This disease, first of all, signals about serious changes in the musculoskeletal system. Basically, this disease is a consequence of the development of one of the stages of osteochondrosis.
At the same time, protrusion is the initial form of an intervertebral hernia. The main and first symptom of it is acute pain in the affected area. In this case, the displaced discs interact on the spinal roots, as well as on the spinal cord itself.
If a person does not seek medical help in time, he risks getting a more serious disease - an intervertebral hernia, which in the end will have much worse consequences. Also, protrusion of the spine, which develops into a hernia, is much more difficult to be treated and very dangerous for human health.
The appearance of protrusion is accompanied by dystrophic changes in the fibrous ring of intervertebral disks, that is, in other words, their structure changes, elasticity is lost, as a result of which the disk flattens and bulges beyond the vertebra. But it should be noted that the fibrous disc retains its shape and integrity, so that the gelatinous core remains inside.
Spinal protrusion can be of several levels of difficulty:
1. Bulging from 0 to 3 millimeters is not the cause of any discomfort, and has no harmful effects,
2. The protrusion from 3 to 5 millimeters is a condition that is often accompanied by discomfort and frequent pain. Especially they appear with heavy physical exertion.
3. The protrusion of 5 millimeters - this condition is regarded as an intervertebral hernia.
The causes of the protrusion
To date, there are several main reasons that lead to the appearance of protrusion of the lumbar spine. These reasons include:
- poor posture,
- insufficient development of the muscular structure of the body,
- hereditary predisposition
- failure of metabolic processes of the body,
- age changes
- large irrational loads on the back and spine,
- the presence of severe infectious diseases of the body.
As already mentioned, the most common posture diseases are protrusions. What it is, is clear to all, but few know how to prevent the occurrence of this disease.
Stages of protrusion formation
To date, doctors have identified several stages of protrusion formation:
- At the first stage, up to 70% of the structure of intervertebral discs (disk) is destroyed. They lose their elasticity and cracks form in the fibrous membrane. This stage is manifested by sharp local pains in the affected area.
- The second stage of the disease is characterized by disc protrusion. At the same time, the pulpous nucleus moves from the center to the edge, thus, fibrous disc tissues are stretched. At this stage, the disc bulges up to 2-3 millimeters, as a result, sharp pain and discomfort in the transverse section can be felt.
- The last stage is characterized by a strong protrusion of the spinal disc. In such a case, disc fibrosis and vertebral hernia are ruptured, pain can occur in the affected area and various neurological disorders, such as numbness of the extremities, can occur.
Classification of protrusions
It is known that one of the most common diseases of the spine are protrusions. What it is, and what are the reasons for their appearance is already clear. Let's find out by what parameters this disease is classified.
So, protrusion is classified by type, type of protrusion and location.
- By type of protrusion are classified into circular and diffuse.
- Diffuse protrusion is a chronic type of disease. With this type of disc bulges unevenly. If you do not cure this disease in time, then sooner or later it will lead to disability and disability.
- Circular protrusion - when the intervertebral disc bulges evenly. In this type of nerve infringement occurs, which causes the development of neurological symptoms - the emergence of pain, numbness of the nervous limbs.
2. The protrusion of the lumbar spine is divided according to the type of protrusion:
- Central protrusion (median) - protrusion occurs in the direction of the center of the spinal canal. In most cases, the disease of this type has no manifestations, but there is a great risk, since the impact on the spinal cord can lead to disruption of its work.
- Posterior protrusion - protrusion of intervertebral discs occurs from the abdomen to the back. Very often, this kind of negative effect on the spinal cord, which leads to a violation of its functionality. It feels severe pain in the affected area, a violation of sensitivity, in some cases a violation of the functionality of the pelvic organs.
- Lateral protrusion (lateral) - the disc protrudes to the right or left side relative to the spine. It can cause the formation of spinal roots. Until the nerves are harmed, the disease has no symptoms.
- Posterior lateral intervertebral protrusion (posterior lateral) - intervertebral discs protrude back to back and to the right or left side. It has a harmful interaction on the roots and structure of the spinal cord. Until the moment of nerve crushing, there are no symptoms.
3. The disease is subdivided by location: cervical, thoracic and lumbar protrusion.
Cervical protrusions very often lead to the development of a wide variety of complications that can provoke a spinal overload. The consequence of this may be the formation of new protrusions, and as a result - the development of intervertebral hernia. The following symptoms can signal the appearance of this disease:
Local neck pains of a chronic or acute nature.
- Restriction of neck mobility.
- Manifestations of headaches, dizziness.
- Pain radiating along arm.
- Numbness and tingling in hands.
- Weakness in the muscles of the shoulders and arms.
Thoracic disc protrusion
Because of the structure of the human skeleton, protrusion in the thoracic region is very rare. The following symptoms may indicate the appearance of this disease in the thoracic region:
- Chronic or acute pains in the thoracic spine, discomfort.
- Chronic pain in the intercostal space or between the shoulder blades.
- Tingling in the abdomen and chest, numbness of the limbs and impaired sensitivity.
- Failure of the organs that are located in the affected area (heart, liver).
- Weakness in the muscles of the press.
It is known that this disease is most often found in the lumbar spine. This is due to the fact that this particular area of the back is constantly subjected to large dynamic and statistical loads. Protrusion of the lumbar spine is most often accompanied by:
Chronic and acute pain in the lumbar region.
- The presence of painful and constrained sensations in the lumbosacral area.
- The formation of sciatica.
- The manifestation of weakness in the legs.
- Violation of the sensitivity of individual parts of the body - numbness, goose bumps, tingling.
- The appearance of irradiation of pain in one or both legs.
- In certain cases, the activity of the urinary and genital organs may also be impaired.
Symptoms of protrusion
The symptoms of this disease are directly dependent on which particular disk is damaged. But until such time as the disc of various spinal nerves is pinched by the disc, protrusion can occur absolutely without any symptoms.
In general, the symptoms of protrusion can always manifest themselves with different strengths, it all depends on how irritated the spinal cord is and the nervous system is affected by the intervertebral disk. The most common symptom of protrusion is severe pain in the affected area, which may eventually lead to a violation of sensitivity.
In addition, it is also possible to determine a number of other indicators that may indicate the presence of protrusion:
- Chronic or acute pain in the affected area (neck, lower back, thoracic spine).
- The presence of migrating and radiating pains.
- The manifestation of sciatica.
- Loss of muscle elasticity and weakening of the muscular system in the affected area.
- Loss of sensitivity of individual upper and lower limbs.
- Presence of stiffness and burning in the affected area.
- Decrease in the sensitivity of the organs of hearing, vision, manifestation of headaches, dizziness.
The most frequently degraded intervertebral discs
Protrusion of the l5, L4 / S1 disc occurs most frequently, since it is these discs that are subjected to the greatest load when performing any actions. L5, L4 are spinal intervertebral discs that are located in the lumbar region. When lifting weights or when sitting there is a lot of pressure on these discs, which causes their degradation. S1 is the first disc from the pelvic bone, which is also often subjected to stress. For these reasons, these discs most often degrade.
As practice shows, there are practically no tangible symptoms of protrusion before the age of 30, basically all of them occur just after this age, since it is during this period that the human body undergoes a large number of interactions that adversely affect his health.
Diagnosis of the disease
Diagnosis of symptoms of protrusion usually begins with a physical examination of the patient by the attending physician. For this, experts use a series of manual tests that allow you to determine the affected area. If intervertebral protrusions are suspected, additional examination is prescribed to the patient - ultrasound, MRI, CG, EMG, X-ray, and so on. X-rays can determine the complexity of the disease, MRI to establish compression of the nerve bundles, and the magnitude of damage to the nerve fibers helps to learn EMG.
From the above, it can be concluded that protrusion is a very common and dangerous health condition. Therefore, her treatment should be carried out under the supervision of experienced doctors.
The treatment of protrusion is a complex of various procedures. They should be aimed at relieving pain, swelling of tissues, restoring motor functions and normalizing sensitivity.
In order to forget what protrusion is, treatment must also be carried out with the help of various medical preparations. Today, various analgesics, muscle relaxants, and anti-inflammatory drugs are used for complete healing and recovery.
Also a great help in the treatment of this disease is provided by special massages that can only be done by highly qualified specialists.
Ways to prevent the occurrence of protrusion
As mentioned above, one of the most terrible diseases is protrusions. What it is and how they appear is already clear. But there are ways that can significantly reduce the possibility of this disease.
It is not hard to guess that the lumbar protrusion in most cases is due to the deformation of the intervertebral discs, therefore it is necessary to constantly strengthen your back while playing sports, namely athletics. This sport contributes to the strengthening of muscle mass and ligaments, which, in fact, keep the whole structure of the back.
Conclusion: one of the common diseases of the back, with which every second person lives today, is protrusion. Treatment of this disease is simply necessary in order to avoid the painful back pain, numbness of the extremities, headaches and allow yourself to work normally, relax and lead an active lifestyle.
Features of the disease
The disks are located between the vertebrae and play the role of shock absorbers (gaskets). They reduce the friction of the vertebrae themselves among themselves and thereby prolong their “service” period. The discs themselves have a dual structure:
- Inside is a watery (pulpous) core, it consists of collagen and special molecules that hold water.
- On top of the core is enclosed in a shell - a fibrous ring of collagen fibers, very durable.
In the initial stages of osteochondrosis, the position of the vertebrae changes relatively natural, which creates additional stress on the entire spinal column. In places of the most intensive movement of the vertebrae, these loads on the disks increase significantly.
The disks themselves do not have their circulatory system and feed diffusely due to the surrounding tissues. When the displacement of the vertebrae disrupts the nutrition of the disks, which leads to the thinning of their outer shell.
The result of this process is the displacement of the nucleus towards thinning. A kind of protrusion of the nucleus beyond the limits of the vertebra appears - physicians call this protrusion protrusion.
Protrusion is the initial stage of a hernia. But its development at this stage can still be stopped by conservative methods, while the hernia is treated only surgically.
The intervertebral disc is a collection of gelatinous pulpous nucleus and fibrous ring consisting of connective and fibrocartilaginous tissue. Degenerative processes lead to a thinning of the fibrous ring, a decrease in elasticity, and the appearance of cracks.
As a result, the core located inside the ring begins to shift and a protrusion is formed, that is, a protrusion of the disk. In this case, the internal fibers of the annulus are damaged. As for the preserved outer fibers, they form a movable fragment of the intervertebral disk.
The resulting protrusion goes into the spinal canal., which leads to irritation / pinching of vessels and nerves located there. In some cases, in addition to squeezing the nerve, the stability of the spinal segment is disturbed.
Disc protrusion - displacement of the pulpal nucleus of the disc towards the spinal canal
If untreated, a rupture (damage to the outer fibers) of the fibrous ring occurs, and the intervertebral disc falls into the spinal canal. This phenomenon is called intervertebral hernia.
ICD code 10
Protrusions and hernias of intervertebral disks receive codes according to ICD 10 in accordance with the location of the cartilage intervertebral disks and the type of their lesion. So, pathology of the cervical region, not related to injuries, in the official medical documentation are indicated by code M50. Such a designation can be used in statistical reporting sheets, temporary disability lists (the “diagnosis” field), as well as in some areas of instrumental control methods. As for the formations located in the thoracic, sacral and lumbar regions, they are denoted by the code M51.
Depending on the localization, the pathological process in the intervertebral disc may be called protrusion.:
Depending on how the fibrous ring protrudes relative to the spine, protrusions can be:
The protrusion of the intervertebral disc goes through 3 stages and is classified according to the direction of protrusion.
There are several stages of protrusion development.:
- First. The fibrous ring is covered with cracks, the density and structure of the intervertebral disc change, the first symptoms of the disease occur.
- The second. The disc bulges 2-5 mm (depending on the vertebra). The patient complains of pain in the back and extremities.
- Third. It is an intermediate stage before breaking the fibrous ring. Protrusion reaches its maximum size, the symptoms become pronounced and complete.
Prevalence and significance
Intervertebral disc protrusion is a common disease.. Most often it is diagnosed in patients older than 30 years. Almost 50% of diagnosed protrusions are located in the lumbar spine. In the thoracic protrusion are less common, and in the cervical - almost never occur.
Often the development of intervertebral hernia begins with protrusions. Therefore, it is important to diagnose the disease in a timely manner and begin treatment in order to avoid serious health consequences.
There are a number of factors in which the risk of developing protrusions increases significantly..
- female identity
- 35-40 years old
- sedentary lifestyle,
- constant spinal movements,
- the presence of bad habits (alcohol abuse, smoking),
- the presence of diabetes
- hypothyroidism - reduced thyroid function.
Intervertebral disc protrusions occur for the following reasons.:
- long-term chronic spinal diseases (rheumatoid arthritis, osteochondrosis, ankylosing spondylitis, etc.),
- overweight, obesity,
- spinal cord injuries (sprains, bruises, fractures, etc.),
- physiological age changes,
- curvature of the spine (kyphosis, lordosis, scoliosis),
- metabolic disorders
- frequent household loads on the spine (for example, labor at the dacha),
- regular and long wearing weights.
Most often, protrusions occur due to high loads on the spine. Pay attention to how to lift weights without harm to the vertebrae.
As a rule, complications develop at the stage when the protrusion turns into a herniated intervertebral disk. Prior to this (at the protrusion stage), a reduction in the lumen and pinching of the spinal canal may occur if the protrusion goes inside the vertebra. In this case, paralysis and paresis occur, sensitivity is disturbed, malfunctions in the work of the pelvic organs appear..
Symptom complex during protrusion depends on the individual patient, causes of disc deformation, localization of the lesion. Moreover, in the initial stages of the disease symptoms may be absent completely.
The most common signs of protrusion include:
- chronic, migrating or radiating pains,
- stiffness, radiculopathy,
- tingling and numbness in the lower or upper extremities,
- feeling of "burning"
- recurrent headaches
- stiffness of movements.
- Constant pain in the neck. The pain is aching in nature, aggravated in the evening and at certain positions of the head. May give to the upper limbs.
- Numbness of hands and neck.
- Weakness in the neck, shoulders, arms.
- Feeling that the hands are "running goosebumps."
- Pains The patient complains of pain between the shoulder blades, which gives to the chest, ribs and abdomen. Pain occurs during physical exertion and when the patient is in an uncomfortable position for a long time.
- Numbness in the chest, the affected area of the back, and in the abdomen.
- Feelings of chest tightness.
- Muscle weakness (affects the abdominal muscles and back).
- Lower back pain. It may bother constantly or periodically (during exercise). Gives to the buttocks and legs.
- Violation of the pelvic organs (problems with urination).
- Feeling of stiffness in the lumbar region.
- Weakness in the legs.
- Numbness of toes and feet.
Protrusions are rarely diagnosed. This is not due to the prevalence of the disease (it is quite high), but with the reluctance of patients to consult a doctor when the first signs of the disease appear. Most people suffer discomfort in the hope that they will “go away by themselves” and come to the hospital when unbearable and excruciating pain appears.
note! Timely diagnosis of protrusions avoids not only the development of complications, but also disability. To establish the presence or absence of a pathological process, it is necessary to conduct a single instrumental examination - magnetic resonance imaging.
MRI allows you to see the processes occurring in the disk, and assign the appropriate treatment. Other survey methods (CT, radiography) at this stage are uninformative.
Video: "What is intervertebral disc protrusion?"
Intervertebral discs tend to recover on their own.therefore, the task of therapy is to activate this mechanism. Modern techniques allow to stop the pain and stop the progression of the disease.
Familiarize yourself with intervertebral disc protrusion treatment. The focus is on drug therapy. with the use of muscle relaxants, chondroprotectors, nonsteroidal anti-inflammatory drugs. The drugs effectively relieve pain, eliminate the inflammatory process and restore cartilage, but the constant use of medications increases the risk of side effects.
Also physiotherapy procedures are used to treat protrusionssuch as shock wave therapy, magnetic therapy, electrotherapy, laser therapy, balneotherapy, etc. These procedures can relieve pain, inflammation and swelling, increase muscle tone, improve metabolism.
A similar effect is achieved by physical therapy, which redistributes the load on the intervertebral discs, restores the elasticity of connective tissues, strengthens the muscular corset of the back. If you wish, you can enroll in the pool.
Another effective protrusion treatment method is manual therapy. The actions of an experienced therapist can eliminate muscle spasm, relieve pinched nerve roots, get rid of pain and relieve local inflammation.
A significant improvement in well-being is observed already after 5-10 procedures. Be careful: if there are contraindications, any manual actions are strictly prohibited.
What is the essence of the disease?
As already mentioned, protrusion is one of the stages of general degenerative changes in the spinal tissue called osteochondrosis.
With prolonged negative influence of risk factors, pathological changes occur within the intervertebral discs. These discs consist of two parts:
- The pulpous core (the inner part) is a gel-like substance that occupies the central part of the disk and consists of collagen fibers, proteoglycans (molecules that hold water). Due to the latter, the amount of water in the core of the disk is very high, which provides it with depreciation properties.
- Fibrous ring (outer shell of the disc) - consists mainly of durable collagen fibers. Its main task is to keep the pulpous nucleus in place and maintain the necessary shape of intervertebral disks.
The intervertebral disc does not have its own blood vessels, but is fed by the diffusion of nutrients from the surrounding vertebral tissues. Violation of this process is at the heart of the development of osteochondrosis and protrusion.
When the metabolism inside the disk is disturbed, it dries out, the height of the disk decreases, the fibrous capsule lends itself to loosening process, due to which it loses its strength. This is the first stage of osteochondrosis.
If the pathological factors have not stopped their negative effect, then the process moves to the second stage - the formation of a vertebral protrusion. Due to the decrease in the height of the intervertebral disk, the bodies of the adjacent vertebrae approach each other, they exert great pressure on the damaged disk, which leads to the “extrusion” of its contents beyond the spinal column. At the same time the fibrous ring maintains its integrity. Such protrusion of the fibrous ring with the disc core is called protrusion. Concurrent degenerative processes in the spine develop in parallel - spondylolisthesis, spondyloarthrosis, spondylosis, vertebrae subluxations, spinal curvatures.
The final stage of degenerative changes in the vertebral discs is the rupture of the fibrous ring and the formation of a herniated disc (the pulpous nucleus is squeezed out beyond the intervertebral disc). In some cases, a hernia is sequestered — a separation of a part of the nucleus, which leads to complete destruction of the disk and complete loss of its function.
It should be noted that different discs give in to the pathological process in unequal measure. First of all, those disks that undergo the most stress suffer and are subject to protrusion. As a rule, these are disks of the cervical vertebrae and lumbar. The thoracic spine is least affected.
What is protrusion?
The intervertebral disc is formed from the outside by a durable spongy (fibrous) capsule. Inside it there is a pulpous core rich in water and collagen. The "locking" plate separating the disk from the vertebral bodies is hyaline cartilage. With age-related bone demineralization and “drying out” of cartilage tissue, with an irrational distribution of the load on the back, the contents of the disk are shifted to the fibrous ring.
The inner part of its nucleus “creeps away”, the disc loses its oval shape and, sharpened, protrudes beyond the limits of the intervertebral gap.
This is the protrusion of the disc.
In the people, this process is called vertebral protrusion. A more correct name is the protrusion of the intervertebral discs, that is, the formation of a bulge on them protruding behind the spine.
Circular protrusion is a uniform protrusion of the intervertebral disk around the perimeter. Such protrusions usually develop slowly, are prone to a long-term and chronic course, indicating pronounced degenerative changes inside the disc. Lead to severe loss of disc height and severe complications. Without special treatment, they become the cause of permanent disability and disability.
This limited bulging of the disc in any direction. Depending on the direction of protrusion, there are:
- dorsal disc protrusions - protrusion occurs in the direction of the spinal canal, the holes where the spinal nerve roots exit the canal, so this is the most unfavorable protrusion because of the high risk of spinal cord compression and neurological symptoms,
- lateral protrusions of the discs - protrusion to the right or left side of the spinal column; such protrusions rarely cause neurological complications, occur relatively favorably and asymptomatically,
- ventral protrusions of the discs - protrusion in the anterior direction, develop very rarely and do not represent a special clinical interest, since they are asymptomatic and do not contribute to complications.
Thus, circular and dorsal protrusions of intervertebral disks are most dangerous, which requires their active treatment.
The symptoms of vertebral protrusion vary widely and depend on the localization of the protrusion (spinal region), its type, compression of the nerve roots, and concomitant degenerative changes in the spinal tissues.
The cervical segment of the vertebral column is one of the most mobile, therefore protrusions are often encountered here. Pathology may manifest the following symptoms:
- chronic or acute pain in the neck with spread to the shoulder joint and along the arm,
- feeling of numbness in the neck and upper limbs,
- reduced muscle strength of the arms
- stiffness and restriction of head movements,
- constant headaches with localization in the back of the head,
- high blood pressure
Protrusion of the cervical vertebrae is a very dangerous condition, because, in addition to squeezing the roots of the spinal cord, compression of the vertebral artery can occur, which passes through the canal inside the cervical vertebrae and provides blood to the back third of the brain. In rare cases, it can even lead to a stroke.
Symptoms of protrusion of the thoracic spine
Protrusion of the thoracic region is very rare due to the anatomical and physiological features of this segment of the spinal column (the vertebrae are practically immobile, which significantly reduces the background to the pathological effect on them). But, nevertheless, protrusions of the thoracic region still occur and can manifest themselves with the following symptoms:
- chronic or acute chest pain, along the intercostal spaces, between the shoulder blades,
- feeling of stiffness in the chest,
- development of shortness of breath and pain with a deep breath,
- pain and discomfort in the heart and abdominal organs.
Such symptoms of pseudo-lesion of internal organs cause a person to treat non-existing diseases of the heart, liver, lungs and other organs for a long time and without result, and in fact the cause of painful sensations lies in the diseased spine.
Symptoms of disc protrusion of the lumbar spine
In this section, protrusion occurs most often due to the large static and dynamic loads on a given segment of the spinal column. Symptoms include:
- acute and chronic back pain that can spread along the leg,
- development of attacks of lumbosacral radiculitis,
- stiffness and limitation of the amplitude of movements in the lower back,
- violation of the work of the pelvic organs,
- numbness, loss of sensitivity of the legs,
- reduced muscle strength of the lower limbs, the development of paresis and paralysis,
- erectile dysfunction in men, infertility and pelvic pain in women.
It is the lumbar lesion that often causes disability and disability of a person.
Such methods of examination as radiography of the affected spine, magnetic resonance and computed tomography will help to recognize the disc protrusion.
Principles of treatment
Successful treatment during protrusion of the disc will be only in the case of its duration and complexity. During the exacerbation of the process (acute pain syndrome), drug therapy is prescribed to eliminate inflammation, pain, swelling of the nerve roots, pathological spasm of the paravertebral muscles, the establishment of microcirculation and metabolism in the tissues of intervertebral discs.
It is necessary to remember that it is impossible to cure protrusion by conservative methods, but it is possible to stop its progression and prevent exacerbations of pathology.
To do this, use such conservative methods of treatment:
- manual and osteopathic correction of the spine,
- spinal traction,
- Spa treatment.
Only in extreme cases, resort to surgery. Despite modern equipment and minimally invasive techniques of spinal surgery, it is always a big risk. Therefore, such radical treatment is resorted to under strict indications, but before that it is necessary to try all methods of conservative therapy.
. Most of the articles on protrusions, hernias and osteochondrosis of the lumbar spine are not entirely correct, they contain the same partially false information.Maybe I'll ever write my article about these diseases, written from my point of view. And here I will write typical "errors" that can be found in similar articles. Just the following rules are important to understand for treatment and prevention. 1) Relationship of osteochondrosis and protrusion. It is believed that the next stage of osteochondrosis is protrusion. This is not true. Osteochondrosis is formed as a result of long-term compression of the vertebrae and lack of mobility (in everyday life it is a sedentary lifestyle). Protrusion is formed as a result of the fact that the back muscles are not able to withstand the load and protrusion is a kind of protective mechanism. That is why sedentary people also have osteochondrosis and protrusions, while athletes generally have only protrusions. 2) It is believed that back pain can be caused by protrusion. Not quite right. Protrusion can cause muscle inflammation and then in very rare cases, and the cause of the pain is usually squeezing of the nerve roots due to osteochondrosis. Again, this is why athletes do not feel the pain of protousi. 3) It is argued that back pain is caused by pathology in the spine. This is true, but it doesn’t take another thing into account: people blame back pain on those same protrusions and osteochondrosis, but they forget about the reasons that cause them - a sedentary lifestyle, lack of exercise and weightlifting. 4) It is said that one of the main causes of osteochondrosis is the deterioration of the nutrition of intervertebral discs. This is not true. It means that in the absence of loads, the blood flow deteriorates. In fact, this question can be viewed from the other side: intervertebral discs are necessary for the movement of the spine. As soon as these movements stop (sedentary lifestyle and lack of exercise), the body tries to reduce these discs "as unnecessary".
Totally agree with you. Nowadays, more and more people suffer from their spines. Sedentary lifestyle, the weakening of the muscular system. And it’s too bad that in our country they don’t inculcate physical education to improve the health of the body.
Tatyana and Alexey! Agree with you. And further. All doctors are alarmed and sound the alarm about the sedentary lifestyle of most working people. But no measures are being taken to improve the nation, neither by doctors, nor by the government. How can you sit in an office chair, doing small physical workouts every hour, an entire 8-hour working day and not get sick? Need to lead the problem to reduce working time for another hour. The country will not disappear economically, and people will become healthier and more positive.
To shorten the working day by an hour is wonderful, at home an hour more in front of the TV. Problems are not with the state in grafting zozh, but among citizens with an understanding of the basics of biology, anatomy. To each his own.
Protrusion - what kind of beast?
A bit of anatomy. In order for the spine to absorb every time you move, there is a substance between the vertebrae, a bit like a jelly candy with a filling inside. This is the intervertebral disc. Intervertebral, not “intervertebral”, notice!
So, in children, this disc is really similar in consistency to the sweets they love, and in adults it “wears out” and “grows out”, losing water (dehydrating) and its cushioning properties. For clarity, we will assume the most so-called candy fibrous ringand a more liquid filling, a bit like marmalade or thick jam, is gelatinous pulpal nucleus intervertebral disc.
If this ring preserves the integrity and the disk structure is not broken, then protrusion takes place. If the ring is broken and part of the disk has flowed out, it is a hernia. Thus, the protrusion of the disc is not the disease, as it were, but the initial stage of the formation of an intervertebral hernia. It is during the protrusion stage that the pains in the lower back, back or neck become permanent, aching, exhausting the patient. Chronic spinal disease, which affects the intervertebral discs and cartilage, and is called osteochondrosis. Thus, the protrusion is the beginning of osteochondrosis, the hernia is its continuation.
To confirm the diagnosis, the patient is usually sent for neuroimaging - CT scan or MRI of the spine. By the way, in order to make it more convenient, doctors agreed to call the process unchecked for CT or MRI “discosis”. The term funny and little caught on in scientific literature.
Causes of disc protrusion
The main cause of disc damage is chronic microtraumas during physical overloads and during everyday loads on the spine with poor biomechanics. Because of this, the process of convergence of the vertebrae begins with age. As a result, the pressure on the outer fibrous ring increases, and the disc begins to bulge from under the edges of the vertebra.
The main reason for the "bad" load on the spine and circulatory disorders of the discs are muscle spasms. They must be eliminated in order for the protrusion treatment to be successful. In addition, overweight and spinal curvature (scoliosis, kyphosis, lordosis) can be the causes of increased stress.
It is believed that the less you load the spine (for example, the less you carry weights), the less likely the transition from protrusion to hernia. But few people know that the load on the spine depends largely on the position of the body. For example, when lifting any kind of back-bent weight, the pressure on the lumbar spine increases 10 times compared with the standing position. If you thought that the maximum pressure on the lumbar spine occurs while standing, you were wrong!
I also note that in itself the size of the protrusion is not as important as its position relative to the spinal canal, where the spinal cord is located, and the intervertebral holes, where the nerve roots pass. For example, in the cervical spinal canal is the narrowest, so even small protrusions can give the same symptoms as a full hernia. And vice versa - in the lumbar spinal canal has a relatively large diameter, so even large hernias for a long time may not manifest themselves.
There are quite a lot of them, and not all specific ones, therefore it is impossible to make a separate diagnosis here. So, among the symptoms of protrusion: headache (often in the occipital region), dizziness, sudden jumps in blood pressure, numbness or tingling of the fingers and toes, certain muscle groups of the limbs, a feeling of "wadded" hands and feet.
As a rule, pain is present - local back pain, pain in the extremities, migratory pain, weakness in the muscles, stiffness of movements, burning sensation in the limbs.
Sometimes the first stage of protrusion may manifest acute attacks of pain, which has a clear localization. Patients accurately point to a point on the spine where “it is terribly painful to touch,” pain usually lasts about a week and is explained by damage to the ligaments around the disc. These ligaments are richly innervated by pain-sensitive receptors. Over time, the disease goes into the second stage: when the pain becomes constant, aching, gives (radiates) to the arm or leg, under the scapula, into the buttock, to the heart area - anywhere, depending on the location of the protrusion and the location of the nerve roots.
Such a frequent disease as intercostal neuralgia may well be explained by unrecognized disc protrusion in the thoracic spine. Symptoms of compression (compression) of the root, such as numbness, paresthesia (crawling, discomfort) and physical weakness in the muscles of the extremities, which means that the protrusion of the disc has passed into the third stage and there is only a little left before the hernia, can join. Located in the lower vertebrae of the lumbar protrusion can also cause unpleasant phenomena associated with impaired innervation of the bladder and rectum: urinary retention or incontinence, constipation.
How to treat?
Having heard the diagnosis of “protrusion”, a person asks himself the main question: “How to get rid of pain in the back or neck”? The principle of treatment of disk protrusion depends on the severity of neurological disorders. If the patient suffers from severe pain, he is prescribed drug therapy to relieve pain. In some cases, assigned paravertebral, epidural and epidural blockade.
In our country, protrusions are usually treated with physiotherapeutic methods: medical gymnastics, special massage, spinal traction, acupuncture. But electrophoresis and magneto-phonophoresis with various dietary supplements are ineffective here, although they have always enjoyed success in patients.
A truly effective method is considered to be spinal traction, which is carried out with the help of specially selected goods, sometimes in water, which is considered to be more benign. By the way, in contrast to the treatment of a hernia, the use of manual therapy for protrusion is possible and justified.
In most cases, protrusions do not require surgical intervention, but if the development of the disease is not stopped, the risk of the need for surgery increases significantly. Let me remind you that in 80% of cases with timely referral to a neurologist, the operation can be avoided.
Best of all - prevention
To stop the progression of protrusion or to prevent its occurrence, there is not much to be done: exercise regularly, acquire proper posture skills, lose weight, eat right and generally lead a healthy lifestyle, give up bad habits and, of course, eliminate the increased stress on spine.
Nevertheless, no one has yet managed to stop the passage of time. Age-related changes in the spine occur in the same way as age-related changes in the skin of the face. But usually people try to keep their skin supple, they spend much more time than gymnastics, and in vain. Although aging can not be stopped, but to minimize the manifestations of osteochondrosis and prevent complications - in your hands.
What is disk protrusion
Intervertebral disc protrusion - one of the complications of osteochondrosis, the initial stage of a rather severe disease of the spine - intervertebral hernia.
The protrusion of intervertebral discs (PMD, from the Latin "protrudere" - "to speak for.") Is called protrusion of the intervertebral disc beyond the spinal cord without breaking the fibrous ring.
Protrusion occurs as a result of damage to the internal fibers of the fibrous ring without breaking the outer shell, which holds the gelatinous nucleus of the nucleus within the boundaries of the intervertebral disk. In this case, the ring extends beyond the intervertebral disc, forming a protrusion. The size of the protrusion is from 1 to 5 mm. As a result, irritation (compression) of the nerve roots occurs and pain occurs, which is non-permanent (intermittent) in nature, which is explained by the varying degree of nerve irritation in various body positions.
What happens during protrusion of the disc?
To understand what happens during protrusion, consider the structure of the intervertebral disk. The gelatinous pulpous nucleus, the central part of the intervertebral cartilaginous disk, is surrounded by a fibrous ring consisting of fibrous cartilage and connective tissue.
As a result of degenerative processes, the fibrous ring becomes thinner, loses elasticity, cracks appear in it, into which the gelatinous nucleus begins to shift, a protrusion forms, a protrusion - this is the protrusion of the disk. With protrusion only the inner fibers of the fibrous ring are damaged, and the remaining outer fibers form a movable fragment of the intervertebral disk.
The resulting protrusion exits (falls out) into the spinal canal, resulting in irritation or pinching of the nerves and vessels there. In addition to squeezing the nerve, the stability of the vertebral segment itself may be disturbed.
When the fibrous ring of the intervertebral disk breaks (damage to the outer fibers) in conjunction with the protrusion of a fragment of the gelatinous nucleus, when its connection with the core substance is not broken, an intervertebral disk prolapse (loss) occurs in the spinal canal, which is considered a true intervertebral hernia.
Symptoms of protrusion of the disc. Types of protrusions
By her own protrusion Asymptomatic, and until irritation of the nerve fibers or roots occurs, does not manifest itself. Symptoms of disc protrusion depend on its location and size. The most common protrusions in the lumbar and cervical spine, while the cervical protrusion is more dangerous. Pain can "give" in the leg, arm, neck, neck, intercostal spaces (depending on the squeezed nerve). There may be a weakening of muscle strength, as well as muscle pain in the areas of their innervation and a violation of sensitivity. Most often sciatic nerves suffer from compression.
The degree and severity of symptoms directly depend on the pathology that led to protrusion, sizes and tops of potruzii (lateral, median, posterior), degree of compression of the nerve roots and spinal cord.
Pain can "give up" in the leg, arm, neck, neck, intercostal spaces (depending on the squeezed nerve), there may be a decrease in sensitivity, muscle weakness, burning sensation, pain, numbness, tingling in limbs, stiffness of movements.
Symptomatology is quite individual and depends on the cause of damage to the disk and localization. Actions such as sharp bending forward, standing or sitting in a fixed position provoke or intensify the painful continuous pain.
Disc protrusion in the cervical spine
In the cervical spine there are seven vertebrae, between which are intervertebral discs. The cervical region is very mobile and the disks provide mobility and elasticity of movements in the neck, and stability of the head position. When wearing discs appear protrusionwhich can cause spinal cord or root compression. Influences on spinal structures and causes symptoms:
- chronic local pain in the neck,
- muscle weakness in the shoulder, arm, elbow,
- numbness and tingling in the hand,
- pain radiating along arm.
Protrusion in the thoracic spine
Protrusions in the thoracic spine is quite rare. The fact is that the mobility of the vertebrae in the thoracic region is much lower than in the cervical or lumbar, and therefore, the possibility of excessive exposure to the discs is much less. But, nevertheless, a certain amount of movement is still there, and protrusions may appear during disc degeneration. Symptomatology depends on the location of the protrusion and the degree of impact on nearby nerve formations. The following symptoms are possible:
- pain in the middle of the back,
- weakness of abdominal muscles
- pain, numbness and / or tingling in the chest, abdomen,
- stiffness in the back or soreness
- pain in the intercostal space.
Protrusion in the lumbar spine
Most often protrusion arise in the lumbar spine. This section of the spine suffers most often due to a large load (the center of gravity of the body is in the lumbar region) and a large amplitude of movements. As a result, lumbar discs are more prone to damage and the appearance of protrusions. The situation is aggravated by age-related degenerative processes.
Symptoms protrusion in the lumbar region depend on the location and degree of pathological changes in the disc. It can be:
- chronic lower back pain
- stiffness in the lower back
- muscle weakness in the thighs and calf muscles,
- pain, numbness or tingling in the feet, toes,
- dysfunction urination (in rare, emergency cases).
Lateral (lateral) protrusion
The term "lateral protrusion" means that the projection of the fibrous ring is located on the side (right or left) of the spinal column. The probability of pressure on the roots of the spinal cord is quite high. This type of protrusion is quite rare (in 10% of cases) and is often asymptomatic, while the protrusion does not put pressure on the nearby roots.
Causes of pathology
There are protrusions for a number of reasons:
- poor posture and weakening of the muscular system,
- age changes
- lack of adequate exercise (sedentary work, sedentary lifestyle),
- too large loads on the spine (heavy physical work),
- disruption of the immune system,
- genetic predisposition.
According to statistics, among the causes of disability in the Russian population, about 30% are occupied by protrusions and hernias.
Intracanal discs protrusions are especially dangerous - with such a pathology, protrusion occurs to the internal channel of the spinal column.
What is dangerous disease?
Most often protrusions occur in the cervical and lumbar region, less often in the thoracic. Their danger lies not only in the location of the vertebrae - the direction of protrusion of the disk nucleus plays an important role.
With a protrusion of 1-2 mm, the patient usually does not experience discomfort, the first signs of the disease appear during protrusion of 3-4 mm. If an MRI or CT scan fixes 5 mm, then a diagnosis is made - a hernia. In this case, the fibrous ring is often broken.
However, in the case of a foraminal intracanal protrusion, the protrusion occurs towards the nerve canal, and there may be left-sided and right-sided pathology.
A protrusion already in 2 mm will give symptoms. The channel has a diameter of only 5 mm, and bulging can lead to very serious complications.
When protrusion in 3 mm in the cervical region blood circulation is disturbed, the power supply to the posterior third of the brain can be stopped, the movement of the upper shoulder girdle is disturbed.
Protrusions occur most frequently in the lumbosacral region. The gait is broken, paresis (immovability) of the lower extremities is possible. Other symptoms appear:
- numbness in the lumbar region, temporary, severe pain in the affected area,
- weakness of the lower limbs,
- pain in the leg
- limited mobility of the lumbar spine,
- violation of the sensitivity of the skin on the legs,
- violation of urination,
- problems with erection (in men), gynecology (in women), pain in the pelvis.
If the bulge occurs at the site of the cervical region, are noted:
- headache in the neck,
- neck mobility limitation,
- neck pain extending to the arm
- increase in blood pressure.
Protrusions are destructive-degenerative changes, and today it is believed that they can not be cured. However, this type of pathology can be suspended. With proper conservative treatment during remission, the pain will not be felt.
The treatment is performed by a neurologist or surgeon, it depends on the degree of protrusion and its type. The course of treatment includes a number of drugs.
Among them - non-steroidal anti-inflammatory drugs, muscle relaxants, corticosteroids, chondroprotectors, drugs to improve blood circulation.
Appointments are made after collecting a history of a number of surveys, including:
- motor and neurological tests
- MRI or CT scan,
- X-ray of the affected vertebral column,
- general analyzes
- in the most difficult cases - the study of cerebrospinal fluid.
The treatment course necessarily includes, after the relief of pain, UHF, electrophoresis and other procedures. Today apply spinal stretching, hydromassage procedures. A good effect is given by the courses of manual therapy and reflexotherapy.
If conservative methods of treatment did not give a positive result, it was not possible to stop the increase in protrusion, which is quite often the case with foraminal intracanal protrusions, they resort to surgical intervention.
Such operations are complex and involve a great risk, since the intervention takes place in the immediate vicinity of the spinal cord.
Turpentine baths, dry heat, are considered popular folk remedies for the treatment of intracanal protrusion of intervertebral discs. To relieve inflammation and swelling, they use compresses from fresh Kalanchoe leaves, from vodka and crushed garlic.
Intracanal intervertebral disc protrusions are one of the most complex pathologies of this species. It requires urgent treatment and very often leads to surgery.
A selection of my useful materials on the health of the spine and joints, which I recommend you to look at:
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Denial of responsibility
The information in the articles is intended solely for general information and should not be used for self-diagnosis of health problems or for medical purposes. This article is not a substitute for medical advice from a doctor (neurologist, therapist). Please consult your doctor first to know exactly the cause of your health problem.
What are the protrusions?
Depending on the direction in which the pointed disk bulged out, it happens:
- Median protrusion - the displacement of the disc content occurs to the center of the spinal canal,
- Foraminal protrusion intervertebral discs - their bulge in the posterolateral direction with compression of the spinal nerves,
- Circular protrusion - long-term uniform “flattening” of the disk in all directions.
The most dangerous are posterior protrusions of the disks, which are still identified as dorsal (or dorsal) protrusions.
What is it, and most importantly - the danger of dorsal disc protrusion? Bulging backwards, i.e. to the back, the contents of the disk squeeze the roots of the nerves and spinal cord, causing pain, delayed bowel movement and urination.
The posterior disc bulging can be medial, circular and diffuse. With no treatment for diffuse protrusion, a series of neurological symptoms appear.
Types of intervertebral disc protrusions
How do diffuse dorsal disc protrusions manifest themselves, and what is it? This term describes non-uniform multiple convexities of a disk with a significant degree of damage to it - up to 50%.
Such a protrusion carries the greatest risk of inflammation in the affected segment of the spine: a huge bulge simultaneously squeezes two nerve endings and, being directed to the spinal canal, compresses its contents, causing bouts of severe pain and reflex disorders in the limbs.
The term means location protrusion back and sideways with respect to the spinal column. With this arrangement of protrusion, the probability is high not only of impact on the roots (as in lateral protrusions) on the right or left, but also on other structures of the spinal cord. As well as lateral, this protrusion may be asymptomatic, as long as there is no physical impact on the nervous structures.
The causes of the hernia, protrusion of the spine coincide with the factors that contribute to the development of osteochondrosis:
- age (with time the risk of developing degenerative, dystrophic manifestations in the spine increases), these are involutive changes in tissues,
- minimal physical activity
- deformities of the vertebrae after injuries, bruises,
- congenital pathology of the motor apparatus,
- vertebral diseases of inflammatory origin (ankylosing spondylitis, rheumatoid arthritis),
- static overstrain of the spine due to prolonged monotonous posture (seated, standing),
- professional sports,
- deformation of the joints of osteoarthritis,
- hormonal imbalance
- metabolic disorder,
- tobacco smoking, alcoholism,
- tight heredity
- substandard sleeping elements.
The main cause of protrusion is considered monotonous static stay in one position. Is it possible to prevent illness? It is necessary to eliminate such risk factors.
The terminal stage of disc degeneration can be called damage, rupture of the annulus with the subsequent formation of a disk hernia. At the same time, the squeezing of the pulpous nucleus outside the disk itself is observed. Can it be argued that this is the final stage of the disease? Sometimes a hernia sequesters. Part of the core is completely separated, which leads to the destruction of the disk, the loss of its functions.
The illness itself is completely reversible (only with timely treatment). The progression of the disease goes into intervertebral hernia, causing:
- sensitivity impairment
- decrease in motor functions,
- muscle weakness
Soreness of the spine increases gradually. It is characterized by aggravations in spring and autumn. Scientists have shown that the propensity for protrusion varies among different vertebral discs. Most often the disease develops in the structures of the cervical, lumbar. This is due to the significant load on these parts of the spinal column. Can we talk about the most protected departments? Experts indicate that the thoracic spine less than the others suffers from protrusion.
A variety of pathology
Disc protrusion is classified (depending on the possible protrusion of its elements relative to the perimeter of the disc itself) into the following types:
- Circular lesion - this species is characterized by a protrusion of the disk along its entire perimeter. It develops slowly, has a tendency to a chronic course. This indicates significant disc degenerative changes. Such a disease quickly reduces the height of the disk, causing complications. Without timely treatment, this ailment causes permanent disability.
- Local protrusion is a limited protrusion of the disc in one direction.
There are several directions of the last protrusion:
- Dorsal - bulging occurs in the direction of the spinal cord. This is the most adverse variant of the disease that can cause compression of the roots of the spinal cord and the emergence of a neurological clinic.
- Lateral protrusion - protrusion to the right, left of the spine. This pathology is considered the most favorable, it is relatively asymptomatic, does not cause neurological manifestations,
- Ventral protrusion develops during protrusion of the disk forward. This is the most rare, asymptomatic form that does not cause complications. Therefore, it does not cause much scientific interest.
There are several types of protrusion:
- Central or medial - protrusion of a similar plan occurs in the center of the spinal canal. At the same time there is a huge risk of injury to the spinal cord. Symptoms of protrusion do not appear.
- Lateral type of lesion is considered the rarest type.
- The posterolateral lesion is considered the most common. The bulge is located behind and to the side. This greatly increases the risk of damage to the structures of the spinal cord.
- The posterior protrusion is directed to the back, this leads to the defeat of the structures of the spinal cord, which provokes soreness, motor disturbances, loss of sensitivity. In severe cases, there is a risk of disruption of the pelvic organs.
Symptoms of the disease
The symptoms of the disease are varied. They depend on the following factors:
- the location of the lesion (of the spine),
- type of pathology,
- presence of compression of the nerve roots,
- related spinal ailments,
- general well-being and condition of the patient,
- severity of spinal lesions.
The cervical spine is considered the most mobile area of the spine. This explains the frequent development of protrusions of this area. Pathology manifests itself:
- neck pain of chronic or acute genesis,
- irradiation of pain in the area of the shoulder joint, along the arm,
- numbness of the neck, limbs,
- decrease in muscle strength in the arms,
- limited head mobility
- constant pain in the head,
- pressure surges
The bulging of discs in the cervical region is considered a dangerous condition. Pathology squeezes the roots of the brain, causing compression of the arteries. Such an illness may be complicated by stroke. A sure sign of this lesion is a constant soreness in the neck and neck.
Lesion of the disc of the thoracic spine is rare. It is associated with the anatomical features of this area. These vertebrae are fixed, which minimizes the possible pathological effects on them. When a similar illness occurs, the patient is concerned about:
- pain in the chest, along the intercostal spaces, between the shoulder blades,
- chest stiffness
- soreness when taking a deep breath
- soreness of the heart.
Such a pseudo-painfulness of the internal organs often causes patients to struggle for a long time, without result, with pathologies of the heart, liver, and lungs, which are actually absent. Lumbar protrusion is a frequent pathology, since this area of the spine is most amenable to stress. Frequent manifestations of the disease:
- pain in the loins, extending to the leg,
- frequent episodes of sciatica
- stiffness of the waist,
- disruption of the pelvic organs,
- reduction of strength in the muscles of the legs,
- paresis, paralysis,
- violation of erection, pain in the pelvis, infertility.
Often illnesses of the lower back can provoke disability, disability of a person.
Diagnosis and therapy
Before curing protrusion, it is recommended to undergo a full examination. For verification of the diagnosis used:
- Radiography of the affected spine.
- Magnetic resonance imaging. In the study of such a plan reveal the dehydration of disks, dystrophic changes in them. Note the narrowing of the dural space. MRI is the only technique that allows for the differential diagnosis of protrusion with other ailments (hemangiomas, tumors, syringomyelia).
- Computer examination of the body.
Before treating a protrusion, the doctor is determined with the method:
- drug therapy,
- comprehensive struggle with the disease
- folk therapy.
Most protrusions are treated with a conservative or surgical method. When acute, shooting pain occurs, it is important to prescribe nonsteroidal anti-inflammatory drugs. For maximum effectiveness, in the first days they are administered parenterally, and then transferred to oral administration. Muscle relaxants (Mydocalm, Sirdalud) are used to relieve stiffness and muscle spasms.
Popular treatment of protrusion with ointments, gels. In the complex therapy of such a disease, they can be of great benefit and significantly speed up recovery. Usually they are applied from the third day of therapy. Surgical treatment is prescribed in exceptional, severe, neglected cases.
Comprehensive treatment of protrusion includes fixing the affected disc, stretching the spine. Then shown exercise therapy, physiotherapy apparatus. With this treatment:
- decreases the load on the affected disk,
- muscle tone is restored,
- the whole spine is working.
Often, during protrusion, a wellness massage is used, which normalizes the metabolism of tissues and the work of intervertebral disks. Due to this, the patient's condition improves in a short time. Similar diseases can be treated with proven alternative medicine recipes:
- The fight against the disease with garlic. For treatment using alcohol tincture of this vegetable. For its preparation requires alcohol or vodka and fresh garlic. Infused for ten days in a dark place. The finished medicine is reminiscent of the pulp on the consistency. This mass is applied to the affected areas and fixed with a soft cloth and plastic. A similar procedure is performed twice a week for a month.
- During protrusion treatment Kalanchoe gives a quick and reliable effect. His healing leaves are applied to problem areas and attached with a plaster. Such a compress is best done at night for three weeks.
Without treatment, the effects of the disease are adverse. Pathology quickly escalates and progresses. At terminal stages, the appearance of paresis and paralysis of the patient’s body is possible. Disc protrusion is one of the manifestations of osteochondrosis. Such a pathology may occur with a sedentary lifestyle. Like any other disease, osteochondrosis is better to prevent than to cure. It is important to lead a correct, healthy lifestyle, move more, eliminating bad habits.
What are the dangerous protrusions?
Spinal diseases do not manifest for a long time. Low perceptible signs of protrusion — the instability of blood pressure, burning in the fingers of the extremities, dizziness and headache — have been “written off” for years for chronic ailments and fatigue.
Meanwhile, the inner contents of the disk continues to move to the outer parts of the fibrous membrane.
Gradually, it gives cracks. The gelatinous tissue of the core fill them. With a sudden movement, the thinned disk capsule can rupture, and its inner tissue will “fall out” into the spinal canal, and an intervertebral hernia is formed.
The term means the direction of the protrusion from the abdomen to the back. This arrangement protrusion most often leads to direct effects on the spinal structures and leads to pain syndromes, sensitivity disorders, motor disorders, dysfunction of the pelvic organs.
Causes of disc protrusion
Many factors can cause protrusion, for example:
- sedentary lifestyle, static stresses while continuously in a single posture (sedentary work),
- poor posture, underdeveloped back muscles,
- spinal injury and microtrauma,
- excessive loads on the spine when playing sports or at home (sharp bends and turns of the body when lifting weights),
- age-related changes, various diseases of the spine: osteochondrosis, osteoporosis, scoliosis, etc.
Diagnosis of protrusions
For diagnosis intervertebral disc protrusion various methods are used. The most informative magnetic resonance imaging (MRI) of the affected spine. This is a complex, but fairly safe method of research, which gives almost complete information about the size of the protrusions, the width of the spinal canal, the severity of inflammatory changes and the presence of comorbidities.
Computed tomography of the spine (CT) with intervertebral disc protrusion does not provide complete and correct information; it may show incorrect protrusion sizes.
Treatment and prevention of protrusions
Timely recourse and proper treatment can cope with the problem of intervertebral disc protrusion in 90% of cases.
With protrusion treatment NSAIDs, muscle relaxants, chondroprotectors, and painkillers, if necessary, are used. Appointed exercise therapy, physiotherapy.
Effective relief in the treatment of protrusion can have a medical plaster NANOPLAST forte. It allows you to remove pain and inflammation, improve blood circulation in the affected area of the spine, reduce the dose of painkillers and anti-inflammatory drugs.
During protrusion, the medical plaster NANOPLAST forte is applied to the area of the affected spinal joint, depending on the location of localization - the lower back, neck or chest. To remove the acute symptoms of the patch to apply from 3 to 5 days. The duration of the course of treatment during protrusion is from 9 days. It is usually recommended to use the patch in the morning for 12 hours, but it is possible to apply it overnight.
What is similar to hernia and protrusion, what is the difference between them?
The differences and similarities of hernia and protrusion:
- The protrusion is considered the "pre-heel" state of the disk. Its height and shape change, but the integrity of the shell is preserved,
- The moment of hernia formation is considered to be a rupture of the disk capsule and “squeezing” a part of the gelatinous core out
- A protrusion with a size greater than 5 mm is identified as a hernia,
- Both the protrusion and the hernia compress the neurovascular bundles with different force.
The main thing is how hernia differs from protrusion - these are symptoms and consequences, as well as the nature of the treatment.
Left without treatment, protrusion of the disc may go to the stage of hernia
Protrusion "gives out" itself, causing the following symptoms:
- Headache, pain in temples, dizziness,
- Stiffness, "tightness" of the spine, dull pain in different parts of it, spreading it to the upper or lower limbs,
- Tingling in the fingers or toes, weakness in the limbs,
- Reduced mobility of the muscles of the body.
With the formation of a hernia, constant severe pain, intercostal neuralgia, "shooting" and impaired sensitivity becomes the ultimate part of life.
The formation of a large hernia is accompanied by a strong swelling of the tissues and difficulties with innervation of the extremities, compression of the structure of the spinal cord and paralysis.
How to treat protrusion?
Treatment of protrusion is complex and individual, depending on the size of the intervertebral disc bulge and neurological manifestations, aimed at preventing the further development of dystrophic processes.
What is the treatment of protrusion of intervertebral discs of the spine?
You will learn about the main methods of protrusion treatment from the video:
As a symptomatic therapy in the first few days in the treatment of protrusion, injections with diclofenac solution are prescribed.
Injections eliminate the edema of the paravertebral tissues and reduce pain.
Further, therapy with oral administration of NSAIDs (movalis, ibuprofen), spasmolytics and muscle relaxants (mydocalm), as well as analgesics. For 3-4 days, ointments and gels with anti-inflammatory and analgesic components are connected to the treatment regimen.
At home, drug treatment of protrusion can be supplemented with taking vitamin teas and herbal decoctions, as well as warm compresses based on them:
- Twice a day to drink tea from the berries of wild rose, leaves of lingonberry and black currant (1: 1: 1),
- Prepare a water infusion by mixing 1 part of black elderberry flowers, 4 parts of birch leaves, 5 parts of willow bark. Drink half a cup of infusion before meals, 4 times a day.
Rehabilitation and exercise therapy
Eliminating inflammation, efforts are directed to rehabilitation, including the restoration of fibrous tissue of the disk and strengthening the muscles of the back.
How to effectively strengthen the muscles of the back, you will learn from the video:
In the absence of anomalies in the formation of posture, it begins with traction of the spine, the essence of which is in a gradual increase in intervertebral cracks, where the disks are located.
The next stage is gymnastics, which plays a key role in the restoration of blood supply and nutrition during the protrusion of spinal discs.
Unlike other organs, intervertebral discs do not have an extensive blood supply system. The current nutritional components to them is carried out mainly through muscle activity.
The complex of physical therapy is selected individually - during protrusion, it should improve the outflow of inflammatory fluid from the paravertebral zone, contribute to the restoration of the disc and strengthen the muscles of the back.
Protrusion exercises - dynamic, performed lying on your back or stomach, squatting or sitting, eliminating the static load on the spine.
Is it possible to do massage during protrusion?
Massage of medium intensity is shown after the subsidence of acute manifestations.
Its various types - classical, segmental, point - improve blood and lymph circulation in the muscles and areas of destructive-degenerative changes, have an analgesic and absorbing effect, normalize muscle tone and increase their strength.
However, in order to avoid injury to the ischemic disc, care should be taken with the use of vibration techniques and to eliminate the intense massage effect.
When protrusion of the intervertebral disc requires a very soft massage
Sport, but not very active
A moderate addiction to swimming and aqua aerobics, yoga, Pilates “pumping” the press and “light” sports will speed recovery.
However, it is worth to be careful. So, swimming breaststroke causes tension in the neck muscles, unnecessary during protrusion in the cervical region, and running increases the load on the discs three times (at the time of landing).
Therefore, you should minimize the load on the spine, and swim styles that maintain its natural position - on the back or the crawl. A quiet walk (perhaps with sticks) prefer to run.
Caution and require training on the bar. Is it possible to hang on the horizontal bar during protrusion? When performing a full hang, with the loss of a point of support, the gravity receptors are “switched off”. The muscles of the back relax. Body weight puts pressure on the spine stretched and relaxed. There is a compression strike, increasing at the time of jumping from the bar. Further deformations are inevitable.
But half-hanging with a light touch of the floor with the legs contributes to the soft stretching of the ligaments and the release of neurovascular bundles.
A few words about the surgical treatment of protrusions
Protrusion is successfully treated with conservative methods, but if there is no expected relief, or the remission is too short, you may need the help of a surgeon. His intervention is usually minimally invasive and is performed by puncture.
As a rule, surgical intervention during protrusion is reduced to puncture.
How to fix the "bulging" drive:
- At the onset of the disease, when the glandular structure of the disk is preserved, it is important to perform laser valorization (cauterization) of its nucleus beginning to protrude,
- Instant relief comes from the bone blockade method. In the area of pathology lead medicine. Immediately joining the work, it relaxes spasmodic muscles, relieves puffiness and pain,
- Hydroplasty is the most gentle and effective method, which involves the introduction of a special fluid inside the disk, which feeds intact parts of it and “washes” the ischemic areas.
- Also, damaged areas of the nucleus can be “evaporated” by cold plasma nucleoplasty — by introducing cold plasma into the disk.
Do not brush off the pain - the “signals” that the spine sends long before a serious illness, and a cerebral spinal accident can be prevented.