## Why do hernias form? Stress on the fragile spine when the person is young, caused by excess weight or rapid growth of the skeleton. __Low mobility.__ The spinal disc has no direct blood supply. It receives its nutrition from the adjacent vertebrae through vertical movement, simply by walking. A sedentary lifestyle causes the discs to lose their nutrition, moisture, and elasticity. This ages the discs and causes them to be herniated. __Lifting heavy weights.__ Overtraining and a sharp increase in the amount of weight lifted can cause issues. The spine needs time to adapt. It can also be dangerous when someone who is not strong enough carries everyday items like bags or boxes. This may well turn into a herniated disk, especially if the discs have already been under stress. __Age.__ All the accumulated spinal problems caused by these issues are exacerbated by natural aging. > Hernias occur mostly in the lumbar region between the sacral vertebrae L4–L5 and L5–S1. In the cervical region, they occur in the lower vertebrae C5–C6 and C6–C7. ## What are the signs you might have a hernia? With a herniated disc in the cervical spine, you feel ===a nagging pain in your neck that radiates to one of your arms from your neck to your fingers. Pain increases with physical exertion. With a lumbar hernia, a nagging pain from the sacrum extends down the back of the leg to the little finger or down the side of the leg to the big toe. Sometimes the pain spreads to one buttock or both at once and sometimes weakness in the foot develops. An accurate diagnosis can be made with an MRI scan. But this is not enough, as you need to make sure that the cause of the pain is in the hernia. And if there are several of them, it is important to understand which one is causing the pain. To do this, the neurologist collects a medical history, as well as, checks muscle strength, reflexes, and a number of neurological symptoms. ## Can you exercise if you have a hernia? It is possible, but the choice of exercise is important. Skiing is not desirable because the high load on the lumbar spine can lead to an increase in the hernia. The same applies to barbell squats, deadlifts, and overhead presses. Running should also be avoided because of the impact load. When doing yoga, you should do bends with a straight lower back, and in the gym, it is better to exercise with your own weight or small weights. It is important to regularly strengthen the muscles of the back with gymnastics and swimming. ## Should hernias be removed or not? If possible, hernias should not be removed. The best thing to do is avoid them in the first place. The main symptom is pain, so with an intervertebral hernia (and even in the case of more than one) you can safely live with it if it does not interfere with your life. If the pain is recurrent, the neurologist will prescribe a standard treatment for 1.5-2 months including medication, physical therapy, and possibly wearing a corset. If this does not help, you might need surgery. There is no need to be afraid of surgical intervention. Today there are high-tech and minimally invasive operations like nucleoplasty, endoscopic or microsurgical hernia removal with a puncture of 7 mm, and operations using various implants.