Understanding Hernias: Surgery or Waiting – What's Best

In essence, back pain is an ongoing discomfort, a constant companion for some. But what triggers this? Let's unravel the mystery.

The human musculoskeletal system, our structural framework, has evolved to suit bipedal motion, standing tall on two legs. Yet, there are moments when it appears to yearn for the days of yore, those tree-climbing adventures of our distant past. Consider the lats (broad back) muscles, now a domain of bodybuilders or intrepid mountaineers.

Our spine, our support, was designed to absorb the impact of walking, bounce during running, and handle other active, sudden movements. It's a bit like a hybrid of a spring and a shock absorber. That's why our vertebral column has curves and elastic "cushions" between the vertebrae - the intervertebral discs.

However, our Creator, in crafting this human biomechanics masterpiece, did not foresee the intricacies of our modern lifestyle or the prolonged hours spent hunched over computers. Our necks weren't intended to function merely as tripods for our eyes, and the vertebral column was never meant to be a mere pillar.

The World Health Organization (WHO) statistics strike a direct blow to the back: 1.4 billion adult inhabitants of the planet live a sedentary lifestyle. Almost one in four men and one in three women lack physical activity due to sedentary work, daily traffic jams, standing in public transport, queues in stores, and clinics... It's why sciatic nerve compression can happen.

But this is enough to disturb one's posture, lead to muscle tension, and bring constant back pain along. You or someone you know likely experiences back pain or discomfort, numbness in limbs, acute headaches, ringing in the ears, and floaters in the eyes. People have become so accustomed to these symptoms that they simply adapt to them in daily life: they use extra pillows, shift to the other side, wear lumbar belts, apply advertised ointments, take painkillers.

Back pain is the most common cause of disability among people under 45 in Europe and the USA. Signs of depression are reported in 60-100% of people suffering from chronic back pain, which often leads to panic attacks, and many don't know how to cope with them, even though it's all written here. Enduring pain is not an option for anyone - it doesn't matter how young you are and that it's "nothing serious."

Timely MRI and consultation with a specialist can save years of mobility and prevent irreversible consequences. For example, paralysis. 80% of people who eventually see a specialist worsen their spine problems through self-treatment. As long as a person lives with pain and "applies ointment," changes occur in their bone, cartilage, and nervous tissues, often irreversible.

A staggering 92% of all back pain cases stem from spasms in the paravertebral muscles. Even by the age of 30, almost everyone harbors an intervertebral disc herniation, albeit minor, at around 3mm. The intervertebral disc boasts a sturdy fibrous ring housing a gel-like nucleus pulposus. Cartilage envelops the disc from above and below.

Discs prevent contact and wear between vertebrae. If an intervertebral disc is subjected to significant and prolonged pressure, it undergoes degenerative changes. The fibrous ring gradually deforms, becoming uneven in thickness. Meanwhile, the nucleus pulposus continues to be exposed to stress.

In regions where the thinned fibrous ring weakens, the nucleus asserts its presence beyond the vertebral boundaries. This projection is what we call a protrusion. Typically, a protrusion leads a quiet existence, without sounding alarms. The peril lies in a person's lack of awareness regarding the looming danger. With time, the protrusion expands, where it's thinnest, it might eventually rupture the fibrous ring. And voila, a hernia is born.

Herniated discs occur when the inner core pushes through the outer layer. This can lead to the compression of spinal nerves or the spinal cord itself, resulting in pain and various other symptoms. Herniated discs can be categorized into four stages:

1. Prolapse: The inner core protrudes by 2-3 mm.
2. Extrusion: The disc extends by 4-15 mm.
3. Sequestration: The fibrous outer ring ruptures, causing the inner core to exit beyond the spinal column.
4. Fragmentation: The herniated disc breaks into pieces.

Progressing through these stages can take five to ten years. However, it's vital to understand that not all herniated discs necessitate surgery, especially during the early stages.

When Surgery Becomes a Necessity

In cases where the herniated disc severely compresses the spinal cord or nerves, leading to severe pain, immobility, limb dysfunction, dizziness, temporary paralysis, or organ dysfunction, surgery is often the only viable option. These advanced stages leave little room for non-surgical treatments to succeed.

Surgery for a herniated disc is an intricate procedure. It involves removing the protruding part of the disc and up to 20% of adjacent tissues. The surgeon must strike a delicate balance. They must preserve enough of the disc to maintain its role as a cushion between the vertebrae while ensuring that the removed portion is substantial enough to prevent a recurrence of the herniation.

Surgical intervention on the spine is physically traumatic. Beyond the risk of infection, it entails extensive dissection of living tissues, prolonged hospital stays, and an extended recovery period. Moreover, the spine's proximity to crucial neural pathways leaves little room to limit the scope of surgery, subjecting the body to substantial trauma.

Non-Invasive Treatments

The foundation of spinal treatment at these stages is the rehabilitation of the surrounding muscles. A hernia occurs because your muscles are pressing on the disc. So, treating the spine involves treating the muscles.

First, the focus should be on relieving muscle spasms. Cordus is a key player in this regard, and the reason it's your go-to solution is detailed extensively here.

The most effective approach to relax muscles is to target the proprioceptors - sensors responsible for relaxation. Activation of these sensors initiates muscle relaxation. The intervention needs to be localized and direct, pressing directly on the area. It also needs to be deep (approximately 24-28 mm) since the paraspinal muscles are deep. While one intervention may not produce radical change, several weeks of treatment will yield results.

The third stage of treatment involves gentle spinal traction. Hernias develop when there is excessive pressure on the intervertebral disc. Spinal traction creates additional space for the disc, alleviates decompression, and enables the hernia to retract. To achieve a significant effect, around a month of treatment sessions is typically required.

Devices like Cordus and Sacrus exert their anatomical peaks gently into the muscles, driven by the individual's body weight. The body itself regulates the permissible pressure, emphasizing the naturalness and safety of these methods.

So, before jumping to the conclusion that surgery is the only option for your herniated disc, consider exploring these non-invasive methods. Only in the most severe cases is surgery the unequivocal choice. In many instances, taking a balanced approach that respects the delicate balance of the spine can lead to more effective and less traumatic solutions for herniated discs.