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If you have back pain every now and then, you are not alone. Because it is Back pain a real one Widespread disease, which regularly affects around 20 million Germans. If the pain does not go away by itself within a few days, it could a herniated disc is the cause be. Here you can find out exactly what this disease is all about, what diagnosis and therapy look like, and how you can effectively prevent a herniated disc.

What is a herniated disc and how does it arise?

Each of the 23 intervertebral discs in the human body acts like a Buffer between the vertebral bodies. They serve as spacers, so to speak, and dampen shocks. For this purpose, the intervertebral disc is covered with a gelatinous nucleus (Nucleus pulposus) equipped with a hard fiber ring (Annulus fibrosus) is surrounded. While the gelatinous core has cushioning properties, the task of the fiber ring is to stabilize the intervertebral disc in its position. If the gelatinous core breaks through the fibrous ring, the doctor speaks of a herniated disc. This can create pressure on the spinal cord running in the spine with its nerve tracts.

In nine out of ten cases it is a herniated disc Lumbar spine area, a so-called lumbar disc herniation. If the transition from the lumbar spine to the sacrum or from the thoracic to the lumbar spine is affected, the doctor also speaks of a lumbosacral or thoracolumbar disc herniation.

About ten percent of all patients with a herniated disc suffer from a herniated disc Cervical spine, also called cervical disc herniation.

Typical symptoms of a herniated disc

The symptoms of a herniated disc depend primarily on the type and extent of the defect. Typically those affected suffer from sudden back painthat get stronger, especially when exercised. In addition, there is usually one hardened muscles in the spine area.

Is the Lumbar spine Affected, the pain often radiates to the buttocks or legs and / or the patient feels a tingling sensation in the legs. The pain is usually worse when you cough or sneeze.

In the case of a herniated disc the Cervical spine sufferers complain primarily of neck pain, which, depending on the extent of the disease, radiates into the arms and the back of the head. In extreme cases, paralysis is noticeable.

It is not uncommon for a herniated disc to be announced several days in advance. If you suffer from back pain that lasts longer than five to seven days, or that radiates into the legs or arms, be sure to consult a doctor!

How is the herniated disc diagnosed?

At the beginning of the diagnosis there is one detailed anamnesis, that is, a patient survey. The doctor finds out, among other things,

  • where exactly the pain lies
  • since when it exists and
  • how it is concretely perceived by the patient (for example stabbing, piercing ...).

A physical exam is usually followed up imaging proceduresto clearly diagnose a herniated disc. X-rays are not very meaningful - in most cases the doctor also orders computed tomography (CT) and / or magnetic resonance tomography (MRI).

So-called myelography is rarely used. This is an invasive procedure in which a contrast agent is injected into the spinal canal. Only then is an X-ray or a computer tomography carried out. Since this procedure is not free of risks, it is only performed when the doctor wants to assess the spinal canal as precisely as possible.

What therapy options are there?

A herniated disc pulls not necessarily an operation after yourself. On the contrary: in almost 90 percent of all those affected, the symptoms improve with conservative treatment methods. After six to eight weeks, the symptoms usually have completely disappeared.

Conservative treatment

First of all, the doctor prescribes pain reliever and anti-inflammatory drugs. They take the pressure off the patient and prevent them from adopting a relieving posture. Because: Any form of relieving posture additionally tenses the muscles. If the pain is very pronounced, it is possible to inject locally anesthetic agents and / or cortisone preparations directly into the affected area of ​​the body.

Also warmth has proven to be helpful - for example in the form of red light, moor or fango packs. The warmth stimulates the blood circulation and also loosens the muscles. Another measure accompanying therapy is step bed positioning, in which the legs are raised on a so-called intervertebral disc cube while lying down in order to relieve the nerves.

Operative treatment

An operation is only necessary if the pain is very pronounced and conservative therapy does not work. Even in the case of paralysis or sensory disorders, the doctor often recommends a surgical procedure, in the course of which the herniated disc is surgically removed.

An important part of treatment: rehab

Even if the symptoms of the herniated disc improve quickly, it is advisable not to simply go back to business. Instead, experts recommend that the therapy be followed by an outpatient or inpatient rehabilitation measure. This includes, among other things Physiotherapy, massages or aqua aerobics, with the help of which the core muscles are strengthened.

In the course of orthopedic rehabilitation, the patient also learns how to feel particularly well in everyday life behave in a back-friendly manner to minimize the risk of another herniated disc. It also makes sense to participate in a so-called Back school to participate. Here, physiotherapists familiarize the participants with various exercises that can easily be carried out inside their own walls.

Who is particularly at risk?

The risk of a herniated disc increases with age at. Because: Over the years, the intervertebral disc loses moisture and its elasticity decreases. As a result, the fibrous ring becomes brittle and one wrong movement can be enough to force the disc out of its correct position.

In addition to older people, people who

  • who regularly lift heavy loads,
  • with desk work,
  • being severely overweight as well
  • with a genetic predisposition

an increased risk of a herniated disc.

Is Prevention Possible?

It is entirely possible to effectively prevent a herniated disc. It is particularly important Avoid being overweight or reduce in order to reduce the load to be borne by the spine.

In addition, the following applies: One strong back muscles is the best prerequisite for preventing a herniated disc from occurring in the first place. Back-friendly sports are, for example, swimming, Nordic walking or cycling. If you decide to ride a bike, however, you will prefer a model with raised handlebars so that you can adopt the most straight, healthy posture possible.

One is at least as important good mattresswhich ensures that the intervertebral discs can regenerate optimally overnight. If you work long hours at your desk every day, you value one ergonomic workplace. In this case, it is also advisable to get up regularly and to stretch extensively to avoid tension. If you are one of those people who often have to lift heavy loads, you should also exercise caution here: never lift heavy weights with a hunched back, always bend your knees. One-sided lifting should also be avoided.


A herniated disc is a painful disease that makes it impossible to take part in everyday life without worries for many weeks. It is therefore all the more important effective prevention with the help of sport and back exercises. Should you nevertheless be caught, follow the instructions of your doctor exactly and include rehabilitation measures after the therapy so that you can Make your life more back-friendly in the long term can.

Last changed on: 07/24/2019

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