Category Archives: Spinal Hernia

Massage for patients who have disc herniation; how to perform it in a proper way?

It is not a secret for anybody, that the diseases of the spine is a widely spread problem. Besides, the disc herniation is a leader among the diseases which can bring the most serious harm to the organism of a person. Not taking into our consideration serious pain syndromes, which can immobilize the person, almost arresting all movements. However, in other articles we have talked about such kind of disease in details, what is it, what are the symptoms and so on. In this article we would like to pay attention to massage for patients who have the disc herniation.

How is treated the disc herniation?

massaLet us consider the process of the disc herniation treatment process. First of all we mark an acute period of the disease. During this particular period a patient suffers from a strong pain in the back, which can be accompanied with different neurological symptoms.

Treatment during this period is usually one and the same: the patient is prescribed to take analgesics and nonsteroidal anti-inflammatory medicines; also it is possible to perform some physiotherapeutic procedures. These medicines application and physiotherapeutic procedures performing usually are enough to cut the pain syndrome, to remove inflammation and swelling, which are the cause for this pain appearance. It is necessary to draw your attention that the cute period is not very long if the treatment prescribed is adequate.

But the most difficult period starts further. According to the human psychology ‘if it does not ache, so the problem has disappeared”. Actually, everything is just the other way round, from this period some serious treatment should be started. And the main tasks for such treatment must be prevention of recurrences and the disease progressing. So, what should be done to achieve these aims?

Treatment after the “cute period”. Let us restore the spine

There are not any difficulties in this period of treatment. The main task is to restore proper functioning of the ligamentous apparatus and muscles corset of the back. In this case the organism will prevent the disease self-acting. Two main methods are usually used for this purpose; they are massage and movement therapy. At that you should understand, these methods are not interchangeable, they are mutually reinforcing methods. And if the movement therapy is described in details in other articles, massage techniques are described very facially, especially their use for disc herniation treatment and if it is at all possible to use them with this purpose.

It is not heal all, but it is an effective method of treatment

ext2In general massage is used during the rehabilitation period of treatment. For example, for patients having the disc herniation in the lumbar part of the spine, massage can improve the blood circulation in the affected area, to relax the cramped muscles and to stretch them. At that the pain syndrome will come down, irritability of the nervous terminals will decrease, muscle atrophy will be prevented. In general it is possible to perform massage only if the pain syndrome has been already cut, or it is very weak.

There are some different techniques of massage for the disc herniation treatment. Only a doctor can consider which type of massage can be applied in every particular case: classic massage, point massage (acupressure), reflexosegmental massage and etc. Its choice depends on clinical signs of the disease and how strong they are, presence or absence of other concurrent diseases, individual features of the patient and etc.

Also we should mention that for treatment of classic clinical signs of osteochondritis we can apply practically all kinds of massage: frolement, frottage, vibration, foulage. A massage therapist should observe that the massage do not cause to the patient any pain feelings, because if the massage is performed correctly it cannot cause any pain appearance.

Very often point massage is used for the disc herniation treatment as well as other types of massage. After the massage session the patient must feel comfort, relaxation, warmth in the area on which the massage is performed, movability of joints must be better and general feeling is improved. Time period of such session can be different; it is also defined by the doctor and can last from several minutes to an hour. Quantity of sessions, their periodicity is defined according to the state of the patient, his/her age and area on which the massage is performed. Usually one course of treatment comprises 20 massages and break between courses can be up to three months. In the end I would like to mention that use of the massage without simultaneous application of other methods will not bring you a stable positive result. This is precisely why for the spine treatment only some complex of methods is applied, which give an opportunity to achieve the recession of the disease.

What is the difficulty of a disc herniation treatment in the cervical department of spine?

Disc herniation is a quite widely spread disease, a lot of people suffer from this disease, but some cases of the disease stands aside, and we talk about cases when a disc herniation is in the cervical department of spine. The reason for its appearance is some specialty of this department, about which we shall talk below. This specialty can make the life of the patient very complicated and treatment of the disc herniation in the cervical department of spine very difficult.

What is the difficulty?

sheyaThe main problem is that the cervical part of spine is very small. It looks like some kind of «bottle neck» of the human body, the most vulnerable spot. The volume of the neck is very small; it is possible to say that about the diameter of the spinal canal and about the spinal cord in this canal. At that, through this relatively small part of the body a lot of blood vessels and nervous canals travel. Their high density can be justified by the necessity to supply to the brain a lot of oxygen and at the same time the brain must receive all necessary nervous impulses from all nervous terminals.

In normal situation such high density of the very important vessels and canals do not constitute any problems. The cervical department of the spine is very mobile, even if we talk about people with a very low level of physical activity; this department always bears high load. In this way the organism try to “make insurance” against possible problems.

But this constant load on the cervical department of the spine has “the reverse side of the coin”. The reason for the most diseases of the spine is a metabolic disorder. More often it depends on age, but now we should take into our consideration environmental pollution, and far from being ideal meal hobbits, so such diseases can acquire even relatively young people. As a result the osteochondritis and other spine diseases can appear. At that the intervertebral discs suffer the most.

Why does the disc herniation appear?

Let us start from the fact that the intervertebral discs do not have their own blood vessels. All necessary for their nutrition substances they get with the help of diffusion from the neighboring tissues. And the process of diffusion itself is to some extend «capricious»; a disc can get necessary quantity of substances, under condition that they are not only at their proper place in sufficient quantity, but the person (including neck) have enough physical activity (load). Nowadays as we have already mentioned, we have problems with both of these requirements.

What is going on further? The intervertebral disc begins to lose water, and after that its absorbing abilities. In the result it cannot fulfil its functions, gradually under the constant pressure it starts “to hold its ground”, or to say it easier , to mushroom, as a result in some place protrusions can be formed, potentially future prolapsed discs, and they can be the reasons for some unpleasant symptoms. If the protrusion was formed without any symptoms, then the person preferred to ignore the pain which is not very strong at this stage of the disease, so the next stage is the disc herniation.

In this case we mean that in the intervertebral disc a breakage occurred through which the nucleus pulposus goes out. This movement of the nucleus pulposus out of the limits of the disc is the disc herniation. We are not going to describe the symptoms by which this process is accompanied, we should mention only that for the cervical part of the spine even the protrusion becomes a problem (because of the above mentioned density of blood vessels and nervous canals traveling through the neck), the disc herniation in this case can be easily compared to a catastrophe.

How to solve this problem?

Treatment of patients who have such diagnosis as the disc herniation in the cervical part of the spine must be started immediately after the full diagnostics has been fulfilled. It is necessary to mention that the doctor must make a lot of investigations in order to define the size and the location of the disc herniation, and also to consider the necessary treatment. We are not to get into the details about the abovementioned investigations; we shall discuss possible variants of treatment.

In general, there are two main methods of treatment, conservative and surgical.
How to avoid an operation?

Conservative treatment means that recovery will be achieved without operative interference. In this case a doctor has two main tasks:

  • first of all to remove pains and neurological syndromes;
  • Secondly, to prevent progressing of the disease and formation of a new prolapsed disc of the spine.

That is why the first stage of treatment denotes particularly removal of the pain syndrome. With this aim the patient is to stay in bed for several days. He is prescribed to take analgesics and anti-inflammatory medicines. Their task is to cut the pain syndrome. At that analgesics just “sweep under the rug” pain, and anti-inflammatory medicines help to remove the inflammation and as a result the compression on the nervous roots will disappear, and at the end it will lead to decrease of the pain syndrome.

In most cases, this is enough for the first stage of treatment, to cut the pain syndrome.
The next stage is to prevent progressing of the disease and wellness. For this purpose their no need of any medicines (in most cases), the main methods on this stage comprise massage and movement therapy.


These methods give an opportunity to restore the state of the muscles and ligaments, which in their turn in the future will keep the spine column in the correct posture and sufficient physical activities will provide normal nutrition for discs. It is quite enough for the future under the condition of regular performing of complexes of movement therapy and healthy meal habits to prevent the patient from occurrence of a new prolapsed disc.

Operation is only the last resort measure

As we have already mentioned, treatment of the disc herniation in the cervical part of the spine is possible to remove in most cases without operation. Surgical interference is applied only in those cases, when for a long time it is not possible to cut the pain syndrome, or the prolapsed disc is the reason for the disorder in functioning of the internal organs.

The most effective exercises used for back treatment of patients having herniation in the cervical and lumbar part of the spine

It is commonly known that the herniation of intervertebral disk presents itself in the form of the fibrous ring bulging, this bulging can develop up to its breakage, in the result of which the nucleus pulposus moves towards the bulging, up to its falling out into the spinal canal. As a result we have compression of the nerve terminals of the spinal cord, and in their turn they respond on this influence by severe pain, functioning of some internal organs may be disturbed. The herniation of intervertebral disk can be formed in any department of the spine, but most often it is formed in the cervical and the lumbar part of the spine. Physical exercises are the base for herniation treatment (except for the moment of pain management), they give an opportunity to restore the muscles corset and to improve the state of the ligamentous apparatus, and because of this to avoid recurrences of the disease.

Exciting causes of the herniation of an intervertebral disk

ef-up1This problem cannot arise in a moment; it is a result of longstanding negative processes, which are running in the spine and in the whole body, and these processes last for many years. And the disease reveals itself after the influence of some provoking factor, which is some kind of the last straw, but it is not а cause of the disease. More often than not, improper lifting of some loads is this provoking factor, when the load is lifted by back, not by legs.

Degenerative processes, which take place in the discs, lead to the herniation of intervertebral disk. The reasons for these processes appearance are the following:

  1. Incorrect loading of spine. We talk not only about some loads lifting, but also about taking care about your correct posture, to work in comfortable position and so on. Disregard of these simple rules is an acceleration factor in destruction of the intervertebral discs;
  2. Lack of water in the body makes a very negative influence on connective tissue, including intervertebral discs. The main function of them is shock- absorbing function, which they can perform only if the quantity of water is sufficient, they take this water from the neighboring tissues. If the quantity of water is not sufficient, then the discs will dry out in a literal sense of this word, and it will increase the possibility of the herniation development;
  3. Absence of normal physical activity. It is a good reason why physical exercises are the base for the herniation treatment, but they are also necessary in the everyday life. Thanks to these exercises our muscle and ligaments of the spine are developing, their task is to keep the spine in the optimality state. Besides, intervertebral discs take their nourishment (they take necessary nutrients and get rid of unnecessary) by diffusion. Diffusion will run successfully, if there is some physical load, which improves the blood circulation. And the easiest way to create it is by physical exercises.
  4. A serious problem is also an unhealthy diet. The spine itself and its intervertebral discs need some particular elements, which can get into the organism only with food. The most important among them are well – known to all people: calcium, magnesium, phosphorus and so on. If there is a deficit of the abovementioned elements, then bony tissue becomes weak and spongy, and intervertebral discs start to decay. So, good nutrition is simply necessary for a healthy back.

Main rules of performing exercises for herniation treatment

ef-up2You should proceed to perform such exercises immediately after the pain syndrome has been removed. But you should obligatory follow some rules, otherwise physical exercises, if you have the herniation, will do you harm instead of good.

1. While choosing the exercises you should pay attention to your state and any pains should be absent. It is necessary because, bulging of the disc can move in any direction. You should perform exercises which do not cause you any discomfort, and only these exercises will be really effective for the herniation treatment. And if while performing the exercises you experience some light discomfort, it is necessary to perform these exercises, but you should perform them as carefully and precisely as possible. The exercises which cause sharp pain in the back while you perform them should be excluded. It is easy to understand that such exercises performing should be put on ice, but they can be a peculiar kind of a “diagnostician”. If after some time you repeat the exercise and it will cause you less pain, then you are on the right way.

2. At the initial stages you should avoid those exercises which presume “twisting” of the body.

3. Also you should avoid blows to the region of the spine, jumps and sharp jerks.

4. You should perform the exercises as often as it is possible during a day (2-6 times), but you need to divide the complex of exercises into several separate parts, which you will perform in different periods of time.

5. You must not apply a sharp force to the problematic areas of the spine.

6. You should start the exercise with minimum amplitude and load, and only after that to increase them gradually.

7. Do not try to recover during one day, during one moment “to set” all discs and all vertebrae together. The spine can be restored very carefully, and at the same time the blood circulation in the affected by the disease part of the spine should be improved gradually.

Exercises for treatment herniation in the lumbar part of the spine

In the majority of cases the herniation occurs particularly in the lumbar part of the spine. The complex of exercises such as below is a standard one and it is aimed at people who suffer from the herniation for a long time. But it should be taken into consideration that treatment is practically always individual, and it means that the physician caring for the patient can recommend some additional exercises to this complex. In general the aim of these exercises is to strengthen and to develop functional abilities of the spine, and also general training of the body muscles.

ef-up3Exercise 1

Lie down with your back on the floor, straighten your hands along the body, the legs should be in a slightly bent position. While performing this exercise you should not hold your breath. Tense the muscles of the abdomen, the abdomen must be hard. You can control your muscles if you put your hands on the abdomen. This exercise is done 10-15 times.

Exercise 2

This exercise is also performed when you lie on your back; hands are straitened along your body. You should lift a little your body, at that your legs should stay on the floor all the time. This position should be kept for 10 seconds, after this you can slowly descend on the floor, returning to the initial position. After the exercise is done, you should have a short brake, not more than 10 seconds. This exercise you should repeat 10-15 times.

Exercise 3

The initial position is lying on the back; your legs are to be bent a little. You should straighten your right hand ahead, placing the palm on the knee of the left leg. After that start to bend the left leg, while doing this, your right hand should maintain resistance to the left leg bending, not permitting it to reach the head. This exercise is done with some effort during 10 seconds, after which you can gradually and slowly return to the initial position. Then you should have some rest during 10-15 seconds. This exercise should be done 5-10 times, after that change the hand and the leg (the left hand is against the right leg), repeat the exercise 5-10 times more. During your rest you should relax the muscles of the body, hands and legs to the full extend.

Exercises for treatment herniation in the cervical part of the spine

The complex of the exercises given below is performed for treatment herniation in the cervical part of spine. But you should take into consideration that this part of spine is very “capricious” according to many aspects, so you should be very careful performing the exercises. Besides all exercises are selected individually, and your physician can add some more exercises to the below complex. Also these exercises cannot be done while sharp disease course, on the opposite, in this period it is necessary to put the retentive bandage, which will rest to the affected discs and vertebrae.

The given below complex of the exercises is aimed at the neck muscles elasticity restoration and vertebrae movability improvement.

Exercise 1

You can do it when you sit or stand, hands are down along the body. You should turn the head to the right end position and after that to the left end position. This exercise is done 5-10 times. When you do its lighter variant, then little turns to the sides are enough.

Exercise 2

The initial position is the same as in the previous exercise. You should slowly stoop your head, trying to press your chin to the breast. You should do it 5-10 times.

Exercise 3

You can do it when you sit or stand, hands are down along the body. You should slowly throw your head back, at that it is necessary to draw in the chin. This exercise should be done 5-10 times.

It is necessary to draw your attention to the fact that you can do these exercises only after you have consulted your doctor. The above mentioned complexes of the exercises will not do you any harm while the spine herniation treatment, but only the doctor can take into consideration all individual factors of your case and to choose the most effective for you complex of the exercises.

Also, do not forget that exercises recommended after the operation of herniation removal can be slightly different from the above mentioned complexes.

Symptoms and treatment of a prolapsed disc l4-l5 and l5-s1

A prolapsed disc – it is a disease when the vertebral pulp is dislocated through the formed in the fibrous ring breaking. It is worth mentioning that this disease does not appear during one day, a disc herniation forms prior to it (bulging without the fibrous ring breaking). But it is not a rare case when the disc herniation is forming without any symptoms manifestation; that is why the onset of a prolapsed disc is unexpected for a person.

More often this disease appears in the pelvic part of a spine, rarer it appears in the cervical part of the spine, and the rarest case it is when it appears in the thoracic part of the spine.

The pelvic part of the spine is the weak point of the spine

Why the pelvic part of the spine is the most common place for appearance of a prolapsed disc? The reasons are very simple. This particular part of the spine takes the maximum load; the body center of gravity is located in this particular part of the spine. At the same time, the spine in this part has quite large movement amplitude, and it is the most mobile.

Cases of disease, when l5 s1 prolapsed disc occurs, are more often, a little bit rare is l4 l5 prolapsed disc. These particular intervertebral discs take the maximum load; they do have any rest almost never. Even if a person lies down, they do not lose their load.

Very often we do not even think how large the load which the lumbar spine bears is. And often, without understanding it, we do our best, in order to make our disc to «capitulate». One lifting of load by “our back” is worth much. And we lift loads correctly very seldom.

Causes of the disease appearance

l5s1Causes of a prolapsed disc formation can be different, but in most cases it appears as a result of the degenerative disc disease. In the result of the current degenerative processes the nucleus pulposus starts to lose water, accordingly it loses its absorbing abilities. The fibrous ring also has no sufficient quantity of the nutrient materials, and as a result its structure starts to ruin. As far as the load on the spine does not decrease, and the nucleus pulposus has lost its absorbing abilities, it starts to press the walls of the ring, and in the result of this process a disc herniation is formed. If the disease has not been detected on this stage, then in some period of time the fibrous ring will break and a prolapsed disc will be formed.

Metabolic disorder contributes to the contraction of this disease, also it can be excessively active lifestyle (for example professional sportsmen), or too sedentary behavior (people with sedentary lifestyle and low level of movement activity). The problem is that an intervertebral disc does not have its own net of blood vessels and it takes all nutrients from the neighboring tissues with the help of diffusion. Under condition of absence of necessary load diffusion simply does not flow adequately; and the intervertebral disc is kept on «starvation diet».

As we have already mentioned, because of it the pelvic spine suffers above all things, and as a result we have prolapsed l4 l5 or l5 s1 discs.

Pain as the main symptom of a prolapsed disc

In common case the disease reveals itself by local pains in the affected region, which can become stronger when in motion. This pain can spread also to the gluteal region, it can “shoot up the leg”, spreading to the internal and external surfaces of the hip. Sensibility can be also disturbed in that part for which the pressed nervous root is “responsible”. So, very often there is numbness of the foot, reflexes of the leg can disappear (knee reflex and Achilles reflex), sensibility can increase or decrease. Such symptoms will appear almost always, for example, under dorsal l5 s1prolapsed disc.

Much worse the situation is, if you have to deal with diagnosis – l5 s1 «median back prolapsed disc”. The problem is that the prolapsed disc starts to press peculiarly on the spinal cord or to compress «horse tail», and in the result of this the pelvic organs functioning is disturbed seriously. Such cases of the disease can be treated only surgically.

The most unpleasant and dangerous form of this disease is a sequestrating prolapsed disc. In this case a part of the prolapsed disc is detached, and the symptoms of the disease often increase, pains become unbearable. Besides this, it is not rare, when a sequestrating prolapsed disc l4 l5 leads to the same results, as the above mentioned form, “horse tail” compression or compression of the spinal cord itself. Many doctors consider that this type of the prolapsed disc can be treated only surgically.

What kind of treatment should be applied?

Conservative treatment

l5s1-2At the beginning of treatment of this disease always conservative methods are applied. It should be mentioned that they are effective and sufficient in the overwhelming majority of cases. In particular more than 70% of patients experience serious improvement already in 12 weeks of treatment, and in half a year from the moment the treatment started more than 90% of patients recover. And only in rare cases it is necessary to apply surgical interference.

Conservative treatment starts at the moment when the precise diagnosis is established. First of all the patient is ordered to bed rest for several days, analgesics and anti-inflammatory nonsteroidal medicines are prescribed. Also neuromuscular relaxants can be prescribed, if the pain syndrome appears in the result of muscles spasms.

On this stage the conservative treatment is aimed at the pain syndrome arresting and inflammatory process removal. In the result of the inflammatory process removal, compression the nervous roots, is removed totally or decreases, and as a result the pain syndrome disappear.

After the pain syndrome is arrested, the main stress in treatment is made at physiotherapeutic procedure, massages and movement therapy. It is worth mentioning, that nowadays a lot of new methods of the prolapsed disc treatment appear; there are the following new methods: acupuncture, Shockwave therapy, laser therapy, etc. Unfortunately, not all offered methods make the declared influence, it happens very often when they are of no use at all, so, it is better to defer to your doctor’s opinion and to follow procedures prescribed by him/her.

And movement therapy is the key to your total recovery and restoration of your movement activity. Complex of physical exercises is performed with the aim to restore the ligamentous apparatus and the muscles corset, it gives an opportunity to stop the development of the disease and prevent recurrences or formation of this disease in some other intervertebral disc.

Surgical treatment

This type of treatment is the last-resort treatment; in the most cases doctors try to avoid it. Surgical interference is recommended only in that case, when during a long period of time it is not possible to arrest the pain syndrome, or the disease starts to affect seriously the internals functioning. It usually happens when the diagnosis «the prolapsed disc l5 s1» or “sequestrating prolapsed disc” is established.

Now development of the surgical methods of treatment is aimed at decreasing of the surgical trauma. The reason is that the injured during the surgical interference muscles do not have enough time to restore, metabolic process is disturbed, the muscles corset cannot perform its task to the full extend, and this leads to the formation of a new disease or recurrences of the old one.

That is why the microdiscectomy is widely used now, which is micro neurosurgical interference. It is performed using optical enlargement (by a binocular eye loupe or by a special microscope). In the result the trauma is very small, and the risk of recurrences is minimal.

The other method, which is widely popularized nowadays, is the endoscopy. When using an endoscope the trauma the least, but this method has its drawbacks. Particularly, there are serious limitations because of size and location of the prolapsed disc, if it is possible to remove with the help of this method.

The disc extrusion

The disc extrusion is the first stage of progress of the already formed herniated disc. On this stage the fibrous ring has been already broken and the nucleus pulposus already started to come out of its limits, but it is still kept by the longitudinal ligament. This stage of the disease is called also as «lumbago».

Let’s get down more to details, how the herniated disc is forming and which stage in this process the disc extrusion takes.

Forming of the herniated disc can be divided into 4 main stages. Each one has its own peculiar features, treatment for all stages is also different; each stage is requires more complicated treatment than the previous one. And so

The first stage is a bulging disc

extThis phase is a degenerative one. On this stage the intervertebral does not have enough water and as a result pressure in the disc decreases, it loses its tension; it becomes softer, flexible. In spite of water shortage all tissues of the disc keep their volume. At the same time the axial load does not decrease, and with the flow of time it can increase (for example, if a person gains weight due to unhealthy food or some inherited genetic reasons). In the result the wall of the disc starts bulging little by little, coming out of the anatomy limits of the spine. But it is only the beginning of the disease.

There are not any specific symptoms on this stage, you can mention only that your back is a little bit more tired than usual and your quick tiredness after some physical activity. Some small bulging cannot provoke a pain that is why people can successfully ignore this stage, they do not see any actual reasons to consult a doctor.

The second stage is a prolapsed disc

As we have already mentioned, the nucleus pulposus has almost lost all its absorbing qualities and the fibrous ring is also weaken (because of the same reasons lack of water and nutrients). But the nucleus pulposus does lose its density, and load on the spine is as usual it does not disappear. Under this influence the nucleus pulposus starts to move from its natural location and to press the fibrous ring. Further “the principle of a breaker hammer” is working: every movement of a person which creates load onto the spine makes the nucleus pulposus “to beat” the fibrous ring. It is not a beat in its direct meaning; it is just increased pressure, but «constant dropping wears away a stone». But some day or other the fibrous ring starts to retreat. Bulging is increasing.

We would like to draw your attention to the fact that till this moment there is no pain, the only symptom is the increased fatigability. Very often some “good creature” suggests you in this situation to go info sport, to strengthen, to restore your back. But all common trainers in all common gyms have some different point of viewhow to restore your back”, and as a result you start to do the exercises which only force the development of the disease.

As a result the nucleus pulposus finds the weakest place in the fibrous ring (which is already seriously damaged) and wedges into it; and from this moment the second stage starts, a prolapsed disc. Pay your attention that the fibrous ring has not been broken yet, the nucleus pulposus does not come out of its limits. There is only a serious bulging.

Symptoms of a prolapsed disc

In some cases this stage of the disease does not have any symptoms, if the bulging does not reach the nervous roots. Otherwise the character of pain and its localization will totally depend on the place of the prolapsed disc formed. There may be local pain in the neck or in the leg, it can irradiate to the leg or to the hand, sometime this pain can spread to the intercostal space or to the napex. Some relaxation of the muscles is possible in those areas for to which the compressed nervous root travels, in the addition to the above relaxation can be combined with sensibility disturbance.

If a person has a prolapsed disc a headache is also very common, ups and downs in arterial tension, dizziness, numbness of legs and hands, numbness of fingers (if the problem is in the cervical region of vertebral column).

In general, symptoms are not very indicative, very often people associate them with very different diseases, they are not even aware of some problem in the back.

Disc extrusion is the third stage

ext2The next stage of the disease is the intervertebral disc extrusion. If you do not treat the prolapsed disc, and we understand now, that in the majority of such cases this disease is ignored, then sooner or later the fibrous ring will not be able to stand the pressure of the bulging nucleus pulposus and it will be broken. This break usually happens under serious load on the spine, it is some kind of “shot”, in the result of which the nucleus pulposus breaks the disc and comes to the fibrocartilaginous ring. From this moment a person actually has the herniated disc.

Most often (approximately 90% of cases) this disease affects the lumbar part of the spine. The reason is that this part of the spine the most serious loads, this particular part of the spine suffers from improper items of weight lifting and from similar problems. At the same time if the problems are present in this part of the spine it will probably lead to serious consequences.

The disc extrusion itself is the early stage of the herniated disc formation and if a proper treatment is applied it is possible to eliminate it totally. But about this we shall talk a little bit later. Let us start with the manifestation of symptoms of the disc extrusion.

The disc extrusion symptoms

Let us get down to the most widespread cases, when the problem is in the lumbar part of the spine.

Usually «shot» occurs under some provoking influence. Hypothermia, weights lifting, stress and some others can be in the role of such influences. In this moment there appears sharp local pain. Over some time (a day or two) this pain starts to spread to the buttocks, and after that to the leg. This pain will be very and it can seriously restrict movements of the leg, as a result a person starts to limp.

Practically always this pain is in combination with neurologic syndromes. The leg, to which the pain spreads, becomes weak quite seriously, there is a disturbance of sensibility in it, and also there can be numbness (more often in feet), the knee reflex and the Achilles tendon reflex becomes weak or disappear totally.

You can’t but agree, such symptoms it’s almost impossible to ignore, and this time any person will go to consult a doctor.

Treatment of the herniated disc on the early stage

The disc extrusion is the early stage of the herniated disc formation, and operative interference is not necessary in this case, usually it is possible to cope with it applying conservative methods of treatment. In this case the task of treatment is to eliminate inflammation of the compressed nervous root, its swelling and to remove compression.

ext3Such patient is prescribed a bed regime for several days, analgesics and nonsteroidal anti-inflammatory medicines. If the pain is provoked by a muscles spasm, then muscles relaxants are prescribed. Under condition of keeping to a bed regime and applying appropriate medicines the pain will disappear gradually in several days.

If it is necessary, a doctor can prescribe massages and physiotherapy.

After this pain has disappeared totally, physiotherapy becomes the main method of treatment. It gives an opportunity to restore muscles corset and to improve the state of ligamentous apparatus. And this in its turn will prevent recurrences of the disease and formation of new herniated discs In this event, a patient must understand, that in the future he needs to do movement therapy himself because the state muscles and ligaments should be kept in a good condition. Also the patient should make a new movement stereotype, learn to avoid provoking movements.

On this stage, the conservative treatment is fulfilled; it is expected that in the future a person will take care of his back himself and follow given to him recommendations.

The fourth stage is the sequestered disc

It is the most complicated variant of a disc herniation development. We get the sequestered disc, when nucleus pulposus leaks out to the spinal channel. Extrusion very rare develops into the sequestration; it is possible only in that case if the longitudinal ligament has not kept the nucleus pulposus, and the nucleus pulposus broke off totally from the disc. Sequestration is not only the most painful kind of herniation of an intervertebral disc, but also it can result in very serious complications.

Primary symptoms of this disease are similar to the symptoms of extrusion, but they are manifested more intensively. The problem is that the hernia starts to compress the spinal canal, and it can be a reason for hands and legs paralysis. Additional problem is that the nucleus pulposus which fell into the spinal canal contains quite high concentration of protein molecules. In the result the autoimmune inflammatory reaction may appear similar to that, which appears under rheumatism.

I would like to draw your attention to the fact that such serious form of the disease is possible to cure in very rare cases by the conservative methods of treatment. Many doctors consider that sequestration must be operated. But it is necessary to remember that an operation is the last resort method. And if there is a chance to avoid it is better to take this chance.

Is acupuncture useful for the prolapsed disc treatment?

Acupuncture is one of the ancient methods of treatment of different diseases. Nowadays acupuncture is used for treatment of the prolapsed disc of the spine. In general this method is based on knowledges about a body constitution, nervous centres locations and the correspondent to them acupuncture points.

Nowadays this method is very often offered for treatment of osteochondritis, it is considered tha t the most optimal way of its use is in combination with massage. According to the specialists’ assurances, this method gives a good effect while spinal diseases treatment, because around the spine there are a lot of active points. On the other hand, there are no official data, that treatment of the prolapsed disc of the spine by acupuncture can be actually effective.

Let us get all this straightened out. What actually is this method of treatment?

Old Chinese medicine

akuOne of the underlying concepts of the old Chinese medicine is the concept of the vital energy, which flows in the body of a man by the certain channels. This energy is Qi (pronounced “chee”), is energy in the very broadest sense possible. It is assumed that this energy provides for normal functioning of all internal organs, flowing through them. And diseases appear because of its flow is disturbed or stopped.

There are more than thousand acupuncture points on the body of a person. It is considered, that by influence on these points it is possible to improve or to restore the flow of the vital energy to the concrete ill organ. The task of acupuncture is to reveal and to eliminate “stoppage” of the channels, by which the vital energy flows. When the vital energy flow is restored, a person recovers.

Contraction of the prolapsed disc

One the one hand this explanation is not scientific and it is not considered as a serious one. On the other hand, doctors confirm, that we do not know everything about the human body functioning, so, this concept has right to exist, particularly if this method has been used during more than several hundred years, and it has not been proved till now that it is not effective (it has not been proved either that it is effective).

The prolapsed disc disease is formed in the result of degenerative processes in the spine. Osteochondritis is usually the cause of these processes. The main characteristic feature of it is the displacement or leakage of the pulpal core, which takes place after the disc bulging and breaking of the fibrous ring.

The prolapsed disc is one of the mostly widely spread and the most difficult manifestation of the osteochondritis. When this happens, even teenagers can suffer from pains in the back and in the spine while physical activity. But usually these pains are ignored, and the disease is progressing gradually.

The disease informs about itself by the strong pain syndromes, and it has a very unpleasant feature to spread to the legs or to the hands. The pain syndrome appears, when a prolapsed disc starts to press nervous roots, which goes from the spine column. As a result the pain can spread along the whole irritated nerve.

Treatment of the prolapsed disc by acupuncture

aku2The first task of treatment is to arrest or to decrease considerable the pain syndrome. Under classical conservative treatment analgesics in combination with nonsteroidal anti-inflammatory medicines, neuromuscular relaxants are prescribed. When the pain syndrome is arrested or decreased, the main task of treatment is to restore muscle corset and the ligamentous apparatus of the body.

Acupuncture treatment can successfully cope with the task to arrest the pain syndromes of different character. Acupuncture gives an opportunity while treatment of the prolapsed disc to remove swelling and inflammation, ensuring the removal of the nerve terminals compression. Only after this specialists can start treatment of the main disease.

The effectiveness of combination of acupuncture and medicament methods is often mentioned, it gives to achieve an immediate result. On the other hand, nobody can prove that the particular this method gave an additional pain arresting effect. In any case, it is necessary first of all to consult your doctor, to listen to his opinion. Do not forget that in any case of the disease a specialist, a qualified doctor is to follow you during the process of treatment. Otherwise you take a risk to receive the same disease, but in a chronic form.

Innovative acupuncture

aku3The progress is not at the same place, it concerns also such spheres as the methods of the old Chinese medicine. For example, acupuncture now is a little bit updated if to compare it with the original methods. Now, a low rate electrical impulse goes through a needle; it stimulates the points of acupuncture. These impulses are generated by a small specially designed device, which can work from usual batteries. Intensity and frequency of the impulses must be regulated by a specialist.

After the needle is introduced into the region of the spine, a patient experiences a sense of faint prickling. It means that the electrical impulses flow. Soon in the place of the needle introduction there is numbness, a faint dull ache, flow of warmth or prickling. Pay your attention the needles for acupuncture are introduced into the body for quite a long period of time from 15 minutes to an hour and a half. If it is necessary the needles are turned a little, it is done manually or with the help of warmth.

Acupuncture effects

Ignoring the back pain for a long period of time means that muscles during a long period of time are in spasmodic state. In the result of this state, degenerative processes can take place, and osteochondritis can be formed, and the prolapsed disc will manifest itself. Also the blood circulation can be disturbed in the affected region of the spine.

Curative acupuncture, performed by an experienced specialist, can give a positive effect already after several procedures; constant spasm of muscles will be removed or it will be less, consequently the pain syndrome will be arrested or it will be decreased. Gradually swelling will go away, and inflammatory process will be stopped.

But even under this effect you should not be glad beforehand, if you will not start to take care of your back, this effect will be just temporal.

The sequestered disc of the spine. Its conservative and surgical methods of treatment

The most difficult variant of a spinal disc herniation development is the sequestered disc or just the sequester. In this case an intervertebral disc comes out; to be more precise its nucleus pulposus comes out into the spinal channel, besides into its region, where there is meninx fibrosis and cerebrospinal nerves. This form of herniation leads to the most serious pain syndromes, besides it can lead to paralysis, which occurs in the result of compression of the spinal canal by herniation. As the disease can lead to very serious complications, it is considered that the most preferable way to treat the sequestrated disc of a spine is an operative interference.

Symptoms and manifestations of the disease

By virtue of the fact that the influence is made directly on the spinal nerves, manifestations of the sequestered disc are much more serious and complicated than manifestations of a simple disc herniation. Usually this disease may acquire people who suffer from a disc herniation or bulging for a long period of time. Patients remember very well the beginning of the disease (disc sequestration), because almost always it is very acute and it goes along with a very sharp pain. But sometimes there are cases, when the disease flows without any symptoms for a long period of time and patients complaints’ are very few. Taking into consideration this absence of symptoms, appearance of the sequestered disc is much unexpected event.

sekvMore often manifestations of the disease appear after some provoking factor, such as hypothermia, stress situation or loads lifting; and a very strong pain develops in the low back. Very soon this pain spreads to the leg, going along the back or side surface of the hip. It leads to the serious restriction of the leg mobility, or even to the full immobility, when the person cannot walk at all. The pain will be accompanied by neurologic symptoms: the leg becomes weak, numbness appears and the reflexes in the leg disappear. This disease can develop up to the paraplegia.

It is necessary to draw the attention to the fact that manifestations and symptoms of the sequestrated disc are very similar to those of the usual disc herniation in the pelvic part of the spine the difference is only in their symptoms strength and speed of development. Besides, a common disc herniation, which makes influence on the nerve root, hardly ever leads to the leg paralysis; in any case it gives a person an opportunity to move.

The sequestrated disc is dangerous, and its danger is compound. The problem is not only that the herniated disc presses the spinal canal (mechanically and by inflammatory process in the tissues), the problem is that it can lead to paralysis. Parts of the nucleus pulposus create and additional problem when they fell into the spinal canal. The fact is that they contain a high concentration of protein molecules. And it can provoke an autoimmune reaction of inflammatory character, similar to that which is invoked by the well-known to everybody rheumatism.

Problems of treatment

Treatment of such disease as the sequestered disc has its peculiar problems. First of all they are connected with its location.

Inflammatory process which appeared invokes a serious disturbance and restriction of blood circulation in the affected area, and as a result nutrition of the correspondent part of the spine is disturbed considerably. Besides, the herniated disc itself occurs “hidden”, and it is an additional problem. Therefore, very often the traditional conservative methods of treatment are ineffective; analgesics and anti-inflammatory medicines just cannot penetrate to this affected area. In this case results of treatment depend a lot on the competence of the physician caring for patient; incompetent prescriptions will not bring any good results in treatment.

Taking into consideration all the above mentioned it is easy to understand why many people think that the sequestration can be treated only by operative methods, and very often this idea is supported by narrow minded neurosurgeons. You should remember that any even the most sparing operation will not make the spinal column healthy. And in case with the sequestered disc there is a very high risk of recurrences.

In fact, therapeutically correct and competent methods can give an opportunity to avoid the operation. But actually with this diagnosis there are not many chances for conservative treatment to be successful, they are lower that while treatment of usual disc herniation.

Conservative treatment of herniation

At the beginning of the treatment patients are almost always prescribed to take nonsteroidal anti-inflammatory medicines. Their task is to remove inflammation, which appears in the compressed root; if the inflammation is removed pain will be also removed. The disc herniation certainly cannot be removed with the help of these medicines, but they can considerably relieve the patient’s life. As a rule treatment starts from these medicines. But these medicines should not be applied more than two months, because the risk of appearance of side effects grows highly.

sekv2Neuromuscular relaxants are applied for elimination of painful myospasms, and it improves to some degree the blood circulation.

One of the well-known solutions is a procaine block of the affected segment of the spine. It will decrease swelling and remove spasm, weaken inflammation of the compressed nerve. Such block gives immediate effect, and it can work during the period from one to three weeks. If it is necessary it can be repeated but not more than once a week.

Manual therapy will be effective only in that case, if the disc herniation is accompanied by displacement of intervertebral joints; by the way it happens very often. But you should take into consideration that rough manipulations are not admitted in this case; they can provoke swelling and increase spasm of muscles. All these will lead to an additional harm and will be able to send the patient to surgical table. With the same care massages should be done.

Other physiotherapeutic procedures will help only to half quantity of patients and in some cases can lead to feeling unwell. That is why you should be very careful with procedures and apply them only after the doctor’s prescription.

Very often it is recommended to patients to use a back belt. It is used only while sharp phase of the disease and during that period of time when a person is in vertical position. While having rest you should put it off.

Movement therapy can be applied only after the pain syndrome has been removed totally. By this you should follow the doctors’ recommendations and to increase load gradually, starting from light and simple exercises, which cannot cause any pain.

When it is necessary to use the operative treatment?

We can distinguish four main surgical indications:

  • if during half a year treatment period the state of the patient is not better or is even worse, in spite of all doctor’s prescriptions being used correctly by the patient;
  • if the weakness of the patient’s muscles along the travel od the nervous root is increasing very fast;
  • practically always the operation is necessary for treatment of the sequestration, especially in that case, if some part of cartilaginous tissue broke off the herniated disc. To set the sequestration is impossible, so in case when neurological disorders appear it is better to make the operation. But if there are not any neurological disorders it is not necessary to hurry up with the operation, very often they can dry out and reabsorb.
  • If during treatment there is some improving, but it changes for deterioration in some period of time, and this situation repeats several times in the same part of the spine.
  • Modern surgical methods give an opportunity to minimize the risk of after operational recurrences and complications. In particular, operation aimed at sequestration removal is a neurosurgical operation, and it is possible to minimize a risk to do harm to other internal organs while operation.

Disc prolapse treatment by exercises

Almost all patients suffering from spine problems are recommended to do special physical exercises. Usually that is treatment by exercises or movement therapy for patients suffering from a disc prolapse, radiculitis and other spine problems.

Movement therapy is your best friend to kill spine problems

Movement therapy is your best friend to kill spine problems

The cause of almost all problems of joints (including spine) are their disturbed blood circulation and histotrophic nutrition along with excessive physical activities. Hypodynamia, physically demanding labor or excessive sports activities can provoke the abovementioned problems. But anyway the main seeds of the majority of such problems are tortoise and «sedentary» lifestyle, under such conditions muscles weaken and lose their ability to perform their direct functions, such as to keep spine. As a result it is excessively overloaded, and that is at the bottom of the majority spine diseases.

That’s exactly why, independently from all other prescriptions and instructions (massages, medicines, and as the last resort measure – surgery) for all patients suffering from disc prolapse or other spine problems of this sort, movement therapy is prescribed.

What’s the challenge of such movement therapy? As we have already mentioned, the main problem almost in all cases is weakening of spine muscles “corset”, and in its turn it leads to such diseases as disc prolapse of cervical spine. Movement therapy (gymnastics) in this case is aimed at strengthening of spine muscles “corset”, to bring it to its normal state.

For example, a disc prolapse is one of the most widely spread diseases nowadays. Movement therapy of this type of disease comprises performing light bending and unbending exercises, including also spine sprain exercises. In addition to the above all exercises should be performed slowly and gently. This kind of movement therapy gives an opportunity to “warm up” muscles and to improve histotrophic nutrition of joints.

Individual attention should be paid to such nasty disease as disc prolapse of cervical spine. Movement therapy is considered to be necessary in this case also, since it is considerably effective treatment for early stage of this disease. But cervical spine is much more “capricious”, and it is not always possible to correct all its problems exceptionally with the help of movement therapy.

Generally, an individual complex of exercises should be prescribed for every sickness case for every patient. Exercises for this complex are selected and formed so as to influence the problematic part of spine muscles “corset” and spine itself. In these circumstances it is very important so that physical exercises do not bring pain or cause discomfort, because in that case they can do true harm to already mutilated spine. As you have already understood, this is a very “custom-shaped” thing – movement therapy for disc prolapse treatment. Movement therapy video you can view below, but before starting to do these exercises you should consult a doctor by all means!

And in our turn we shall draw you an example what is the most popular movement therapy for disk prolapse like.

What exercises, activities you should do?

  1. Swimming. It is a very useful, substantially necessary component of movement therapy. In water spine keeps always in correct position and compression decreases. And at the same time swimming allows to involve all groups of muscles, excellently training spine muscles “corset”. Hence try to swim as more often as possible, giving preference to swimming on your back or swim the crawl.
  2. Take a backless stool, put it on the floor and place a pillow onto the stool. Lie on the pillow, your belly down so that your body bends precisely in the problem part of the spine. Relax and breathe calmly with top part of your breast. As a result you stretch your spine and “corset” muscles.
  3. Go around perimeter of your room on all fours. Pay attention that your back is straighten and your hands are straight.
  4. Resting on the floor, on one side (first on the right side, then on the left side) twist your body moving your hips frontwards, and breast backwards. Put some bolster under your problem part of spine (this exercise can be recommended for all patients).
  5. In position resting on your back on the floor you should point your toes to you touching the breast. This exercise is aimed at spine muscles “corset” strengthening.

Movement therapy for strengthening joints and muscles

  1. Standing on all fours you should lift simultaneously opposite hand and leg. Fix this position for several seconds.
  2. Lie down on your back, bend legs in knees. You should lift and fix in this position pelvic part of your body.
  3. This exercise is known to many people as «boat». Lie down on your belly try simultaneously to lift as high as possible your upper and lower parts of the body, your belly must stay on the floor. Physically the exercise is very difficult, but it is very good for training spine muscles “corset”.

Doing this exercises remember a good old joke – as much time you spend to get your disc prolapse so much time you need to do exercises to get rid of it. Besides exercises of movement therapy, some yogic exercises, exercises from other healthy sports practices may be very useful. But your attitude to these practices must be very serious and you can apply them only following your doctor’s recommendation. You are not to overload your spine or stretch it excessively otherwise you run a risk to get progression of your disease instead of remedy.

Besides, movement therapy will be very effective in combination with massage. Thus in most prescriptions made by a doctor, massages are included into the complex of treatment of such diseases.

Treatment of a lumbar disc prolapse

What is a disc prolapse? It is the displacement of the disc nucleus, which is accompanied by fibrous ring breaking. A lumbar disc prolapse is the most common among spine diseases, it occurs in 90% of medical cases.

A cervical spine disc prolapse is slightly rare and a dorsal spine disc prolapse is the rarest. Treatment of a lumbar disc prolapse as treatment of a disc prolapse of the other parts of the spine usually is held by conservative methods, without surgery. Under such method of treatment more than half of patients get rid of disc prolapse symptoms almost completely already in a month and in a year up to 95 % of patients recover completely.

Previously people of middle age and people of hoary age suffered from such kind of diseases. Nowadays it turns out that disc prolapse becomes an “ageless”, even young people can suffer from this disease, although it is the most common for people older than 30 years.

What is it, a disc prolapse of lumbar spine?

As we have mentioned before, this type of a disc prolapse is the most common. The main ground for this disease is a specific functionality of this part of spine– it is the very part which bears the biggest load directed on intervertebral discs.

Here is a picture of a prolapse disc

Here is a picture of a prolapse disc

Discs in this part of spine are relatively higher (in comparison with discs in other parts of a spine). And very often this specialty is a reason for such phenomenon as a prolapsed intervertebral disc. There is one more factor – narrowness and weakness of a longitudinal ligament, which cannot prevent a vertebral disc prolapse formation only because of its anatomic features.

Such unpleasant diagnosis as a lumbar disc prolapse is suspected if the following symptoms appear: intense pain in the lumbar part of spine, which can spread to the gluteal region; pains which spread to side or back surfaces of legs and radiate to toes; reduction or disappearance of Achilles and knee reflexes. In severe cases, there may start disorder in pelvic organs functioning; in this case it is almost always necessary to carry out surgery.

Manifestations and causes of the disease

The following factors can provoke a lumbar spine prolapse: not only too passive (sedentary way of life, low quantity of physical exercises), but also active lifestyle of a person (professional sportsmen, people, whose job involves heavy physical activity.

p-grThe point is that an intervertebral disc takes nutrient materials not from its own net of blood vessels (simply, there are not any blood vessels in a disc), but by means of diffusion process. That is the reason why physical activity should be proportioned – if there is lack of physical activity, supply of nutrition materials to the disc will be disturbed, in the result of this the disc will start to lose its strength, and this in its turn will lead to different pathological processes, to degenerative and dystrophic disc diseases, among them a slipped disc is the most widely spread.

A developed slipped disc will inform about itself by the following symptoms:

  • local pains, which become stronger, when in motion;
  • pains, which can spread to gluteal region, and also to side or back surfaces of a hip;
  • innervation occurs very often in the «area of engagement» of compressed root;
  • there may happen disturbance of sensibility (decrease or increase) of legs;
  • Disorder may happen in pelvic organs functioning.

Conservative treatment – could it be efficient?

Treatment of a lumbar disc prolapse usually is held by means of conservative methods; in the majority of cases it is quite sufficient. The research has shown that more than 70 % of patients during 12 weeks of treatment have significant improvement of their state and they can do without surgery. If to take into consideration more prolonged period of time, then more than 90% of patients overcome their disease.

p--gr2Conservative treatment set the priority for pain syndrome removal in acute period of disease, and when it is removed – to prevent a disease recurrence.

Almost always in acute period of disease a bed regime is prescribed for a patient for several first days together with anodyne and nonsteroid anti – inflammatory medicines. In some cases neuromuscular relaxant can be prescribed only by a doctor. It is not a rare practice when medical blockings are used, but such practice is not approved by all doctors; it is deemed that injection made, adds additional irritation, and as a result they prevent fast recovery. In any case treatment and certain medicines are prescribed by a doctor on the ground of run diagnostics and analysed symptoms.

When the pain syndrome is removed, quantity of applied medicines decrease, and the main attention is paid for movement therapy, massages, and physiotherapeutic procedures. The main task is to improve the state of muscles corset and ligamentous apparatus. Conservative treatment itself presumes, that in the future a person will take care of his/her spine individually, that is to avoid dangerous movements; will change to some extend his/her movement stereotype; will regularly do exercises of movement therapy on his/her own.

Surgery is as a last resort treatable.

Surgical measure is considered to be a last resort treatable. It is applied only in those cases, when during a long period of time it is not possible to cope with pain syndrome removal, and the disease has a bad influence on internal organs functioning (and it happens very often with patients ill on a lumbar spine prolapse).

p-gr3Earlier for treatment of such diseases a classical surgery was applied, which assume creation of quite big trepanation hole. Prolapse was removed successfully, but damage of muscles led to their disability to restore, and in its turn it led to regular disease recurrences. That is exactly why surgical methods with assume a maximum possible reduce of surgical injury.

Nowadays a „gold standard” of surgery is microdiscectomy for lumbar spine prolapse treatment. Essentially, that is a neurosurgery operation, which is held under very strong optical zoom with the help of eye loupe or operational microscope. By means of it, necessary section reduces considerably (up to 3-4 cm), accordingly a risk of recurrences and after operational complications become minimum.

Also endoscopic removal of a slipped disc gains a big popularity, thus this is quite new trend and that is the reason why it is seriously criticised compared with other methods. This method has its own advantages and disadvantages. On the one hand the size of section is this case is minimum (up to 2,5 cm), and as a result risk of recurrences and complications is minimal; a patient can walk on the next day after operation, and leave hospital for home in 3-4 days. On the other hand, this method has certain restrictions which depend on location and size of a slipped disc.

Excision of a prolapsed disc

A prolapsed disc is represented by a vertebral pulp displacement, which is accompanied by a fibrous ring breaking. A prolapsed disc of the lumbosacral region of a spine is the most widely spread, a prolapsed disc of the cervical region of a spine is rarer, and the rarest case of this disease can occur in the thoracic region of a spine.

Overwhelming majority of people, ill on this disease, can successfully recover after a course of conservative treatment. Excision of a prolapsed disc is performed only in case when a conservative treatment turns out to be ineffective; it is quite rare case, and surgical interference is necessary only in less than 10% of cases.

Disease manifestations

Manifestation of symptoms of a prolapsed disc depends on the part of a spine in which degenerative changes take place.

ud-grSo, if a prolapsed disc is formed in the lumbosacral region, then it is characterized by local pains in the affected region, irradiating to the cluneal area or to the led accordingly to the affected side (ischialgia). Innervation of the affected roots produces an effect of prickling, numbing and leg weakness, abnormality of leg sensibility may develop. Under nasty forms of this disease malfunction of pelvic organs occurs (a straight intestine and a urinary bladder).

In the result of the development of degenerative changes in the cervical region of a spine, pain irradiating to the hand or to the shoulder appears. It may be accompanied by faintness, numbness of fingers, and increase in the arterial pressure. In some cases there are headaches, which may be accompanied with faintness and the increase in arterial pressure.

Contraction of a prolapsed disc in the thoracic region of a spine goes along with constant pains in the chest, especially, when a person is in a constraint, uncomfortable position. Also it is possible that a scoliosis or kyphoscoliosis forms in the thoracic region of a spine.

The main method of diagnostics of the disease is a magnetic resonance tomography. In the overwhelming majority of cases a surgical operation for a prolapsed disc removal is not necessary, symptoms of the disease gradually disappear, and there happens a remission. Majority of patients (more than 70%) have considerable improvements of their state during 12 weeks, if to take into consideration more prolonged period of time, this number increases.

ud-gr2Generally a surgical excision of a prolapsed disc is considered as a last resort method, it is recommended to apply only in that case if conservative methods of treatment cannot cope with a pain syndrome.

The base of conservative treatment is a therapy applying nonsteroidal anti-inflammatory medicines in complex with analgesics. In some cases it is possible to apply corticosteroids. And movement therapy is applied as an additional solution; it is aimed at the restoration of a spine muscles corset. Taking into consideration tremendous abilities of a human body to recover independently, it is not the main point of treatment, but a very important one.

You should take into consideration, that alternative methods of a pain syndrome treatment (for example acupuncture) area far from being always effective.

Surgical interference

ud-gr3Surgical interference, as it has been said before, is a last resort method. It is recommended only in case of development neurological disturbances and a strong pain syndrome, which is impossible to remove by methods of conservative treatment. For example, surgical interference is necessary in that case when «horsetail» compression occurs, in the result of which not only strong pains start, but functioning of pelvic organs is disturbed.

The price paid is very high – excision of a prolapsed disc with the help of surgical interference gives a quick effect, but at the same time there are some disadvantages of this solution. As far as it is necessary to operate on enough inflamed already area, so more often than not it is necessary to deal with a weaken muscle corset on this area, and as a result it may lead to disease recurrences (new prolapsed discs and intervertebral disc protrusions).

Consequently, excision of a prolapsed disc in the cervical part of a spine, for example, which was not accompanied by a normal process of rehabilitation, in combination with a weaken muscles corset of a neck almost reliably will lead to a disease recurrence and formation of one or several prolapsed discs.

Types of operations

Not long ago, a laminectomy was applied while removing a prolapsed disc and that was considered to be a standard solution. This method of treatment had very serious drawbacks: for example, that is quite large injury for an operative approach. Specifically after- affects of this injury were sources of many problems during further rehabilitation after excision of a prolapsed disc. Particularly, it was necessary much time for wounds repairing, and during this period of time a muscles corset and ligamentous apparatus weakened on the injured area, and this led to the occurrence of recurrences. That is why it was necessary to develop new methods, which make allowance for maximum possible reduction of sizes of a trephine opening and, respectively, of an injury.

ud-gr4Applying of a surgical microscope became the first serious change. In virtue of possibility to use it, there appeared a method of intralaminar operative microsurgical removal of a prolapsed disc; nowadays it is considered an optimal method of a surgical treatment.
Further on a microsurgical removal of a prolapsed disc and different methods of endoscopic removal were applied more and more often. And nowadays development of surgical methods of treatment is aimed at reduction of an operational injury.

Removal of a prolapsed disc by a laser, in spite of all reassurances of advertisements, is not some kind of an extraordinary method. Application of a laser is used as an advertising trick, which is to show that the technology of treatment is very advanced. And what actually happens is that it is quite difficult to control the beam formed by the laser, so there is a risk to damage the neighbouring internal organs. Besides, price for such operation, removal of a prolapsed disc by laser, will be higher than for treatment with the help of other methods, not so „trendy” methods.

Microsurgery

Microdiscectomy is a microsurgical removal of a prolapsed disc. It is a neurosurgical operation, which is recognized as a very efficient method of surgical treatment. In this case operations are made under condition of high-power magnification, which is achieved with the help of a surgical microscope or a binocular eye loupe.

This method gives an opportunity to remove a prolapsed disc of any location and thickness. Thereby high-power magnification, used during operation process, gives an opportunity to work very precisely; a possibility to injure nervous structures of a spinal canal will be minimal. A skin incision in the process of operation is only 3-5 cm, thanks to this a risk of postoperative complications is minimal, specially under condition of correct rehabilitation procedure application after removal of a prolapsed disc.

In general, nowadays the neurosurgery presupposes quite early activity of a patient, already on the third day after operation. Term of hospital stay of a patient is less than one week, and in this case a patient will be able to work, but not physically already in one or two weeks, and to work physically he or she will be able in a month. In this regard it is recommended to limit the term of being in a sedentary position during the first month after the operation.

After a prolapsed disc removal by no means unimportant will be a remedial gymnastics – exactly by its help it is possible to restore a muscle corset and to form correct posture.

Endoscopic removal of a prolapsed disc

ud-gr5Endoscopic method is one of new trends, that is why it is criticized a lot. Application of endoscope gives possibility to reduce operational injury considerably, but there are some strict limits for its application, particularly it depends on size and location of a prolapsed disc. Minimal size of cutting can be considered as the main advantage of this method (up to 3 cm, that is why this method is sometimes called non-operational removal of a prolapsed disc of a spine), thanks to this all possible negative implications become minimal removal of a prolapsed disc of a spine, and quick rehabilitation is guaranteed. For example, a patient can walk in the day of operation, and he/she can leave the hospital on the 3-4 day after operation.