Intervertebral disc herniation: treatment and surgery in Tashkent

Other names: Межпозвоночная грыжа, протрузия диска, грыжа поясничного отдела, секвестр диска

A herniated disc is the release of the internal contents of the disc beyond its outer ring. The diagnosis sounds alarming, and most patients immediately think about surgery. In reality, the picture is different: a significant proportion of hernias exist asymptomatically, and of those that cause pain, the majority resolve conservatively within 6-12 weeks. Moreover, large hernias and sequesters often decrease or completely resolve on their own - the body “digests” them. Surgery is necessary for a minority, but there are a few situations where delay is unacceptable.

🧾 МКБ-10: M50–M51 🏥 Where it is treated: 3 May resolve on its ownA minority need surgeryPonytail - watch

👨‍⚕️ Which doctor

Neurologist, neurosurgeon

🔬 Diagnostics

MRI of the spine

💊 Treatment

Conservative; operation according to indications

📈 Prognosis

Improvement for most within 6–12 weeks

⚠️ At risk

Age 30–50, exercise, smoking, weight

⏱ When to see a doctor

For pelvic disorders - urgently

🚨 See a doctor urgently

With these signs do not wait for a scheduled appointment — the condition requires emergency care.

Нарушение мочеиспускания или дефекации, онемение промежности — синдром конского хвоста, счёт на часы
Нарастающая слабость в стопе, «шлёпающая» походка
Быстрое нарастание неврологического дефицита
Двусторонняя боль и слабость в ногах
Боль с температурой и ознобом
Грыжа шейного отдела со слабостью в руках и нарушением походки

Protrusion, hernia, sequestration

Protrusion: protrusion of the disc without rupture of the outer ring. Often asymptomatic and found incidentally
Extrusion (actual hernia): the contents of the disc extend beyond the ring
Sequestration: a fragment has separated and moved. Paradoxically, it is the sequesters that most often resolve on their own

Размер грыжи слабо связан с силой боли. Небольшая грыжа, сдавливающая корешок, может болеть сильнее крупной, расположенной центрально.

Symptoms

Lumbar: pain in the lower back with shooting in the buttock and down the leg below the knee, numbness, weakness of the foot; worse when coughing, sneezing, bending over
Cervical region: neck pain radiating into the arm to the fingers, numbness of specific fingers, hand weakness
Increased pain with prolonged sitting, relief when walking or lying down
Forced posture, distortion of the body

Treatment: why conservative first

Most patients experience significant pain relief within 6 to 12 weeks without surgery. Studies show that after one year, the results of operated and non-operated patients are comparable - provided there are no neurological deficits.

Staying active instead of bed rest
NSAIDs for a short course, for neuropathic pain - special drugs
Muscle relaxants for spasms
Therapeutic blockades for intense pain
Therapeutic exercise after acute pain subsides is the main method of preventing relapse
Physiotherapy as an auxiliary method

When is surgery necessary?

Синдром конского хвоста: нарушение мочеиспускания и дефекации, онемение промежности — экстренная операция, счёт идёт на часы.
Нарастающая слабость в конечности — операция в ближайшие дни.
Стойкая выраженная боль, не отвечающая на полноценное консервативное лечение в течение 6–12 недель.
Стеноз позвоночного канала с выраженным ограничением ходьбы.

Modern interventions are minimally invasive: microdiscectomy through a small incision, endoscopic methods. Hospitalization is short, you are allowed to get up on the first day. However, the operation eliminates compression of the root, but does not treat the spine itself - therefore, exercises after it are mandatory.

Prevention of relapse

Regular exercises for the back and abdominal muscles are the main factor
Proper lifting technique, avoiding twisting lifts
Weight control
Changing posture during sedentary work, lumbar support
Quitting smoking: it impairs the nutrition of discs
Swimming and walking as regular exercise

Frequently asked questions: Intervertebral disc herniation

Can a hernia resolve on its own?+

Yes, and this is not uncommon. Large hernias and especially sequesters decrease or disappear over time: the body gradually resorbs them. Therefore, there is no need to rush into surgery if there is no deficiency.

Does a hernia always hurt?+

No. A significant proportion of hernias are discovered incidentally in people without pain. It is not the findings in the image that require treatment, but the symptoms - pain along the nerve, numbness, weakness.

When is urgent surgery needed?+

For cauda equina syndrome—impaired urination and defecation, numbness of the perineum. Here the clock counts. Also with rapidly increasing weakness in the leg.

Does spinal traction help?+

There is no convincing evidence that traction is effective for disc herniation. Maintaining activity, pain relief in the acute period, and physical therapy work reliably.

Will the hernia return after surgery?+

Recurrence is possible, so after surgery, muscle strengthening exercises, weight control and proper lifting technique are mandatory. The operation removes the compression, but does not change the condition of the spine as a whole.

The information on this page is for reference only and does not replace a doctor consultation. Only a qualified specialist can make a diagnosis and prescribe treatment after an in-person examination.