Herniated discs of the lumbar. Symptoms and Treatment. Vocabulary, gymnastics, massage, non-surgical removal of laser surgery, the effects of

At occurrence of back pain, it is important to identify the problem. Herniated discs of the lumbar - a violation of the integrity and structure of the intervertebral discs. In order not to aggravate the development of this disease, it is important to begin treatment at the first symptoms manifestations.

The causes of disease

Scientists are unanimous in some factors of education herniated disc:

• The age factor. 30 years of human bone tissue obtained the necessary nutrients from the adjacent tissue, and after 30 years there is their gradual destruction, they lose their density and elasticity.
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• Sexual factor. Amortization of bone tissue in women is much slower than men. In this connection, they later acquired diseases of the spine.
• pathologies herniated lumbar department can carry hereditary. Therefore, people with a predisposition to the development of a hernia should take preventive measures.
• injuries obtained in the past, may occur over time, again due to excessive load on the spine.
• sedentaryLifestyle.
• Handling heavy labor conditionsWhich involves lifting weights that overloads the spine.
• Lesson heavy sportsIn which athletes lift weights regularly.
  
• Drinking alcohol and smoking. Smoking results in insufficient tissue oxygenation. Alcohol causes deficiency of vitamins and metabolic process in the human body.
• Overweight It leads to excessive load on the spine, which is weakened muscular corset.
• Lack of vitamins. Prolonged observing strict diets, the body does not receive the necessary nutrients, especially calcium, phosphorous, proteins and vitamins of group B, which are necessary to supply the skeletal system.
• Lack of sleep. Due to the lack of time for the body to rest, failures occur in the body's systems that lead to problems with blood circulation and metabolism, which affects the functioning of the spine.

signs of pathology

Symptoms of a herniated disc of the lumbar, even in the initial stage of the signal that you need to consult a specialist to assign the necessary course of treatment, which will be much more effective at early stage.

They are as follows:

• The emergence of severe pain in the spine or in the inner thighs.
• When the hernia patient may feel numbness and tingling of the legs of one or both at once, what happens when tripping on the sciatic nerve.
• Pain aggravated by coughing, running, sitting, standing and sneezing for a long time, then pain subside again.
• During the abrupt change of their position or lifting heavy pain increases.

Manifested symptoms: impaired stool, urinary bladder or urinary retention, impotence in men.

kind of hernia

Herniated intervertebral lumbar, and treatment of symptoms which are due to its specific characteristics, are classified as follows:

• Central hernia (SHmorlja hernia). It has the character of a congenital pathology and has the form indentations rather than protrusions on the affected area.
• Median spine hernia. Its causes are unknown. Over time, the hernia disappears without any impact on it. It manifested in the sensation of pain, which increases sharply and then subside again.
• dorsal hernia. Going intervertebral disc protrusion into the spinal canal, which leads to the infringement of the nerve roots. First, there is a pain in the lumbar region, but eventually begins to move in the area of ​​the feet.
  
• sequestered herniation. There is a breach anulus, its protrusions, then divide and output the nucleus pulposus in the channel lumen. If it is not treated, over time, a person comes pinched spinal nerve channels.

manual therapy

The aim of manual therapy in the treatment of herniated discs - to relax muscles and reduce pain in the lumbar spine.

Collecting information on human disease and his condition, chiropractor assigns the complex therapeutic procedures:

• acupuncture;
• application of hot stones;
• the use of paraffin and other devices.

To begin, the doctor performs massage to warm up your muscles vertebra, then gently pushes the patient of land with a view to restore cartilage that popped into place, eliminating the pain as a result of jamming nerves. As a general rule, a patient should feel relieved after the first session and retreat of pain. The average rate of application of procedures - 10 sessions.

After a full course of treatment the pain completely disappeared, restored mobility of the spine, normal blood circulation in the affected area.

There are also contraindications for the use of manual therapy in the spine.

Despite the large number of its advantages, chiropractic prohibited:

• people with cancer, and suspected cancers;
• in the presence of inflammation of lymph nodes;
• suffering from hypertension;
  
• having various diseases of the circulatory system;
• having an infectious disease.

Laser therapy

Laser therapy works on the causes that trigger the development of pathological changes in the intervertebral discs. It is applicable when the medication has not brought results, and there are no contraindications to this treatment. The use of laser is recommended in the early stages of development hernia - diameter of not more than 6 mm.

An important feature of the use of laser is that it can be used for pregnant women and nursing mothers.

Laser treatment is used, if:

• the patient feels constant pain lumbar and lower limbs on the side where the nerve root;
• atrophied and numb leg muscles, reduced range of motion;
• frequent headaches, dizziness, sleep disturbance;
• there is a general deterioration of the patient's condition.

The patient is undergoing tests in a stationary point, the results of which is assigned to laser therapy.

There are two ways to perform this procedure:

1. vaporization. The method consists in the fact that the action of the laser on the affected area of ​​the disk exposed to evaporation, which leads to its destruction.
2. Laser reconstruction. It involves activation of cartilage growth at the expense of heating disks by irradiation at low power.

Laser therapy - this is a long process of treatment, it is usually three-stage:

1. The first stage - 8-10 sessions. It aims at the elimination of exacerbations as well as its features. Usually after the first stage of treatment brings relief, however, that there was no recurrence, it is necessary to continue therapy.
2. The second stage - 13-15 sessionsIn which the progression of the degenerative processes suspend and stabilize the patient's condition occurs.
3. The third stage - the final consists of 5-10 sessions. At this stage the cartilage intervertebral disc is renewed.

Laser therapy - unpainful procedure.

Massage

Herniated discs of the lumbar (symptoms and treatment determined by a doctor) in the first stages of education is not strongly pronounced signs.

Massage promotes the use of:

• restore functions of the spine;
• ossification prevention;
• strengthens the back muscles;
• It helps to preserve joint function.

Massage is assigned a doctor, because the state is taken into account and the affected area of ​​the patient, the course of disease and a number of individual characteristics of the patient.

Depending on this, it is assigned to the required massage technique, whose main objectives are:

• improvement of blood microcirculation in the affected areas;
• muscle relaxation;
• quenching of pain:
• improving the mobility of the spine;
• the impact on the nerve roots, lowering their excitability;
• prevention of atrophic state of muscular system.

Classically hand massage:

• First Specialist warms the entire area of ​​the back, holding a general massage to the muscles warmed up, and the patient does not feel pain, then goes to the place of location of pain.
• Performing massage specialist alternates smooth and moderate stroking rubbing, applying a circular motion, alternately with point pressure.

Vacuum massage:

• For its holding applied pneumatic banks or glass.
• Before the massage, pneumatic banks need to compress, to remove them from the air and attach to the patient's body.
• In glass jars should be placed a burning torch alcohol for a few seconds and then attach to the body.
• Specialist moves attached by the banks to the body, carrying out massage, but without reaching the spine closer than 5 cm.

Honey massage:

• Using the classical manual massage the skin is heated, and then applied honey.
• By honey may be added medicated oil, thus enhancing the therapeutic effect.
• After the procedure, a specialist conducts manipulation to improve blood circulation: tightly adheres open hand to the skin and dramatically tears off her. In this case, the patient will feel an unpleasant tingling.

Apparatus massage:

• It recommended for herniated roller machine.
• Specialist affects this device on the back massaging with the desired pressure and velocity.

Preventive massage:

• It carried out when the desired result has been achieved (the pain disappeared, to normalize the patient's condition).
• To prevent back pain, it is necessary to support the spine muscle tone through preventive massage.

Physiotherapy

A positive result depends on the accuracy of exercise the patient and carry out such regulations:

• It is important to deal with on a daily basis.
• Avoid sudden movements and high loads in the classroom.
• Gradually increase the load, as well as the duration of employment.
• The patient must feel tired after an easy workout, but do not overwork.
• If you experience pain exercise should be interrupted and contact your doctor.

Exercises are performed 10-15 times each:

1. Lie on your back, stretch your legs to the side. Take a breath, you need to strongly stretch the abdominal muscles and exhale - relax again.
2. Lie on your back, legs slightly bent at the knees and arms extended along the body. Then, lifting your shoulders off the floor, you need to reach with straight arms to the knees. Pausing as 10-12 sec., Again take a prone position and relax.
3. While holding on their heels in a sitting position, hands to lean on the floor. Bend the spine upwards, putting away arms forward, and again take a starting position.
4. Sit on a chair, straighten your back, put his hands on the lower back and legs shoulder-width apart to breed. The position occupied by the slopes of the body to begin to right and left, forward and backward, while straining abdominal muscles.
5. Standing straight, hands clenched into a fist, to get behind the waist and legs to put on a shoulder-width apart. With slow breathing fists must be carefully pressed into his back, leading them down as you exhale become straight.

Contraindications:

• complicated by processes hernia;
• tumor metastasis;
• high body temperature;
• disease, worsening general condition and state of health of the patient.

spinal traction

spine stretching technique is called traction. The essence of this method: under load, create your own muscles or as additional devices for this purpose is carried out stretching of the spinal column. As a result of stretching the vertebrae back into place and avoided painful spasms.

spinal traction is conducted in different ways:

• Horizontal. The patient is placed on the surface, where there is the elevation for the head, and his hands and legs attach fixing loop. In this position by stretching the vertebrae under its own weight.
• Vertical. This technique is used in the early stages of development of a hernia and it can be carried to the patient at home using a horizontal bar for this purpose.
• Underwater. This procedure is used in clinics, where the patient is placed in a pool, using for this purpose pads and handrail. The water has a relaxing effect on the body of the patient. Underwater treatment method can be used during acute hernia.

Advantages of this method:

• To prevent possible preparative treatment;
• prevent operation under a positive effect;
• relief of pain experienced by the patient;
• reduction of tension in the muscles;
• reduction in the load of the intervertebral discs;
• decrease pressure on the nerve roots;

Spine traction is contraindicated:

• If you experience pain in the latter conducted procedures;
• the sensation of pain during the session;
• the lack of results after a course of sessions conducted by aquatic therapy.

Exercises using curling

Vocabulary torsion (helical gymnastics) does not operate at the complicated processes hernia.

A positive result depends on the correctness of the patient and their implementation of these rules:

• perform exercises on the floor and on a hard surface, can podstelit mat;
• pre-ventilate the room, close the windows to avoid drafts;
• prior to the slightly warm affected areas light stroking massage;
• conduct training on an empty stomach;
• exercises are performed with a small amplitude, slowly and carefully;
• with painful sensations should immediately terminate employment;
• if you feel a pleasant, easy fatigue of the muscles, the exercises are performed correctly;
• Proper breathing technique: breathe out is on strengthening; inhale during relaxation;
• curling performed slowly and smoothly;
• increase each exercise for 1 movement after 2-3 sessions;
• for exercise clothes should be comfortable.

The complex of exercises:

1. Lie on your back, place your right foot on the left knee. Arms extended, eyes upward. In this position, lower the legs to the left, and the head is turned to the right. This exercise is done with the other leg and arm.
2. Lie on your back, bend legs and pull to the stomach, then bend to the left, the head is turned to the right. Exercise perform, leaning the other way.
3. Lie on his stomach, his hands folded in front of him and put his head on them, stretch the floor socks. Raise your head and at the same time take the bent leg to the side and towards the head. A few seconds to stay in this posture and lie down again. Repeat the exercise with the other leg.
4. Lie on your back, eyes looking up. Bend the legs to place them shoulder-width apart. Lifting his left leg, fixing it up, and his right hand to reach to the knee. Then lie down and repeat the exercise with the arc foot.

Contraindications:

• aggravation of a herniated disc;
• high body temperature;
• diseases related to the heart;
• diseases of internal organs;
• metastasis of cancer tumors in the spine.

Rules:

• it is important to do the exercises on a daily basis;
• eliminate sudden movements and rotations;
• gradually increasing the load;
• in the case of the presence of pain at the site of the hernia patient should stop gymnastics and seek medical advice;
• the amount of exercise 10-15 times.

Gymnastics Dr. S. M. Bubnovskaya

The purpose of this gymnastics exercise is to restore and tone muscles:

1. On all fours while exhaling bend your back as much as possible, and on a breath - to bend it. Exercise carried out smoothly, slowly, up to 20 times.
2. Sitting on the floor, to have his hands behind his back and lean them against the floor. To begin the exercise, straighten alternating feet at 45, pulling on his socks on. Do the exercise at least 5 times.
3. Lying on his back, his left arm to have a head, and his right knee to try to hold on to his left elbow. Repeat with the other hand and foot. The number of executions - 15 times.
4. Lying on your back, bend your knees, and his hands behind his head start. During the exercise you need to portray cycling, alternating each leg 10 times.

Developed by a special technique, Dr. SM gymnastics Bubnovskaya, aims to restore the intervertebral disc and the normalization of blood flow. Under expert supervision achieved the maximum result.

In some cases, remove a hernia?

Herniated lumbar symptoms and treatment which have been established and conducted activities not contributed to improving the condition of the patient, in need of surgical removal.

Hernia removed when:

• Significant increase hernia to 10 cm.
• Impairment of the function associated with pelvic operation.
• Begun patient problems with urination, and also manifested erectile dysfunction in men.
• The deterioration of the patient's state of health. Weakness, sluggish state, reduced sensitivity in the legs.
• Rupture of the annulus fibrosus and nucleus pulposus from flowing into the spinal canal.

discotomy

When discectomy intervertebral disc is removed in whole or in part. Before the surgery takes place to collect information about the patient's condition, disease progression, analyze the collection. Discectomy helps eliminate hernias and its complications.

Types discectomy:

• Full or classical discectomy - complete removal of the intervertebral disc.
• Partial discectomy. It is assigned when the patient's disease progresses without complications, and removed a fragment of the affected intervertebral Wild.
• Endoscopic discectomy. It is a low-impact and consequences of its minimal. Is performed using an endoscopic device.
• Percutaneous discectomy or nucleoplasty. It is used for the removal of intervertebral hernias of small size and without the fibrous ring.

Contraindications:

• during pregnancy;
• diseases of the circulatory system;
• diabetes;
• heart disease;
• an infectious organism defeat.

Features of the operation:

• Classical discectomy performed lulling patient under general anesthesia. Make skin incision in the lumbar region, size of 10 cm, then produce removal of the affected intervertebral disc. The duration of operation of up to 2 hours.
• Microdiskectomy performed under general or local anesthesia. The operation is performed using a surgical microscope by making a skin incision size of 3 cm.
• Endoscopy is performed with an endoscope under local anesthesia. The surgeon makes the skin incision the size of 1.5-2 cm.
• Nucleoplasty (percutaneous discectomy). Performed in outpatient clinics under fluoroscopic guidance with the patient's local anesthesia. A special instrument is inserted into the intervertebral disc and by means of laser radiation or cold plasma removed hernia.

Postoperative recovery:

• It recommended bed rest for a day, and after 2-4 weeks is allowed to sit.
• Remove the stitches after 2 weeks.
• After the operation is prohibited ups weightlifting, running, gymnastics in the last month.
• It is recommended to wear a support brace during recovery within 2 months.
• LFK prescribed period after the reducing.

laminectomy

When laminectomy occurs eliminate shackle spine - lamina.

Contraindications:

• infections and inflammations;
• diabetes;
• a weakened immune system;
• pregnancy;
• cardiac and respiratory failure.

Features of the laminectomy:

• Before the surgery, the patient should consult a doctor, check your body for a reaction to the drugs used during surgery to identify the absence of allergy to them.
• Before the operation it is important to refrain from smoking, drinking alcohol is forbidden, the patient should not eat food for 6 hours before surgery.
• Laminectomy was performed under general anesthesia. Perform skin incision size of 3 cm. After that, remove the progressive processes of the spine.
• After the operation, the wound is sutured in layers.
• According to statistics, improvement occurs in 80% of the operated people.

Postoperative recovery. This period usually passes without complications.

The main thing is that the patient has complied with all the rules that set his doctor:

• In the first day of operated patients are prohibited to get out of bed.
• The following day, allowed to get out of bed and walk. Extract the patient occurs on day 3 after surgery conducted.
• Recommended follow-up examination after 2 weeks.
• At home, you must adhere to all the doctor's instructions strictly take prescribed drugs, engage in restoring physical therapy.
• To go to work a man can in 2 weeks if his work activity does not require hard physical effort. Classes are familiar sport can be resumed after 2-4 months.

endoscopy

Endoscopy is characterized by minimal intervention in the patient's body, which allows you to maintain the integrity of bone structures and muscle ligaments. Endoscopy allows to reduce the duration of the rehabilitation period and will soon return to the familiar life.

Features endoscopy:

• Before performing endoscopy patient must undergo X-ray examination herniated discs to to determine the exact location and size of the hernia, see the hole from which exit the spinal roots nerves.
• Surgical patients anesthetized local anesthesia. Operates on a patient table placed under the belly roll.
• With the help of X-ray data it applied marking where need to do a small puncture.
• The puncture made by the endoscope is introduced and the working tool is performed through it.
• Hernia removed in fragments.
• After the endoscopy, an endoscope is removed from the hole and place it sutured, after which you need to care for 10 days, changing the bandages.
• A month later, the patient should apply for inspection to the surgeon to do the operation.

Benefits:

• endoscopy - a gentle method of removing the herniated disc, since, performing surgery, puncture done no more than 7 mm in the abdominal cavity, thus avoiding muscle injuries of ligaments;
• moderate pain usually conducted after operation and lasted for several days;
• scars are missing after conducted by endoscopy;
• retained integrity of the bulk of the intervertebral disc;
• when performing endoscopy uses a special magnifying setting that allows you to monitor the progress of the operation.

microdiskectomy

Microdiscectomy - an operation in which a part is removed and hernia of the intervertebral disc. Mikrodisketomiya carried out using a special surgical microscope.

Features of the microdiskectomy:

• Before the surgery, the patient is like an MRI or CT scan of the spine. Also carried a standard collection of tests.
• The operation is performed under general anesthesia.
• With microtools skin incision is made, the surgeon then takes a part removal and hernia of the intervertebral disc, compressing the nerve. After the operation the patient's wound was sutured.
• The operated patient is delivered to the room. There he has to lie on his side 5-6 hours. Once matured time you can walk, but to sit the patient is not recommended.
• Performed daily bandaging of seams, and they are removed on day 7. The patient is discharged from hospital.
• tissue injury as a result of the operation is small, and complications are rare.

Contraindications:

• acute catarrhal or infectious disease;
• skin infection on his back;
• venous thrombosis of lower extremities;
  
• complication of heart disease, lung, diabetes.

Postoperative recovery:

• After discharge from the hospital to operate on a patient should not be given the load on the spine, a long time to sit in one position, angling back to drive.
• The patient should wear a support corset.
• the patient's ability to work occurs after 6 weeks, if his work does not involve heavy lifting.
• During the recovery period it is recommended to exercise exercise therapy and physiotherapy passage.

laser removal

Laser removal of herniated lumbar involves minimal damage to tissues and ligaments. Laser technology enables to control the operating process, the laser radiation dosing and his strength.

With the help of a hernia removed safely laser, thus starts the process of tissue repair, and also contributes to laser ablation treatment of pain and inflammation and destruction of the intervertebral further drive.

Features of the laser removal:

• Before the operation it is necessary to pass inspection: to pass urine and blood samples, a cardiogram pass, an MRI or CT scan, as well as other surveys, which will appoint a physician. Laser ablation is performed under local anesthesia.
• Through a small skin incision, is inserted a special device that emits waves of a certain frequency that remove damaged portions of the disc without damaging the muscle tissue.
• The surgery is performed with high accuracy, as all steps are increased many times and displayed.
• Extract the patient can have the next day after the conducted transaction.

Postoperative recovery:

• The state of health of the operated patient is normalized after a few hours.
• As already written out the next day, the patient has to take prescription drugs anti-inflammatory action.
• You want to perform a set of exercises designed to strengthen the back muscles.
• Operated patient must attend physiotherapy.
• After the operation is prohibited to overload the spine, it is important to avoid heavy lifting.
• Swimming lessons will help strengthen weakened muscle corset back.

Possible complications after surgery:

• Herniated discs of the lumbar (symptoms and treatment depend on the stage of the disease) faces possible serious complications in the postoperative period. Some of the complications are due to that mistake during the operation.
• Allowing errors in the administration of anesthesia to a patient.
• Damage to the patient's spinal cord or nerves during surgery. The consequences will manifest in the occurrence of chronic pain, limb weakness, irreversible paralysis.
• Damage to the brain small vessel shell will lead to its inflammation and inflammatory frolicked the process will manifest itself in constant headaches, memory loss and neurological cause disorder.
• Not the removed pieces anulus during operation. It leads to the inflammatory process and require reoperation.
• If the damage of the arteries feeding the spinal cord blood will develop paralysis of the lower limbs.

Recurrence of hernia

Distant complication may occur a year after the operation. a second operation is needed more often, because the treatment of relapse often to no avail.

Spondylolisthesis - a complex form of recurrence of a herniated disc, which can occur on the background of violations of the integrity of the spine due to the dissection of bone tissue.

As a result, it reduces the level of stiffness of the spine to change his mechanics, will be instability, which will cause the displacement of the spine and hernia formed again.

To reduce the likelihood of relapse is necessary to adhere to the doctor's recommendations for rehabilitation and after its completion. It is necessary to pay maximum attention to your back, carry out a complex exercise therapy, refrain from lifting heavy objects, visit a massage, swimming, protect your spine from the cold.

Exercising after excision of the hernia

When performing gymnastic exercises it is important to do them on a regular basis - every day, and gradually - start with 1, 2, and reach up to 10-15 repetitions. Inhale during the exercise you need through your nose, exhale slowly, 2 times longer than inspiration As you exhale, lips should be phased out tube. It is necessary to eliminate sudden movements and do not bend the back and sides.

Feeling the pain, the exercise should be interrupted:

Exercises on the side	Exercises on the stomach
Pulling two legs knee to the stomach, you need to exhale. Lifting the legs while to straighten them. When you inhale lift one leg, and on the exhale lower it turned over to the other side, do the same for the other leg. Pulling both arms forward, with little to raise the torso. With a hand under his chin, slowly lift the leg.	Based feet on the floor, hands are placed under the chin, in this position, raise your knees, when it should feel the muscle tension in the gluteal area. Perform alternately to both legs pulling up the knee to the elbow. Alternately for both legs to perform knee flexion, turning his head.

Any symptoms of herniated discs of the lumbar quite perceptible to humans, so there is always the opportunity to quickly identify this pathology and seek treatment from a specialist that will help reduce the risk of possible consequences and avoid surgery intervention.

Author of the article: Lyashenko Victoria

Registration of the article: Lozinski Oleg

Video of the lumbar intervertebral hernia

Herniated lumbar treatment and exercise: