Signs and symptoms
A hernia can manifest itself in various ways. Often it is paired with lower or general back pains and a nasty pain that radiates to the leg, sometimes even as far as the foot. In severe cases, it can cause dysaesthesia (abnormal sensation) and symptoms of paralysis. Over time, the pain can become chronic.
Hernias usually occur in the lower back between the lumbar vertebras. The centre of gravity of the body is near the fifth lumbar vertebra (L5), which is why it is possible for an intervertebral disc to rupture or to bulge out of its outer ring.
The bulge can subsequently compress a nerve, which in turn sends pain signals. Due to the continuous pressure, the nerve swells and is compressed even more, intensifying the pain even more. The nerve is filled with inflammatory cells causing a vicious cycle. The pain becomes worse and worse and can even become chronic.
Pressure of the hernia can also irritate and infect the leg nerve, which causes a fierce pain in the leg. The nerve is compressed in the back, but because it runs to the leg and the foot, the pain signals are sent from there to the brain. That is why it feels as if the pain is in the leg or in the foot. Often, this pain is even worse than the back pain.
Nerves consist of two parts: one part is responsible for sensation (sensible nerve) and the other part is responsible for muscle processing (motor nerve). Dysaesthesia and symptoms of paralysis are a result of pressure on these two parts.
Based on the complaints and a physical examination, a general practitioner can usually establish whether the complaints indicate to a hernia. The GP carries out several specific neurological examinations, such as the straight leg raise (Lasègue test) and toe and ankle dorsiflexion, and tests several reflexes. In addition to the common hamstring reflex, a hernia can have an adverse effect on many more reflexes. The lower leg usually jumps forward when the physician ticks against the hamstring with a rubber hammer, but a compressed nerve in the lower back can disrupt this reflex.
Sometimes, X-rays can show that an intervertebral disc might be torn, and other causes can also be detected this way. Generally, there is not much point in taking an X-ray or scan. Apparently, abnormalities of the back are visible in many people, but most people do not suffer any complaints from these abnormalities. Furthermore, the opposite is also common. People with severe back complaints sometimes show no abnormalities in the X-ray or scan.
An MRI scan has the highest chance of diagnosing a hernia, because it also shows the compressed nerve. All these examinations are only significant if the neurosurgeon thinks that operating is worthwhile. Otherwise, it is just a waste of money.
A hernia is operable, but this is quite invasive. In some cases the problem goes away by itself. In most cases PEA can help a great deal against the pain.
In various clinical trials, nearly 1000 patients with hernia pain were treated with PEA. With PEA, the hernia pain decreased significantly, without the problematic side-effects that often occur with other analgesics.
Usually, people who use PEA notice a decrease in the intensity or severity of the pain in the first couple of weeks. When the pain has clearly decreased, it is important to not immediately stop using PEA.
The fact is that PEA creates a new balance in the nerves and suddenly stopping to use PEA can mean that the pain will return. It is better to reduce the dosage gradually and take a lower dosage for several weeks before stopping (for example, 800 mg PEA and then 400 mg PEA per day).
Because PEA is a 100% natural remedy, it is recommended—in order to get the most out of PEA—to use PEA for at least two months. If after one month, you have the feeling that PEA is not working optimally, you can double the dosage. The use of PEA over a period of two months is a realistic evaluation period. After these two months, you can determine the follow-up treatment. After all, some patients might respond more slowly because the effects of PEA occur through the natural mechanism of the body.
The two most common PEA products on the market are PeaPure, produced by JP Russel Science Ltd, which is a supplement that can be ordered worldwide and PEA tablets, produced by Epitech Group S.r.l., an Italian preparation available in pharmacies in Italy and Spain, among other places.
Hernia: what can you do about pain in your back and/or leg?
Hernia literally means ‘fracture’ or protuberance. In this case, this means that a intervertebral disc protuberates out of the normal intervertebral disc space, usually in the lower back. A hernia in the back is also called a spinal disc herniation. However, hernias can also occur elsewhere in the body, such as in the inguinal canal. Then we speak of a inguinal rupture, which will not be further discussed in this article.
In cases of a hernia, part of the intervertabral disc presses on a nerve root causing complaints such as radiating pain from the lower back, often via the buttocks, to the leg and in some cases even to the foot or toe. The skin might feel differently to the touch (numb or irritated). Sometimes, loss of strength in certain muscles might occur, such as an ankle or toe that cannot be moved properly. These complaints are also called radicular complaints (radix=root) or a radicular syndrome. If there is no clear hernia, but there are back pains and radiation of the pain, then we speak of pseudo-radicular complaints.
A hernia does not always cause back pains. However, it almost always causes pain in the leg. The pain in the leg often increases when coughing, sneezing, squeezing (on the toilet), lifting heavy objects or with certain movements. The complaints are thus dependent on movement and posture.
Most hernias occur in the lower vertebras, in the hollow of the back. These are called the lumbar vertebras and a hernia in this area is therefore known as a lumbar hernia.
There are various types of hernias. For instance, a nerve root in the neck can be compressed, which is called a neck hernia or a cervical hernia. In such cases, the pain radiates to the arm. The skin of the arm can feel tingly or numb and sometimes loss of strength of the arm or hand occurs. Usually, there is no pain in the neck itself.
A hernia can also occur in one of the chest vertebras. These are the vertebras to which the ribs are connected. A thoracic hernia is very rare. The most common complaint in thoracic hernia is loss of strength and sensation in the legs.
In general, a hernia is not dangerous. In cases of paralysis symptoms or loss of bladder or bowel control, it is important to seek medical help as soon as possible.
A hernia does not always cause complaints. It appears there are people who have a hernia without being aware of it.