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Fysiotherapie bij hernia klachten.

Een hernia is een uitstulping van de tussenwervelschijf. Tussen twee wervels in bevindt zich een tussenwervelschijf ook wel discus genoemd. De tussenwervelschijf heeft aan de buitenkant een kraakbeenachtige ring met in het midden een zachte kern ook wel de nucleus genoemd. Deze kern heeft als functie om de dagelijkse schokbelasting te absorberen. Wanneer we ouder worden kan het volume van deze kern minder worden. Het lichaam kan dan minder goed deze schokbelasting weerstaan. De kraakbeenachtige ring wordt dan ook minder van kwaliteit. Hierdoor kan het zo zijn dat de kern naar buiten komt en druk geeft op een zenuw. Dit noemen we een hernia. De zenuw loopt vanuit de rug naar het been toe. Vandaar dat een hernia voor klachten in het been kan zorgen. 

Trochantor major syndrome

Veelvoorkomende klachten zijn: pijn, tintelingen, doof gevoel van de huid of zelfs uitval van spieren. Een van de meest bekende symptomen is dat de pijn in het been op de voorgrond staat. Je hebt dus over het algemeen meer beenpijn dan rugpijn. Statistisch gezien hebben over het algemeen mannen vaker last van een hernia dan vrouwen. De gemiddelde leeftijd ligt tussen de 30 en 50 jaar.

Physiotherapy Tilburg hip pain

What symptoms are associated with a herniated disc?

The symptoms can occur in different ways. It may be that the pain kicks in during when you have to pick something up off 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. Where the core bulges out determines where it radiates. So this is down to the level of the bulge. Each nerve has its own muscle and radiating area. When the nerve becomes pinched by the bulge, it can interfere with the care of an area. In addition to pain, there may be tingling or numbness of the skin. In some cases, muscles can no longer be properly controlled, which is referred to as motor failure. The symptoms usually increase with coughing, sneezing or squeezing. 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 is often uncomfortable and the advice is to change positions regularly.

How long does recovery take?

The prognosis of a herniated disc is favorable. The part that bulges and causes the symptoms will slowly disappear. In general, people recover faster from their leg pain. After that, the symptoms in the low back also decrease. It is important to keep moving during these symptoms. On average, a herniated disc lasts several months. Actively working on your recovery can speed up this process.

What can we do for you?

The most important thing is to know how best to deal with these symptoms. A good start is half the battle. Information on the Internet is often outdated and causes unnecessary panic. Together we look at how you can keep moving responsibly again with specific advice. When the back is less mobile, manual therapy can offer a solution to restore the mobility in the back. Movement has a pain-relieving effect and keeps the muscles in shape during recovery from a herniated disc. Proper exercises are important to recover naturally and avoid surgery. More than 80% recover naturally an operation is then not necessary. For severe complaints with matching symptoms it is still possible to intervene surgically. Physical therapy also plays an important role in recovery after surgery. 


Fables with a herniated disc:

  • Bed rest is necessary
  • Anyone with back pain should have an image or MRI taken
  • A hernia always requires surgery
  • After a herniated disc my back always remains a weak spot

Low back & hip specialist Ruben Luijkx

Intervertebral disc in a herniated disc

What can you do yourself?

Because a herniated disc can cause serious pain, often the automatic reaction is to do little and especially to take 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 change your posture regularly. Do not sit, stand or lie down for too long. Start by walking small distances and build up slowly. If necessary, choose a route where you can sit down for a while. When you are at home it is a good idea to lie down. Lying down puts strain on other parts of the intervertebral disc than 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 physical therapist for appropriate exercises and build up slowly as the pain progresses. If necessary, consult with your doctor about appropriate painkillers or anti-inflammatories.

Advice for a herniated disc:

  • Provide adequate variety in lying, standing, sitting and walking
  • Know that the vast majority of people with herniated discs 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 with your physical therapist for exercises that fit 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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