Hernia surgery

A back hernia is a bulge of an intervertebral disc. Symptoms that may accompany a hernia are numbness, weakness, and painful or tingling radiation in the leg. These symptoms arise when the bulge presses on a nerve. A hernia can be treated with an operation, although this is not always necessary.

If you first want to read more about what a hernia is exactly, read the article on the lumbar hernia and the cervical hernia.

What treatment options are there for a hernia?

Most hernias are not operated on. Except for more serious cases, the first attempt is always to treat the hernia conservatively. This means with rest, pain medication and/or physiotherapy. In practice, it has been shown that in 70 to 80 percent of hernias this treatment is sufficient to reduce or even resolve the bulge. In many cases, there is also an inflammation at the nerve root, which will heal further with rest.

In some cases, the orthopaedic surgeon or neurologist will advise an operation. Factors that contribute to this decision are: when the symptoms have lasted longer than six months or there is muscle weakness, for example a foot drop. In severe pressure on the nerve, where there is a risk of permanent damage and unbearable pain, surgery will be considered.

Before the operation

If an operation is chosen, it is advisable to start the physiotherapy treatment programme preoperatively, before the operation date. An important focus is to go into the operation in optimal health ('better in, better out'). There will also be the necessary attention for the first period after the operation (postoperatively).

The physiotherapist will help with advice and guidance in learning correct postural patterns or learning to walk with crutches. Another focus is moving within the pain threshold, actively or passively, and, as far as possible, reducing pain symptoms.

During the operation

Depending on the location of the hernia, a prone position is chosen. If necessary, a roll is placed under the abdomen to flex the back slightly. In general, the procedure is performed under general anaesthesia. During the procedure, the orthopaedic surgeon will try to remove the bulge in its entirety.

After the operation

On the first day after the operation, the physiotherapy treatment will continue, still in the hospital. In general, people may go home a few days after the operation to continue rehabilitation there. There are strict lifestyle rules, especially in the first few weeks after the operation. It is important not to lift heavy objects and to get sufficient rest.

Under the guidance of the physiotherapist, the load will be built up slowly. In general, it is recommended to allow at least six months before resuming heavy work and sport.