What is a herniated disc? Does every patient with low back pain have a herniated disc?

Our spine and the anatomical structures around it (muscles, intervertebral pads, ligaments, etc.) are a dynamic organ that keeps our body upright, protects the spinal cord and nerves coming out of the spinal cord, and provides our head, trunk and waist movements. Our spines are not in the form of a straight tube. It is formed by the overlapping of approximately 33-34 vertebrae, which have physiological inclinations in the neck, back and waist regions, by means of pillows between them. Our spines are constantly exposed to severe stress throughout life. When this stress exceeds the physiological limits, deterioration occurs in the spine and surrounding anatomical structures, and as a result, herniated disc and other spinal diseases occur.
Lumbar hernia is the deterioration and subsequent rupture of the cushions (intervertebral disc) located between the lumbar spine and compression on the spinal cord and nerves coming out of the spinal cord. Back, hip pain and pain radiating to the leg are the most important complaints.
Low back pain is an important public health problem that causes loss of work and workforce. The most common pain after headache is low back pain. The most common cause of low back pain is mechanical low back pain, which occurs as a result of deterioration of the lumbar spine, disc structures and surrounding ligaments. In addition, infections in the lumbar region, rheumatic diseases, spine and spinal cord tumors also cause low back pain.
Not every low back pain is a herniated disc. Today, with the development of imaging methods, patients with lumbar films in their hands have come to visit physicians because they have a herniated disc. Acute mechanical low back pain usually resolves in about 1-3 weeks without any treatment. If low back pain becomes chronic then it becomes a complex problem. In the treatment of chronic low back pain, a multidisciplinary approach is required with physical therapy, rehabilitation, psychotherapy and, if necessary, surgery
A small proportion of patients with low back pain complaints are diagnosed with low back hernia.
The most important cause of herniated disc, the incidence of which has increased with modern life, is a sedentary life and posture disorder. The increase in desk jobs in urban life, excess weight, an sedentary life, and weakness of the abdominal and waist muscles increase the tendency to herniated disc. In addition, smoking, depression, yawning, sneezing, careless and unbalanced lifting are also among the risk factors.
The most important complaint of hernia patients is pain. The character of this pain is that it radiates from the hip to the leg (sciatica and femoralgia). However, depending on the severity of lumbar hernia, numbness, tingling, felting between the legs, under the feet, on the outside of the leg, on the front of the thigh, between the legs, partial or complete loss of strength in the feet and legs, tripping of the foot while walking or turning the ankle inward, urinary incontinence and sexual dysfunction. such as complaints.
The diagnosis of lumbar hernia can be made easily today. We can evaluate the lumbar region in detail with magnetic resonance imaging (MRI). Most of the patients diagnosed with lumbar hernia, who only have low back pain and leg pain, and whose neurological examination is normal, their complaints decrease or disappear with medication, rest and physical therapy. Surgical treatment is required in a small percentage of herniated disc patients. Surgical treatment should be considered in patients with persistent hip and leg pain despite conservative treatment and in addition to neurologic dysfunction.
There is a misconception in society that “patients do not benefit from herniated disc surgery and they get worse”.
Surgical treatment of lumbar hernia, contrary to what is known in the society, is performed in a safer and shorter time, without disturbing the harmony of normal anatomical structures, with microsurgical technique, in parallel with today’s technological developments.
Finally, the most important way to prevent herniated disc is to make changes in my lifestyle such as doing exercises to strengthen the abdominal and waist muscles, not sitting for a long time, not standing in one spot, not lifting things unbalanced and carelessly in a way that will force our back.