Herniated lumbar department: symptoms and treatment, exercise hernia

Hernia, or a herniated lumbar disc, - common pathology (30-40% of cases) of the musculoskeletal system that occurs under the influence variety of factors and is manifested as a result of squeezing the two adjacent vertebrae, which leads to the fact that the nucleus pulposus protrudes through a weakened or torn annulus fibrosus.

Its extruded part puts pressure on the nerve endings are located in the disk area that causes pain and limited motor function.

What it is?

Herniated disc - is abnormal protrusion of nucleus pulposus (gelatinous central portion of an intervertebral disc) that occurs due to rupture of the surrounding annulus fibrosus.

Causes of

The causes of hernias are quite a few and they are divided into endogenous (internal) and exogenous (external):

endogenous:

• This dysfunction can be caused by the body's natural aging.
• A decrease with age concentration of water in the body leads to drying of disks.
• Violation of the supply of intervertebral discs with nutrients.
• This provokes the beginning of degenerative age-related changes of disks. A recovery processes slow down with age.

exogenous:

• spinal injury;
• permanent excessive exercise;
• obesity (excess weight leads to increased pressure on the vertebral column);
• tumors of various etiology;
• tuberculosis, syphilis;
• sedentary lifestyle - this provokes weakening of the muscular system and violation of the right load distribution on the spine;
• acquired or congenital changes in the structure of spine (scoliosis, lordosis et al.).

By the occurrence of hernia risk factors include the following:

• sexual identity: a man between 30 and 50 years suffer from hernias often;
• smoking (impaired tissue oxygenation, including - and intervertebral discs, which leads to premature wear and tear);
• Work driver (constant small vibration during driving contributes to increased load on the spine);
• Regular excessive exercise;
• hypothermia;
• "Shock" loading on the spine;
• emotional stress;
• poor posture while lifting weights (muscle tension of the back, and not the legs, turns during raising);
• overweight, especially if weight gain occurred in a short period of time.

Herniated lumbar spine

Intervertebral fibro-cartilage formation consist of a core, the surrounding rings of hyaline collagen fibers and connective tissue. Due to this structure, they provide stability and cushioning the spine. This greatly reduces the risk of damage due to injury, heavy physical exertion, sprains. It happens, that under the influence of adverse factors is the development of disc space pathologies.

Herniated lumbar spine formed by discontinuities ring of collagen fibers. It occurs protrusion of nucleus pulposus. The result is a hernia, compressing nerve roots and leads to inflammation of the surrounding tissue.

In the absence of proper treatment of a patient having such steps sequentially forming lumbosacral spine hernia:

• Protrusion. At this stage, small size notes protrusions (3 mm).
• Prolapse. Size lumbar herniation is about 1.5 cm.
• Sequestration. Step characterized by pinching the nerve roots and severe pain constant.

symptoms

Serious concerns that you may have a herniated lumbar cause these signs and symptoms:

1. Lumbar lumbodynia concentrated not in one place, and radiates to the calf muscles and feet. If at the same time in the process involves the sciatic nerve, the pain may acquire characteristics of sciatica, surrendering to the sacrum, gluteus muscles, groin, thigh.
2. Pain occurred immediately after the abrupt movement or inclination during lifting of weights. Especially should alert the occurrence of sudden acute pain when trying to lift something heavy in the tilt position - this is the situation most often provokes a displacement or even loss of the disc. This is due to the fact that the height of the lumbar disc is higher than in other parts of the spine, and the longitudinal ligaments - weaker and narrower.
3. At the same time there are other sensations: loss of sensation, numbness, tingling, pins and needles, weakness in the knee joint in the ankle, foot.
4. Appear intestinal cramps, disturbed urination and potency.

Pathological process takes place in the form of the following stages:

1. Prolapse - minimal displacement. Drive in the absence of any strain may come back into place. The manifestation of pain is negligible.
2. Protrusion. The disc is still limited to the vertebral bodies, but has already undergone one more, additional displacement after having been already shifted.
3. Extrusion and sequestration. Slack between the vertebrae displaced outwards core. Subsequently, the capsule breaks and flows outside its contents.

Without treatment on the progression of the patient's hernia in the lumbar sacral spine lumbodynia often develops. Its symptoms - sharp "shooting" pain instantly aggravated by minor movements and limiting the overall mobility in the long term. The patient is sometimes in this state for several weeks.

Diagnostics

Only detailed diagnosis contributes to the appointment of adequate treatment of intervertebral disc herniation in the lumbar region. The doctor should pay special attention to the nature and location of the pain, to hold a special testing and explore the muscles and reflexes on a tour de force.

Often this is not enough, then appoint additional research:

1. Computed tomography (CT) scans, which produce a three-dimensional image of the scanned area of ​​the hernia location. However, CT is considered to be less accurate method than MRI.
2. Magnetic resonance imaging (MRI) as the most informative of all the modern methods. MRI is able to give an accurate assessment of the size of protrusions, its location and other necessary parameters.
3. X-ray examination in two projections, excluding other pathological changes in the spinal column.

complications

Consequences of hernias develop in the absence of adequate therapy. In the first place there is lumbodynia - lumbar backache. This condition lasts for several weeks and is characterized by severe pain, the intensity of which increases with any movement.

Often pathology causes disruption of the hip and knee joints, which further leads to loss of health and disability. The simultaneous presence of several diseases (e.g., hernia and muscle pathology) provokes rapid disease development, as well as the early appearance of symptoms.

How to treat a herniated lumbar spine?

The therapeutic methods used in medicine, meant mainly conservative approach and only in 5% of cases require surgery. On overcoming the disease have to spend more than one month so you need to be patient as the doctor and the patient. First of all, it is necessary to hold anesthetic procedures to facilitate the patient's condition.

medication

Based on the symptoms, treatment herniated lumbar department at home is appointed with the purpose of such drugs:

1. Analgesics ( "Indomethacin", "Ibuprofen", "diclofenac" and t. D.), Which are cropped pain and reduce the likelihood of muscle atrophy. Drugs in this group produced in the form of tablets, injectable solutions, preparations for topical use (gels, ointments and the like. D.). Their action is aimed at the removal of the inflammatory process, which always appears at the infringement of the nerve endings.
2. Muscle relaxants ( "Diazepam", "Sirdalud", "Mydocalm" and t. D.). Their use makes it possible to remove the muscle spasm. To return the discs and vertebrae in the normal position, additionally prescribe massage and physical therapy course.
3. Chondroprotectors spine ( "hondrolon", "Artron," etc...) - contribute to the restoration of cartilage tissue.
4. Formulations to improve blood circulation and lymph movement ( "Aktovegin", "Berlition", "Pentoxifylline" and t. D.). Receiving such medicines helps normalize blood circulation in the affected area and reduces tissue edema.
5. Vitamin-mineral complexes ( "Neurovitan", "Milgamma", etc...) - promote normal passage pulses in the affected tissues, have a relaxing effect and easy repair damaged nerve fiber.
6. Procaine-paravertebral blockade (hormone administration with anti-inflammatory effect). These injections instantly relieve pain for a period of 2 to 3 weeks. Over the entire period of treatment may be 3-4 blockade. In this case, each time the injection should be made at different points near the damaged disk.

In addition to the use of medicine, the doctor will advise the patient:

1. Bed rest and complete elimination of any manual labor.
2. The affected area may be warm or cold applied to it.

The course of medication use in the treatment of hernias in the lumbar spine is designed for 4-8 weeks. Its duration is determined for each patient. If such therapy does not give the desired effect, the decision to have surgery.

Exercises and gymnastics

Exercises at the lumbar hernia in the subacute stage must be carried out from the starting position:

• Lying on his back;
• On knees;
• on his stomach.

They should not be accompanied by pain. When it appears - stop exercise, rest. Optimal use during physical therapy discharge corset.

1. Lying on your back, arms and legs straight. All the muscles are relaxed. Raise your hands slowly up and stretch and give up.
2. Lying on his back. The body is relaxed. Bend your right leg at the knee, shake it from side to side, relax the muscles. The same repeat with the left leg.
3. Starting position - on his stomach, hands under his chin. Bend your knees, alternately tap heels buttocks, relax your muscles relax.
4. Facing sideways or to the gym wall, alternately lift the legs, make swings back and forth and sideways.
5. Lying on his back. Bend, unbend your leg at the knee, move it to the side.
6. Ip - also. Hands alternately tighten the breast leg bent at the knee then right, then left.
7. Standing, feet shoulder width apart. Slowly rotate your trunk from side to side while spreading his hands apart. In breeding hand - breath on lowering - exhale.
8. Standing, feet shoulder width apart, legs bent at the knees, heels close to the buttocks, shoulder width apart. Breath. On the exhale, turn your knees inward tilt without moving the pelvis.

This - a rough set of exercises. More should tell the doctor and exercise physiologist who deal specifically your case.

Massage

Positive effect gives a massage because of the formation of new vascular connections that improve the circulation of blood through the blood vessels undergoing compression. In this case, it plays a major role in the reduction of swelling of the soft tissues of the problem area, which is accompanied by an inflammatory process in the majority of spinal pathologies.

In our time, when the lumbar hernia specialists use acupressure (acupressure). This technique is used all over the world. It has been proved that acupressure significantly improves lymph and blood flow in the problem area. Besides, a massage promotes active removal of residues, toxins and other detrimental substances from the body. As a result, the patient feels significant improvement.

LFK

The amount of exercise at the lumbar hernia expands, because the need to strengthen the muscular system of the back and lower extremities, as well as to re-create the correct posture:

• Lying on his stomach. Bring branch from the trunk alternately right, then the left leg.
• Lying on his stomach. The doctor bends, extends the leg at the hip, hold for 5-7 seconds in the unbent position.
• Lying on his side from the healthy leg, bends from the body injured leg, bent at the knee.
• Lying on his stomach, lift the first on small, then a larger angle of the straight leg.
• Walking with a bag, into which poured clean sand weighing up to 500 grams, on the head. Step over the imaginary obstacles without bending your back. Also, do not stoop, crouch, trying not to drop a bag.
• With his back to the wall bars, align the back and gently take the pelvis backwards so that the blades buttocks, calves and heels touching the wall. Sitting up on his toes, so stand for 3-5 seconds, then return to starting position.

Under the supervision of an instructor and conducted exercises with gymnastic objects: balls, dumbbells, gymnastic sticks. You want to perform well poluvisy (on the bar, but without letting go of the legs) and, gradually, visy. It is important to also do exercises on the stairs.

physiotherapy

Physiotherapy at lumbar herniation applied, and as a method of treatment of the main, and as a method of rehabilitation after surgical or medical treatment.

In this disease prescribed fizioprotsedury following:

• acupuncture,
• underwater massage,
• thermal procedures,
• electrophoresis.

Electrophoresis - is one of the most popular methods of treatment of spinal hernias. The impact on the current problem space "brings" good effect. Most importantly, this procedure makes it easier to correct the pain and functional disorders, which are caused by a hernia.

In addition, electrophoresis "delivers" the medicine directly to the spinal column. For example, when a single or multiple hernia hernia, neurologic manifestations that are quite successfully used such medicine as Karipazim introduced into the human body with the help of electrophoresis.

After these procedures, the pain go away, softened hernia and the intervertebral discs is much rejuvenated, and slow down the aging process.

Innovative methods of treatment of intervertebral hernia

1. Percutaneous laser decompression. This gentle method of treatment, which allows using the microlaser achieve reduction of intervertebral hernia, and reduce the pressure on the surrounding tissue. Parallel laser, which affect the spinal canal, restores collagen fibers cartilage and tightens small cracks on the surface of articular cartilage.
2. Spinal cord stimulation (SCS). used neurostimulator which produces weak electrical pulses for a given procedure. Device sends pulses directly to the nerve endings of the spinal cord of microelectrodes implanted in the epidural space. Epidural space is located between the dura and the periosteum spinal vertebrae.
3. Hemonuklioliz. Effective innovative method for the treatment of hernias of the lumbar spine. In a damaged intervertebral disc injected enzyme preparation, dissolving nucleus pulposus - chymopapain. After liquefaction its nucleus is aspirated, whereby intervertebral hernia is substantially reduced. An obligatory condition for this is quite simple, and low-impact treatments - save disk membrane.

prevention

In order to prevent hernias should be carried out the following activities:

• enroll in a swimming pool;
• eliminate the strong physical exertion;
• not to lift heavy objects;
• do not make any sudden movements and turns the body, and so on.;
• regular exercise, which
• can strengthen the muscles of the back and the lumbar;
• do the exercises from the course medical gymnastics;
• attend courses of therapeutic and preventive massage, which pulls patient's spine specialist.