending on the damage it causes to the nerve over time.
· Lumbar hernias are usually located in the L4 region of the lumbar region. And it occurs between the L5 vertebrae or between the L5-S1 vertebrae. However, hernias can occur in other regions, even in more than one region.
Low back pain can have many causes. There are not only discs in the waist region. There are structures surrounding that region such as muscles, bones, ligaments, and it should be noted that a significant portion of low back pain is called mechanical low back pain.
· But when low back pain occurs, the most important concern in our society is the fear of having a herniated disc and the desire and desire to confirm it with expensive methods such as visual methods and MRI. Considering that 1% of low back pain is hernia, it can be seen that the rate of hernia is low. In addition, examination is very important in the determination of lumbar hernia and is the most important diagnostic tool in differentiating the hernia.
· When low back pain occurs, lumbar hernia should not be suspected in cases where there is no pain spreading to the legs, numbness and tingling, and there is no loss of strength.
· In addition, lumbar hernia gives symptoms as a result of the pressure exerted on the spinal cord by the cambered hernia.
· Examination is the most important diagnostic tool in the diagnosis of lumbar hernia. When the findings obtained as a result of the examination are necessary, visual methods such as computerized tomography, MR, medicated waist film are used in order to determine the size of the hernia and its effects.
· Medicated waist film is an interventional method made from the waist to detect the nerve under pressure as a result of drug administration into the spinal canal. Although the arrival of MRI reduces the usability of this method, it is sometimes necessary. The physician decides whether this is necessary.
· If a hernia pressing on the spinal cord is detected as a result of the examination and the methods taken or performed to support the examination results, the treatment to be applied varies depending on the person, the examination findings, the size of the hernia, and the condition of the hernia in the canal.
· Medication and physical therapy can be applied in patients who have pain but do not affect their social life, the localization and location of the hernia is suitable and no loss of strength has developed. But this should not be forgotten. Over time, depending on the progression of the hernia, it is possible that the clinic suddenly worsens and loss of strength and sensation in the foot and leg may occur, and this may cause a picture called caudo-equina syndrome in medicine that requires urgent operation.
· Surgery is an inevitable treatment method for patients whose social life is affected and who have loss of sensation, strength and reflexes. Because no medical treatment or method can cause this hernia to be retracted.
· Unfortunately, one of the methods that patients with low back pain resort to in our country is to have their back removed by people who are not medically inclined. This effort is generally based on a sense of seeking a remedy. The sense of remedy is the product of an insufficiently informed society.
· Unfortunately, undesirable and more complex events may occur in the face of waist pulling events. It is important to act within the knowledge and recommendations of your doctor while seeking a cure. The surgical procedure is a really frightening situation. However, it should be noted that the use of alternative treatment methods to avoid this is a situation that has severe consequences, which ultimately complicates the surgical procedure and may reduce the rate of benefit as a result of the surgical procedure.
· The aim of physical therapy programs is to strengthen the lower back and abdominal muscles and to increase the flexibility of tense nerves. But it should not be forgotten that it is necessary to do it on time and in place. Because it should be known that the purpose of the hernia is definitely not to be retracted. The most important problem of patients with low-grade hernia is that disturbing pain occurs with various positions and movements, and the possibility of having a really larger hernia in the future is finally in the group of candidates for surgical treatment.
Physical therapy programs can be applied in order to alleviate the pain of the patients in this group and to stop the progression of the hernia. Physical therapy programs are also used for patients who have loss of strength before the surgery to regain their former strength after the surgery.
· There are various methods applied when a herniated disc is detected. These are destruction of the disc with laser, removal of the disc with endoscopic methods and open surgery. Although the first two groups of patients are advantageous in terms of returning to active life after the procedure and reducing the complications of wound infection that may occur after the procedure, an important problem is that recurrent hernia events after these procedures are more common. It can be seen frequently and the patients who can undergo this group of procedures are selected patients. In other words, these methods cannot be applied to all hernia patients. The patient’s age, clinic, weight, current condition of the spine, the location of the hernia should be suitable for this hernia.
Open surgery is a superior method with low recurrence rates as it allows the hernia to be seen directly and evacuated almost completely. Likewise, the biggest fear of herniated disc patients is the fear of suffering the same pain, and this is a situation that disrupts their psychology. Today, patients are mobilized on the 1st day after the surgical procedure.
· It is a fact that there are some prejudices about the surgical procedure among the public. Are these the exact solution? Is there a risk of stroke? Or if my hernia recurs. Thanks to the technological developments he took behind the developing brain and neurosurgery, he succeeded in minimizing the problems that may arise in his surgeries. Considering that there are 5 hernia regions in the lumbar region, there is always the possibility of a hernia in other disc regions that have not undergone hernia surgery. It should be known that the operation to be performed is performed only on the existing hernia area and does not prevent other hernias. There may be complications after all surgeries, as well as complications after herniated disc surgery. Although paralysis, which is one of them, is a concept that can be thought of as theoretical, it is a rare complication in practice. However, the fact that it is rare does not mean that it will not happen. The benefit from hernia surgery is compatible with the clinic of the person. The rate of benefiting from surgery is quite high in patients whose strength losses are not severe. However, it is necessary to accept that nearly complete strength losses occur in patients who avoid surgery even though they have loss of strength for a long time, and it is difficult to recover. This loss of strength is not the result of the failure of the surgery, but the result of the patient not performing the necessary procedure at the required time.
· One of the mistakes made in our society is to reveal the failures of the procedures, not the success rates, but not to consider the patient’s structure and clinic when talking about them.
· It should not be forgotten that the purpose of medicine is to use science to improve people’s quality of life and save life. Doctors are the people who offer and use this information.
· Numbness and tingling may remain in the hips and legs after the surgical procedure. Such complaints generally disappear 6-12 months after the operation.
· A few months after the surgical procedure, sometimes there is a recurrence of pain. This recurrence is due to the adhesions formed during the operation of the surgical field rather than the recurrence of the hernia. These adhesions are tried to be opened through physical therapy programs. The aim is to increase the flexibility of the adhesions in that area. However, if the complaints do not decrease despite all the efforts, a second operation may be required. However, recently it has been determined that some substances used during the operation reduce the formation of these adhesions and have been used.
· Although it is very rare, hernia may recur after hernia surgery in the previously operated area. The reason for this may be a hernia that has not been adequately evacuated before.
· It should be noted that cases of herniated disc are greatly relieved after surgery.
· Patients who have had back hernia surgery have to protect themselves. And they have to strengthen their abdominal and waist muscles with various exercises and not gain weight.
· If there is weight in patients whose lumbar hernia is not at the level of surgery but suffering from pain, it should not be forgotten that reducing their weight to a suitable weight for their height may provide close to 50% relief in their complaints.