Many people regularly suffer from back pain. This can have several causes. Heavy lifting, poor posture or a hereditary condition can be possible causes of back problems. One of the most serious back conditions is a hernia. A hernia is characterized by lower back pain that radiates to the buttock, leg and/or foot. The pain is difficult to control, as it concerns nerve pain.

What is a hernia?

A hernia is a bulge of the soft core of an intervertebral disc, which presses against a nerve root. This causes pain in the lower back that radiates to the buttock, leg and/or foot. A hernia can also occur in the neck, the so-called neck hernia. Patients then suffer from radiation to the shoulder(s), arm(s) and hand(s). In this article I will mainly talk about the spinal hernia. The medical term for this condition is Hernia Nuclei Pulposi (HNP).

Symptoms of a hernia

The first complaints that people usually experience are pain in the lower back, cramping pain in the buttock, thigh and calf and a tingling feeling in the foot. The location and severity of the pain may vary from case to case. Irritation of the nerve root can cause loss of strength. Reflexes can decrease, there can be (partial) failure and it can even lead to incontinence. For most people, sitting and standing are the most painful. Because nerve pain can be very intense, it is important to listen carefully to your body.

Where does a hernia occur?

A hernia occurs in weak spots of the intervertebral discs. Most hernias occur between the 4th and 5th lumbar vertebrae and between the 5th lumbar vertebra and the sacrum. Only 10% of hernias occur one vertebra higher. In three quarters of all hernia patients, the back recovers without surgery.

What are the causes of a hernia?

A hernia can have various causes. In about half of the cases there is a congenital weakness of the disc tissue. Other causes may include: too heavy or incorrect lifting, sudden twisting movements of the trunk, too little exercise, too much sitting, incorrect posture or excess weight. If there is already a weakness in the disc tissue, other causes can increase the risk of a hernia developing.

What can be done about a hernia?

It is best to prevent a hernia. If you have a sedentary job, make sure you have a good, adjustable chair. At many companies you can have your chair properly adjusted through the occupational health and safety service. Make sure you get enough exercise, even during your work. Pay close attention to how you lift. First get on your knees. Pay attention to your posture, shoulders back, back straight, chest forward. Try to make time to exercise between your work. Many companies now offer facilities to exercise during or after working hours.If you do develop a hernia, ensure a good balance between rest and exercise. Consult your GP to determine to what extent pain relief is necessary for recovery. If the pain does not improve after a few weeks of rest and pain relief, your GP may refer you to a neurologist. The neurologist will perform a number of tests to determine whether you have loss of strength or reflexes. The doctor also checks whether you have symptoms of loss.The neurologist can make the decision to have an MRI (Magnetic Resonance Imaging). This scan shows whether it is a hernia and where the hernia is located. The neurologist uses the MRI to determine whether surgery is necessary. In three quarters of cases, the neurologist recommends allowing the hernia to heal with rest, measured movement in combination with pain relief. Given that it concerns nerve pain, the neurologist will usually opt for stronger pain relief. This could be diclofenac or tramadol, for example, but morphine is also an option to control the worst pain. The ultimate goal is for the patient to slowly become more mobile again. Please note that recovery will take at least three to ten weeks. Unfortunately, there are also people whose recovery will take months.