A healthy spine is the key to good health and proper functioning of the whole organism. Unfortunately, the pace of modern life not always get to time for the main "core" of the body. Therefore, more and more young people are faced with such a dangerous ailment like herniated disc of the spine. Let us consider what constitutes pathology and what are the different methods of treatment.
An appointment by a podiatrist, many patients complain of back pain. Most often the reason for this is disc herniation. The disease is a displacement of the disc and the rupture of the fibrous ring, composed of strong collagen fibers. The contents of the disk (purposea -) can begin to compress the spinal cord and nerve roots.
- Acting as a shock absorber, can no longer fulfil its main purpose, which leads to rapid wear of the bone tissue of the vertebrae. Nerves coming from the spinal canal, are strangled. Herniated disc, symptoms of which depend on its localization, not only brings discomfort and pain, but can cause inflammation in the nerve roots and spinal cord membrane. Such a situation often leads to paresis of the lower extremities, impaired urination. It is a heavy consequences, in case of delay in seeking skilled care and lack of proper treatment.
The mechanism of occurrence of a hernia
To the destruction of intervertebral disks lead to degenerative changes (degenerative disc disease), which was primarily due to a sedentary lifestyle. Jelly-like substance contained in the core gradually loses moisture, becoming less elastic. Weak discs are quickly damaged during exercise on the spine. The first step to appearance of hernia – protrusion is a protrusion of uniform (sagging) of the disc outside the vertebra.
Rupture of the fibrous ring occurs immediately, but only after heavy physical exertion. Herniated disc is formed at the time of contact of the nucleus pulposus into the spinal canal.
Stage of education
The process of hernia formation occurs in stages:
- Prolapse is a slight displacement of the disk, which proceeds without visible symptoms.
- Protrusion - a significant protrusion (more than 4 mm) of fibrous tissues of the intervertebral disk beyond the vertebra. Periodically there is pain in the back during prolonged sitting, standing.
- Extrusion is the process where the fibrous ring exploded, and the core starts to come out, gradually forming a drop.
- Sequestration is the most dangerous variant of the development of a situation in which the pulpal nucleus falls into the region of the spinal canal, where the nerves and the solid membrane of the brain itself are located.
What is the reason?
Herniated disc is influenced by a variety of reasons, but the main "culprit" is considered to be osteochondrosis. Degenerative changes of bone and cartilage of the spine can occur at any age. The factors causing irreversible changes include:
- genetic predisposition
- diseases of internal organs
- traumas and injuries of the spine
- dynamic loads;
- sedentary work
- curvature of the spine
- lack of exercise
- infectious pathologies;
- violation of metabolism
- lack of fluids and improper nutrition.
Every year I hear such a diagnosis, an increasing number of young people aged 25-40 years. The reason for this is the lack of proper physical activity, which leads to weakening of the muscle corset back and spine. People whose work involves prolonged sitting (more than 4 hours a day), the risk of disc herniation increases significantly.
Lumbar under pressure
Herniated lumbar disc in medical practice the most common. This is due to the heavy load that you are exposed daily to this spine. Quite often the cause of pathology is pregnancy. Quick weight gain – a serious test for the back. Doctors advise to choose a set of exercises for each trimester of pregnancy to the spine, wearing a corset (or corset), eat right and decrease physical activity.
If a woman already has a lumbar intervertebral disc hernia, you should follow the same guidelines. In the postpartum period, it is important to limit the load and keep your back.
Depending on the localization, the hernia may be located in the cervical, thoracic, lumbar or sacral division of the spinal column. Location relative to the vertebrae hernias are hernias of the following types:
- Median hernia – located at the rear of the spine, it manifests itself on both sides of the vertebra. Difficult surgical treatment due to anatomical features.
- Schmorl's hernia (central) - in this case, it is not the displacement of the vertebrae, but their pressing into the adjacent bone tissue.
- Side hernia – as the name implies, has a side localization and rarely causes typical signs of the disease.
- The posterior disc hernia (dorsal) - protrusion of the nucleus in this case is directed towards the spinal canal. At the same time nerve roots are infringed and pains of varying intensity occur.
- Paramedian hernia - has zadneseralny location, which is fraught with squeezing of the structures of the spinal cord and nerve roots.
Herniated disc: symptoms
Signs depend on the Department in which the spinal column has formed a hernia. Common symptom is back pain. For cervical calving is characterized by the appearance of frequent dizziness and headaches, numbness of fingers, increased blood pressure, possible memory deficits and deterioration of concentration. This pathology is uncommon, but represents a special danger to the patient, as it can affect the blood vessels leading to the brain. Incorrect, sharp movement of the neck can lead to poor circulation.
Herniation of the thoracic patient feels tingling and heart pain can be difficulty breathing. Sometimes there is abdominal pain, problems with urination and bowel movements. To establish an accurate diagnosis in this case for only one patient impossible. Consider that pain may be absent if the bulging disc is directed in the opposite direction from the nerve roots as hernia Shmorlja.
A herniated disc whose symptoms are severe pain (constant or intermittent) in the lower back suggests that perhaps the disease struck the lumbar or sacral region of the spinal column. Typically, patients feel a strong enough pain that radiates to the leg (to the foot) through the gluteal muscle and lateral (or inner) surface of the thigh. Numbness and tingling in the fingers suggests that the hernia compresses the spinal cord.
Strong lower back pain significantly restricts movement, puts strain on the back muscles. If you do not treat this symptomatic pattern to the specialist on time, it is likely that in a year the patient will suffer from incorrect posture, curvature of the spine.
A medical examination should begin with a visit to the doctor. In this case, it is necessary to consult a neurologist. The specialist will conduct a survey and examination of the patient, and then may need additional diagnostics.
Currently, the most informative methods include CT and magnetic resonance imaging. Thanks to these techniques it is possible to know the exact location of the hernia, its size and impact on the spinal canal, nerve roots.
How to treat?
Frequently the treatment of disc herniation is the application of conservative methods, physiotherapy, manual therapy and therapeutic exercises. First of all need drug therapy aimed at relief of pain, elimination of spasm of the muscular system. For this prescribed painkillers and anti-inflammatory (nonsteroidal) drugs: "Movalis", "Diclofenac", "Ibuprofen", "Indometacin", "Meloxicam". Produce painkillers in the form of tablets, gels, and ointments for topical application, injection.
Mandatory components of therapy are vitamins of group B. Under the action of tissue recovered nerves, improves the passage of pulses. To prevent the development of degenerative changes in bone and cartilage, it is necessary to take chondroprotectors: "teraflex", "Arthropod", "Chondroitin", "Rumalon".
Improves blood circulation in the problem area and reduces the stress in muscle tissues receiving muscle relaxants: "Mydocalm", "Venoruton". They are usually combined with non-steroidal anti-inflammatory drugs.
Herniated disc for a long time and successfully treated by this method. He proved a good hand. When executed correctly, the patient will begin to feel relief of pain. This is due to the elimination of the compression of nerve fibers. There are several types of traction (traction) of the spine:
- Hardware traction - is carried out with the help of special simulators and portable devices that allow you to perform the procedure even at home.
- Underwater traction – stretching the spine occurs in the bath or the pool. The upper torso of the patient is fixed in a certain position, and in the pelvic region attached to the cargo. Traction is due to the sagging of the spine.
- Dry traction – the patient is on a special traction table, where the belts will lock to a certain part of the body. To the lower belt, the doctor secures the cargo, the weight of which is calculated individually for each patient. Each time the load will increase and the procedure will return to minimum values.
In each case, the specialist must choose the most appropriate method of exposure to alleviate the symptoms of the disease and improve the patient's quality of life.
Herniated disc: to do the operation?
Only in severe cases, surgical intervention when conservative methods do not provide the positive medical effect. There are certain indications for surgery: failure of pelvic organs, paresis of the lower limbs, weakness of muscles, the size of the herniation is more than 12 mm, sharp pain.
Removal of a herniated disc can be made by one of the following ways:
- Endoscopic is the least traumatic method of removing a herniated disc. The actions of the neurosurgeon are displayed on the monitor, and the image gives an endoscope, inserted through a small incision. The recovery period after such manipulation – up to 3 months.
- Microdiscectomy – currently it is this method prefer, both patients and doctors. The hernia is performed using a surgical microscope through which the surgeon can examine the area of compression of the spinal structures.
- Minimally invasive methods - cauterization, coagulation, cold plasma nucleoplasty, hydroplasty are used to treat hernias of small size (up to 6 mm).