Hernia complaints

Training with knee pain

How does a hernia form?

A hernia is a bulging of the intervertebral disc. Between two vertebrae there is an intervertebral disc also called a disc. The intervertebral disc has a cartilage-like ring on the outside with a soft core in the middle, also called the nucleus. This core has the function of absorbing the daily shock load. As we get older, the volume of this core can decrease. The body is then less able to withstand these shock loads. The cartilage-like ring then also becomes less in quality. This can cause the nucleus to come out and put pressure on a nerve. We call this a hernia. The nerve runs from the back to the leg. That is why a hernia can cause complaints in the leg. Common complaints are: pain, tingling, numbness of the skin or even muscle loss. One of the most well-known symptoms is that the pain in the leg is in the foreground. So you generally have more leg pain than back pain. Statistically, men are generally more likely to suffer from a herniated disc than women. The average age is between 30 and 50 years.

Intervertebral disc in case of a hernia
Physiotherapy Tilburg hip problems

What are the symptoms of a hernia?

The complaints can arise in different ways. It can be that the pain appears when you have to pick something up from the ground. It can also gradually get worse over a few days. The most common complaint is lower back pain with radiation to the leg. With a herniated disc there is often more leg pain than low back pain. The place where the core bulges determines where it radiates. This depends on the level of the bulge. Each nerve has its own muscle and radiation area. When the nerve becomes pinched by the bulge, it can disrupt the supply to an area. In addition to pain, there may be tingling or numbness of the skin. In some cases, the muscles can no longer be controlled properly, which is called motor deficiency. The symptoms usually increase with coughing, sneezing or pushing. When this happens, there is an increase in pressure in the abdomen, which in turn increases the pressure on the bulge. Standing or sitting for long periods of time is often unpleasant, so the advice is to change position regularly.

How long will the recovery take?

The prognosis for a hernia is favourable. The part that bulges and causes the symptoms will slowly disappear again. In general, people recover faster from their leg pain. After that, the complaints in the lower back will also decrease. It is important to keep moving during these complaints. A hernia lasts on average a few months. Actively working on your recovery can speed up this process.

What can we do for you?

The important thing is to know how to best deal with these symptoms. A good start is half the battle. Information on the internet is often outdated and causes unnecessary panic. Together we will look at how you can keep moving in a responsible way. When the back moves less well, manual therapy can offer a solution to restore the mobility in the back. Movement has a pain relieving effect and keeps the muscles in condition during the recovery of a herniated disc. The right exercises are important to recover naturally and avoid surgery. More than 80% recover naturally and surgery is not necessary. In case of serious complaints with accompanying symptoms, it is still possible to intervene surgically. Physiotherapy also plays an important role in recovery after surgery. 


Myths about a hernia:

  • Bed rest is necessary
  • Everyone with back pain should have a photo or MRI.
  • A hernia always requires surgery
  • After a hernia, my back will always be a weak spot

Low back & hip specialist Ruben Luijkx

Intervertebral disc in case of a hernia

What can you do yourself?

Because a hernia can cause serious pain, the automatic reaction is often to do little and especially to rest. Now this is certainly important in the first 10 to 14 days. After this phase it is important not to sit or lie still. Make sure you regularly change your position. Do not sit, stand or lie too long. Start with small walks and build this up slowly. If necessary, choose a route where you can sit down for a while. When you are at home it is good to lie down for a while. By lying down other parts of the intervertebral discs are burdened than by sitting or standing. But certainly not for too long or too often. Try not to bend over too often and be careful with lifting. Ask your physiotherapist for suitable exercises and build them up gradually, depending on the pain. If necessary, consult your GP about the right painkillers or anti-inflammatories.

Advices for a hernia:

  • Make sure there is enough variation in lying down, standing, sitting and walking
  • Know that the vast majority of people with a herniated disc recover naturally. Don't panic unnecessarily and trust your body's ability to recover
  • Pain relief can help tremendously to get moving again(consult with your doctor)
  • Look together with your physiotherapist for exercises that suit the recovery phase you are in.
  • The larger the hernia the faster the recovery!
  • The leg pain often resulting from your herniated disc often subsides faster than the back pain itself

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