Protrusion and hernia of the intervertebral disc: what is the difference. Diagnosis and treatment methods

The intervertebral disc is a part of spinal column that absorbs pressure appearing of the person’s move and other physical activity. It performs its function on the proper way only if it takes a position clearly defined by nature. Degenerative processes change the location of the intervertebral disc, which in the best case leads to discomfort, and in the worst – to severe pain and patient’s immobilization. 

The displacement of the intervertebral disc  load causes two conditions – protrusion and hernia. They are often confused, since the same causes lead to thedisease development. However, the answer whether “protrusion means hernia ” is clear – no. Let’s consider their differences, symptoms, diagnosis and treatment methods.

Protrusion and hernia: what is the difference?

In fact, protrusion is the first stage of discal hernia formation. Under the influence of degenerative processes the disc shifts slightly, but does not break the fibrous ring in which it is located. It is extremely important to seek help with a doctor at this stage, because with protrusion you can use the whole range of therapeutic measures, and in 95% of cases they produce the desired effect. You can’t help restoring the normal disc state during protrusion: for example, after serious injuries.

Usually protrusion has a size of 1-4 mm, but more serious protrusions also occur. According to the statistics, it occurs in 50-60% of men after 40 years of age. In women the disease is less common, probably due to less physical activity. Most often, protrusion affects the lower part of lumbar spine.

There is an opinion that protrusion is uncritical, and it is not always necessary to treat it. It is not true. Protrusion is an indicator that a degenerative process is started in the spine. In most cases it is progressive. In other words, protrusion develops and subsequently leads to hernia, which is much more difficult to treat.

As previously noted, the disk is displaced in protrusion, but the fibrous ring remains intact. If the patient is not treated, protrusion turns into extrusion, that is, the ring breaks, and the intervertebral disc protrudes outward. This is hernia.

Can protrusion become a hernia? Yes. But not always the intervertebral disc hernia is a consequence of protrusion. The fibrous ring can rupture due to injury, fall, sharp heavy object lifting. In this case you need to consult a doctor, and not just because this condition reduces the quality of life. The formation of hernia triggers an autoimmune process: the disc contents are perceived as a threat by immune system, therefore, antibody production begins. An inflammatory process develops, and healthy intervertebral discs suffer.

If the fibrous ring breaks completely, sequestration occurs. This is a disc fragment prolapse that is no longer associated with pulpous nucleus. This condition is especially dangerous. The element can squeeze the nerve roots, which will cause severe pain, as well as persistent damage to the corresponding structures.

Discal Hernia and Protrusion Causes 

• Genetic predisposition. Due to this factor a hernia can occur even in a child. This happens because of protein defect that make up the disk.
• Age-related changes. At young age the intervertebral disc is elastic and soft. As time passed the tissue is getting old, and the disc “becomes stiff”. It loses moisture, becomes less elastic. Shock absorbing capabilities are worsened, and the risk of disk injury increases.
• Injuries. Damaging mechanical effect can result in protrusion or hernia. Especially dangerous are spinal blows and strong buttocks falls (an instant discs compression). This also includes fibrous ring injury as a result of a sharp weight lifting. 
• Hypodynamia. Noteworthy, that the intervertebral discs suffer more if a person is inactive than when in physical activity. This applies to the sitting position, in which most modern people spend a lot of time. The intervertebral discs are under severe stress, which adversely affects the shock absorbing properties. In addition, the intervertebral disc does not receive moisture from surrounding muscles, since they are under the influence of spasm due to a static position. This leads to tissue wear and aging.
• Exercising, which implies a heavy disc stocking. For example, golf, hammer throwing. The athlete “twists” the body, resulting in hernia or protrusion.
• Overweight. Excess kilograms increase the load on the spine.
• Smoking. It is not the reason, but the catalyst. Because of smoking the amount of oxygen in blood decreases, this negatively affects the tissues condition.

Symptoms of protrusion

• Back Pain: from light whining to severe pain.
• Pain spreading to the limbs.
• Tingling in the spine, arms and legs.
• Numbness of the limbs.
• Weakness in the arms or legs.
• Limitation of neck motion (if the cervical spine is affected);
• Pain between the shoulder blades.
• Rarely bladder disturbances (if the lumbar spine is affected).

Symptoms depend on size and localization of protrusion. If the fibrous ring is strong, protrusion can reach 10 mm without going into extrusion. Any way, any regular back- or limb ache should be the reason to visit the doctor.

Hernia symptoms

• Severe pain in the lower back or limbs, chest, neck.
• Periodical acute pain attacks which can be removed with medication only.
• Inability to perform some work types due to severe pain during physical activity (for example, lifting things from the floor, cleaning).
• Numbness of fingers.
• Headache, dizziness.
• Blood pressure spikes.

Similar to protrusion, symptoms may vary depending on location, causes, and size of hernia. Most often, there are three types of hernias. Let’s consider them:

• Ventral (frontal). The intervertebral disc protrudes forward, affecting the anterior spinal ligament
• Lateral (foraminal). Such hernias squeeze spinal nerves.
• Rear (dorsal). Spinal cord tissue is compressed.

Hernia may arise in any direction, and the symptoms are different. You can determine the type of intervertebral disc hernia after MRI test.

Protrusion and Discal Hernia Diagnosis 

The most effective diagnostic method is MRI. Tomography allows you to determine the protrusion or hernia location, tissues and nerves damage degree. In case of hernia MRI makes it possible to detect its orientation and size.

Computed tomography provides information about bones condition, but this method is ineffective in diagnosing soft tissues condition. If necessary, an auxiliary method can be applied. Radiography and ultrasound are also used.

Protrusion treatment

The treatment of both diseases is complex. The doctor develops therapy after a thorough diagnosis, because should consider many features of hernia or protrusion, as well as the patient’s body as a whole.

A therapeutic massage is prescribed to relieve swelling and inflammation. Physiotherapeutic procedures, such as magnetotherapy, are also applied. To restore the full functioning of musculoskeletal system, patient may be assigned to work on simulators. Exercise therapy helps to strengthen the dorsal muscle sling and restore muscle tone. To eliminate pain, relieve stress, neutralize the inflammatory process, medical treatment is used.

Metamer treatment methods have proven their effectiveness. Metamer massage therapy eliminates cramping and pain, improves blood circulation, normalizes the intervertebral discs nutrition with useful substances, liquid. Metameric injections are also used, which allow you to directly affect the disease areas.

There are many effective methods. It is important to correctly develop еру treatment method, choosing the right combination. Our specialists at Bersenev’s Medical Centre know exactly what protrusion is and the ways if treating it. Clinic physicians will conduct a thorough diagnosis, and then develop a therapy taking into account individual characteristics of the patient. Treatment can be carried out at home between the courses of metameric injections. The function of the intervertebral disc can be restored If the patient follows the doctor’s recommendations.

Discal Hernia Treatment

If necessary, a bed rest is prescribed for the patient during treatment. Medicinal treatment is to apply medicine described above. Patients are prescribed acupressure, acupuncture. Metameric methods of treatment are used: massage, injections.

After pain syndrome removal you can proceed with physical therapy and other motor treatment methods.

If the patient seeks help shortly after the symptoms are detected, conservative treatment gives result in approximately 85% of cases. If it has not produced the desired effect, you have to resort to surgical intervention. The operation is carried out only in case of urgency.

Conclusion

To avoid the operating table, it is important to monitor your spine condition, heeding “warning signs”. This is especially true for people after 40 years of age. At the protrusion stage the problem is most easily eliminated, but hernia is not a sentence. It is important to find an experienced doctor who has access to modern methods of diagnosis and treatment. Protrusion or hernia is relatively harmless disease, if properly treated. Physicians of Bersenev’s Medical Centre know the ways of its treating.