Back hernia

A hernia (Hernia Nuclei Pulposi) is the protrusion of the soft core of one or several of your intervertebral discs, causing your nerves to become trapped. A bulge like this is caused by a fracture or weakening of the intervertebral disc. This puts pressure on your nerves or spinal cord. This causes severe pain in one or more of your legs and your (lower) back.

The exact cause of a hernia can’t be determined. You can get a hernia as a result of various different factors. For example, you’ve made a wrong movement, you’ve been sitting down for too long or you’ve carried out work which was too strenuous. Other factors which can influence the development of a hernia include:

• Your height. You’re more likely to develop a hernia if you’re tall.
• Stress.
• Smoking.
• Being overweight.
• Old age.
• Heredity. The intervertebral vertebrae tissue is already weak at birth.
• Muscle building which is too weak.

A hernia can be an acute hernia or a chronic hernia. An acute hernia means you suddenly develop symptoms and the symptoms usually disappear after 12 weeks. A chronic hernia means the symptoms often develop gradually over time and you’ll be suffering for a long time. It’s important you seek help as soon as possible, in order to prevent a chronic hernia. An untreated acute hernia can progress to a chronic hernia.

A hernia may result in you suffering from:

• Pain in your lower back.
• Radiating pain in one leg or both legs. The pain can extend to your foot. The pain may also be felt in your buttocks.
• A decreased sensation or muscle strength in one leg or both legs.
• Pain when coughing and sneezing.

It’s important to listen to the following advice if you’ve been diagnosed with a hernia:

• Keep moving. This will keep your muscles strong and prevent them from stiffening. Don’t overload yourself. Go about your daily activities as normally as possible. You can also request advice from a physiotherapist for the right exercises and movements.
• Take a painkiller in you’re in severe pain. You can take a paracetamol as a basis and supplement it with an anti-inflammatory drug (NSAIDs). Check the package leaflet for the correct dosage or ask your GP for advice. NSAIDs can have unpleasant side effects. That’s why it’s important to exercise caution when taking these.
• Make sure you are comfortable when you lie down. For example, you can tuck a few pillows under your knees if you’re lying on your back. Are you unable to lie on your back? Then lie on your side and keep your knees bent.

Lying down may cause the least amount of pain. In that case you should lie down more often than you normally would. Make sure you continue to move, because your muscles will weaken if you lie down too much, which will worsen the symptoms and delay the healing process.

Make sure you get out of bed correctly. You can do this by:

• Turning onto your side.
• Putting your legs over the edge of the bed while your head is still on the bed.
• Pushing yourself up to the side with both arms and then standing up.

Are you going to lie down again? Then do the same, but in reverse order.

Do you suspect you have a hernia? Then call your GP and make an appointment. Have you already been diagnosed with a hernia, but are you experiencing additional symptoms? Then immediately contact your GP or the emergency department (during the weekends) if:

• You can no longer urinate.
• You can no longer hold your urine or stools.
• You’re experiencing numbness in your vagina, penis or anus.
• The strength in your legs is increasingly reduced.
• You are still in bed after a few weeks. Movement is either not possible or very difficult.
• The symptoms haven’t improved after 6 to 8 weeks.
• The pain doesn’t subside after you take painkillers.

Your GP will discuss the next steps with you, or refer you to another specialist, such as a physiotherapist or neurologist. The hernia may need to be corrected by surgery in very severe cases. The intervertebral vertebra protrusion will then be removed, so your nerve or spinal cord is no longer pinched.