We have talked about the osteochondritis quite in details and a lot. We talked about one of the problems which appear under this disease, it is the disc herniation, and it is the result of the osteochondritis. Topic of the operation which task is to remove the herniated disc material is under a hot discussion, there are a lot of opposite opinions about it. Surgeons consider it the last resort method for removal of such herniation, the only effective, other specialists; on the contrary consider it to be potentially dangerous. It is true they forget to tell that the conservative methods of treatment are not always effective, and finally the operation is inescapable.
But in this case, surgeons consider this variant of the disc herniation to be advanced, and to make the operation is more dangerous and difficult, and possibility of the positive result is lower. Besides, they think that it is better to operate as soon as the disc herniation is revealed. Other specialists, on the contrary, produce their arguments; and some “magic circle” of discussions is formed, and it is possible to go round it eternally. And what is possible indeed, is it possible to avoid the operation while treatment the disc herniation of the spine?
«Age disease», or what is the osteochondritis?
In general this disease leads not only to the disc herniation. In leads to many others very unpleasant manifestations. Usually it is considered as “an age related disease”; it results in degenerative-dystrophic changes and a lot of people suffer from it. It is true that nowadays this disease is becoming ‘younger”. Which changes appear under osteochondritis?
Most of all the intervertebral discs suffer from it. These cartilage plates have excellent absorbing abilities, at that they are quite unpretentious and very “patient”. But when is the osteochondritis developing they lose their properties, particularly to absorb the loads.
Additionally the lack on nutrition which is common with the osteochondritis leads to damages and in its turn it leads to the disc herniation appearance. Special attention should be paid to nutrition of the intervertebral discs. It is notorious that in this cartilaginous tissues there are not any blood vessels and they get their nutrient materials in the very interesting way from the neighboring tissues by diffusion. And in that is the sense of the problem.
First of all, the discs can get sufficient quantity of nutrient materials under condition that these materials are enough in the neighboring tissues. And if to take into our consideration nowadays style of life of the most people which prefer fast food, in which there are not any healthy components, it is a real problem, because there is nothing to supply to the discs.
Secondly, the diffusion can work properly only if the person moves, has some physical activities, in other words there must be necessary loads on muscles and ligaments of the spine. Nowadays for many people it is a problem, because they lead sedentary life, without any physical activities. This style of life is determined very often by necessity, for example particular nature of profession or job.
How the disc herniation is formed?
What is an intervertebral disc? How does it look like? There is a nucleus pulposus inside it, this nucleus pulposus is responsible for absorbing property of the disc. There is a fibrous ring around the fibrous pulposus; the task of the last is to keep the nucleus pulposus in its place. As we have already understood under the influence of the osteochondritis the nucleus pulposus starts to lose its properties. What is going on further?
The lack of nutrition affects also the fibrous ring. It starts to weaken, some cracks appears in it. At the same time, the nucleus pulposus which lost its properties has the same loads as before. As a result it starts to make high pressure on the fibrous ring in “the mode of a bush hammer”, all loads which take the spine, automatically goes to the fibrous ring. As the fibrous ring has been damaged because of lack of the nutrients, it cannot resist any more the normal pressure endless, at some certain moment the nucleus pulposus will find some weak point, which gets the main loads. What will be the result? The wall of the fibrous ring which is under pressure starts to bulge, the protrusion appears finally.
Process of protrusion formation practically always goes without any symptoms, so this stage of the disease is “successfully overlooked” by people. The most offensive thing is that on this stage of the disease it is possible to stop it. But the disease is not revealed and the protrusion is going on its development, and at some moment the fibrous ring cannot stand the pressure and it breaks, through this breakage the nucleus pulposus goes out of the intervertebral disc. This is the disc herniation.
This slopped nucleus is firm enough to make serious pressure on the neighboring with the disc nerve terminals and nervous roots of the spinal cord; this causes the pain syndrome and neurological symptoms. The organism on the level of reflexes tries to immobilize the affected area with the help of muscles tension, after some time the muscles become “tired”, and the muscles spasms start, which increase the pain syndrome.
When does the risk of operation arise?
You should not think that the appearance of the disc herniation automatically leads to operation. Indeed the operation is always considered to be the last resort method, which is applied in the most serious cases. Namely, when it is not possible to cope with the pain syndrome for a long period of time, and the disc herniation starts to disturb the functioning of the internal organs. The last reason is a direct surgical indication, because for example, the disc herniation in the lumbar part of the spine can disturb the functioning of the pelvic organs, there can appear some serious problems in the bladder and intestinal tract functioning, under some serious cases even the paraplegia is possible. In the last case even operation cannot always return mobility to the paralyzed legs.
In other cases, doctors use conservative methods of treatment very successfully.
Let us try to avoid operation?
In general, not any doctor will send you directly to the surgical table. Practically always he/she will try to treat you with the help of conservative methods. It’s a good thing that in the majority of cases this treatment is quite successful and gives the necessary results. So, what is the conservative treatment?
First of all bed rest is prescribed for the patient for several days, a little bit later it is changed for partial time bed rest and etc., till the moment the patient can return to his/her usual normal and active way of life.
The main medicines prescribed for the disc herniation treatment are nonsteroidal anti-inflammatory medications. They give an opportunity to remove the inflammation in the affected area, and thanks to this the compression of the nervous roots decreases and it means that the pain syndrome will be removed. But there is one problem, it is not possible to apply these medicines for a long period of time, they have some negative adverse effects. That is why these medicines can be applied only by a doctor’s prescription and only under his control.
During the acute period of the disease, when the pain is the strongest, along with the anti-inflammatory medicines the doctor can prescribe some analgesics. The patient should understand, that the absence of pain does not mean full recovery; this is only temporary effect of the medicine applied. The doctor prescribes them only to soothe sufferings of the patient.
The statement “if there is no ache, so there is no problem” is a mistake, it can cause to worth situation, because the problem has not disappeared, and additional loads will bring only harm.
On this stage of the disease this treatment is sufficient. In some cases strong drugs can be used, which remove inflammatory more effectively (but they bring more harm to the organism), and muscle relaxants, which give an opportunity to cope with the spasm of muscles, and some other medications. Also analgesic blocks are widely used, under which injections with analgesic medication are administered around the affected area, in most cases it is novocain. This block will be effective for sufficiently long period of time and remove the pain syndrome very effectively.
Movement is life!
When it is possible to cut the pain syndrome, then a real treatment can start. You do not need any medications; the main stress is made on the movement therapy and massages. The task is very easy, it is necessary to bring the ligaments and the muscles of the spine to a normal “working” state, to improve diffusion on the area of the spine. In some cases even a special diet can be prescribed. It is true the main task of this diet is to get rid of the excessive weight (it is also a very important thing), but also to supply the organism with all necessary nutrient materials.
When there are problems with the back the most effective preventative measure is sufficient physical activity (without excessive loads on the back), it prevents development of osteochondritis and disc herniation appearance.