Protes, hernias, osteochondrosis - When they are diagnosed, patients immediately hurry to the surgeon without considering conservative treatment methods, but this is wrong.
According to statistics, 84% of people at least once in their lives hurt.The spine and the surrounding muscles are part of the musculoskeletal system.Consequently, their damage is often accompanied by pain, which can occur after the tiles or turns of the head and the body and weaken to rest.Anatomically, the spine is represented by alternating vertebrae and intervertebral discs.Over time, the latter are subject to the degeneration process, which leads to the formation of protrusions and hernias.These structures can cause pain and can cause pain by compressing the nearby structures: nerve roots and ligaments of the spine.In some cases, they can cause stenosis (narrowing) of the spinal canal (space in which the spinal cord is located).
Among other things, the vertebrae are connected by joints per couple, the structure is more rigid than the intervertebral disc.Their damage in 15-65% of cases causes back pain.Up to 30% of the back pain is due to the injury of the kidnapped sacred and illegal structure that connects the sacred and bones of the pelvis.In the end, any irritation increases the tone of the muscles around it, which over time causes a separate myofascial syndrome.
As a rule, physical activity leads to back pain, especially in cases where it is expressed either intense or when it is produced in an innatural installation, or when it is associated with a long stay in a forced position, for example when the wheel or a desktop.The body weight and a person's physical training are of great importance, since the severity of the load is always relative.
What are the reasons for its development?
It is impossible to unequivocally call the causes of the development of osteocondrosis, but a series of factors that contribute to the occurrence of this disease can be indicated: poor physical development, violation of metabolism in the body, genetic predisposition, expropriation.As a rule, these reasons are combined with irrational nutrition.
What to do if there are pain in the back?
The most important rule is not cars -medici!
Initially, you need to make an appointment with a neurologist or neurosurgeon.To establish an accurate diagnosis, a complete examination of the patient is necessary, necessarily including the radiography of the spine and tomography (magnetic resonance imaging or calculated radiography. The purpose of this or this study should be conducted only by the attending physician based on a specific clinical picture.
The care of the drug of osteochondosis of the spine includes not only the removal of pain syndrome, but also, if possible, the elimination of the causes of the root.The doctor prescribes complex therapy (drug therapy, physiotherapy, acupuncture, bathing)
The complex therapeutic treatment for osteochondrosis includes the correction of power and lifestyle (healthy and active lifestyle, the optimal volume of physical education), the purpose, in some cases - drugs of chondroprotectors that improve the condition of the cartilage tissue.
The main indication for surgical treatment for the degenerative dystrophic spinal disease is the inefficiency of conservative drug therapy for 4-6 weeks, unconscious of pain, as well as increasing the weakness of the legs, which in several cases can be accompanied by urinary incontinence.A premature and improper treatment in such situations can lead to a series of unwanted consequences and complications, up to disability.
Back pains are recognized as the most common.Experts explain this to the characteristics of human anatomy.The fact is that the spine is subject to loads throughout her life: from the moment she stands up during the childhood until her death.The spinal column runs out and sooner or later the problems arise in almost everyone.The most common diagnoses that are made with back pain: "osteochondrosis" and "roots", while patients often put themselves and prescribe treatment themselves, without looking for advice to doctors.However, even for these diagnoses, which, they would seem, everyone is listening, there are often reasons that only an expert specialist can determine.
What is bad there?
In the vast majority (about 95%), the pain is associated with muscles, ligaments and joints.People are called to pull their backs.These pains are unpleasant, but not reported and in most cases they go by themselves in 2-3 days.
3-4% of the pains are associated with radicolopathy (root) - damage to the spinal root.It is usually damaged by an hernia.The pains disappear when the edema that occurred due to the compression passes.
1-2% of back pain is caused by lesions or inflammatory diseases of the spine, oncological processes, diseases of the cardiovascular system or of the gastrointestinal tract, in which pain syndrome can go to the rear.This is the most dangerous type of back pain.To exclude these pathologies, be sure to consult a doctor.
You cannot delay
The main indicator you need medical care is the regularity of the pain.If you are twisted from time to time, most likely there is nothing wrong.If low or medium intensity pain finds you incessantly, you cannot hesitate.It is urgent to consult a doctor if the pain is accompanied by an increase in temperature or pain grows on a treatment background.
Types of pain
Doctors distinguish 3 types of pain, which often make themselves felt in the back.The doctor's task is to carefully determine which type of pain is worried about the patient who contacted him, because each of them will be treated exclusively in his own way.
Nociceptive painOr, more simply, pain in the receptors - in the skin, muscles, ligaments, joints - is considered the most common.The reasons that cause it in X -ray or using computerized tomography are not usually visible.In this case, the specialist diagnoses according to the symptoms of which the patient speaks.The causes of muscle spasm can be, for example, physical activity, when a person raised something heavy, has leaned sharply or a difference in temperature (a commonly seated air conditioning).This type of pain is treated with two types of medicines.
Acute pains are treated with painkillers of anti -inflammatory drugs and relaxing drugs.In this case, there can be no other therapy.When pain syndrome is removed, we recommend that the patient strengthens muscles with physical education.This is the treatment and prevention of the disease for the future.
Physical exercises not only help to strengthen the muscles, but also contribute to the production of endorphins, as well as to serotonin and norepinephrine in the body.These substances increase the pain threshold of a person and remove the depressive mood.
Neuropathic painOr the pain of the nerve, people are better known as root.This type of pain in humans occurs, in particular, when the vertebral hernia becomes large and greenhouses the nerve endings.At the same time, experts warn patients and the entire professional community against improper diagnosis in cases where radiography and the use of magnetic resonance imaging turns out that hernia or any other type of spinal wear are available, but it is not so significant to influence the nerve.It is necessary to carefully understand the real cause of pain.It is possible that it is a fault of a muscle spasm and this type of pain is completely different and the treatment will also differ for this.What is considered osteochondrosis is not only manifested by pain, but also by the norm.
Osteocondrosis is a sign of body aging.But "osteochondrosis" and "pain" are not the same.Since there are practically no nerve endings in the bone tissue, the protrusion (the initial phase of the intervertebral disc. - Auth.) Or an hernia cannot hurt.Even studies were conducted: groups of people were conducted: they chose, mainly those who had never addressed a doctor with complaints about back pain, but found hernia and osteochondosis.
In addition, the doctor provides examples in which patients received a treatment - and took place, despite the fact that the osteochondosis remained on stage.Osteochondrosis today is a concept that is used locally.
There are countries where the word "osteochondrosis" is not used at all.Last year, they officially said that this diagnosis was made by neurologists of the past generation.Abroad, when the patient arrives at the reception and says that his back hurts, he is diagnosed with a non -specific pain in the back, but it is clear that a person has given a load to the muscles.
The confirmation that the pain is caused precisely by the Radicolite and not with the spasm, for the specialists, the symptom in the form of pain in the back of the back, which gives the nerve in the leg, is often for specialists.
The cause of nerve pain can also be complications caused by diabetes and herpes.In diabetes mellitus, patients often complain of pain, since this disease damages the nervous system.The posterpetic neuralgia is characterized by strips of rash along the damaged nerve and, consequently, pain.There are special drugs for the treatment of nervous pain.
For the treatment of neuropathic pain, anti -epileptic and antidepressants are used.The name of drugs of this orientation of patients, I must say, often frightened, so it is important for them to explain that they are antidepressants that increase the pain threshold.These are standard of pain treatment.
Psychogenic painor chronic.This type of pain is not caused by physical changes in the human body, its mental state changes.Symptoms torment the patient in this case for a long time.At the same time, it hurts, as a rule, not only in the back.
It happens that people come and say everything, my head, with constant.Ask: something heavy raised?NO!And there is no clear location.In this case, we can conclude that the patient has reduced the pain threshold and an analyzer of pain, which is in the brain, is constantly felt.It can cause pain in such a patient: overload, stress, feeling of fear.
Anesthetic drugs in this case will not help.Specialists usually prescribe antidepressants, physical education to patients with chronic pain, but sometimes it is sufficient to find a reason using a psychologist or psychiatrist.
A young woman who complained of back pain: six months, he says, was tormented.I recommended to go to a psychologist and physical education.A few days later she became completely healthy again without taking any medicine.The psychologist helped her understand that the cause of stress pain: she had family problems, physical education has helped to relax.
At homeThe most effective remedy are anti -inflammatory oral drugs.Just don't overdo it: I'm safe only for the first time.With prolonged use, these drugs can cause ulcers and bleeding in the gastric mucosa.Traditional domestic treatment - non -short ointments - can only be used as an additional measure.They are harmless, but ineffective.Carsset also gives relief: the fixation discharges the spine, relieves spasms and limits acute movements.Only the corset should be ordinary: elastic, do not warm up.
If the treatment has no effect for three days, it is necessary to consult a doctor who will block with anti -inflammatory injections.Due to the removal of spasms and relaxation of the muscles, the pain leaves immediately and often forever.
Prohibited!
Bath and Massage under the rigorous ban.They improve edema and pain.
Contact manual therapists in the newspaper.Manual therapy is the area in which each specialist represents three hundred charlatans.If you really want to find a good doctor, you should contact certified clinics in which graduates specialists work.
It is important to immediately determine the tactics of the treatment immediately.This should be done by a neurologist or neurosurgeon.It is dangerous to treat your back.30% of the patients of the neurosurgery department tried the home treatment methods and this led to a hospital bed.
When the pills do not help
If the pharmacological treatment prescribes a therapist or a neuropathologist does not give results within 3-6 months and the pain continues to torment the patient, the doctor is obliged to transmit the patient to another specialist.In some situations, physiotherapy can provide significant assistance.It is suitable for the first two types of pain: in receptors and nerves.Physiotherapy is prescribed to those patients who have an allergy to medicines or stomach problems.
For this reason, the treatment passes, but there is no effect, patients often come to us serious, with depression, therefore we approach their multidisciplinary treatment, with the involvement of various specialists: neuropathologists, psychologists, physiotherapists, neurosurgery.
Among the methods that domestic physiotherapists are used, borrowed from Russian colleaguesintracanic electrical stimulation.Its principle is that through a special disposable needle, bypassing the skin barrier, to provide current, directly in the focus of pain.Diagnosis in which this procedure is prescribed, including protrusion and hernia.The procedure, according to experts, is comfortable and does not require pain relief.The effect, as a rule, is warned after the first procedure.In total, they are assigned from 3 to 6.
In addition, it is usedLaser therapy.This technique is also convenient as it can be prescribed to patients with various stimulants, including cardio- and it is not worried that failure will occur.The laser is used not only for the treatment of diseases associated with the problems of the spine, but also as a treatment of the complications of diabetes and the sugar of herpes, which were already discussed.
The laser promotes good recovery.In addition, the device improves microcirculation in the spine itself and, for this reason, the power of the discs improves.As a result, edema and inflammation are removed and the pain, respectively, disappears.
Block
One thing like the "bloc" in medicine is not new.With serious pain, since Soviet times, patients have been prescribed injections in the area where the focus on pain is directly found.Since then, little has changed in district clinics.In the meantime, in accordance with international recommendations, these procedures must be performed exclusively under control, using special equipment that allow you to monitor the process in real time.The consequences of an unparalleled injection can be very different: in the best case, medicine, introduced not if necessary, will not give the necessary effect, in the worst case - this is fraught with serious complications.
The introduction of the drug should be carried out under radiological control: fluoroscopy, CT, magnetic resonance imaging, ultrasound, because the drug is intentionally administered in the area where the source is of pain.In the event that the doctor gets the wrong way, this is fraught with the patient's breath stop both for total spinal anesthesia.
The essence of the block is that the medicine introduced from several months to six months prevents the spread of the impulse through the nerve, which is involved in the nervous impulse.Although this procedure does not guarantee a constant effect, it significantly improves the quality of life of the patient: a person temporarily forgets pain, can sleep calmly or do business.
Operation - Elimination of pain
When medicines do not help: neither pills nor injections, when physiocracy is ineffective, neurosurgeons come to the rescue.Modern technologies allow these experts to return to life without pain for patients who suffer from it for not a consecutive year.There are many methods: from manipulations with the most minimal intervention in the body to complex surgical operations with vertebral prostheses.
With the hernias pinched the nerve, one of the most common and effective methods is recognizedRadiff ablation.In fact, this is a kind of blockade, only instead of a medicine that relieves pain only for a while, an electric current is used that can completely solve the problem.Often, ablation is performed after the block, thanks to which doctors receive a clear understanding of which nerve it is necessary to influence.The procedure is provided both on a paid basis and through shares.
The procedure is performed within 20 minutes.It is called operation, but in reality it is a surgical manipulation that is performed under local anesthesia, necessarily under the control of special devices.First of all, pain syndrome is reproduced and, if the patient confirms that this is exactly the pain he usually experiences, we give a discharge of impulses - and the pain, so to speak, is disconnected.
In special cases, methods are usedneurostimulationsAmong these is the implementation of the electrode.The patient is performed: the surgeon puts a small device at the center of pain, which will suppress the impulses of pain in real time.Patients receive this procedure by quota.
There are times when they have already done various types of surgery, but the pain syndrome has been kept in one degree or another, so we put a stimulating - first in test mode and if the desired effect is achieved, then we put it forever.This is an operation that is performed with a small cut.The only thing is that the patient will have to periodically come for test control.
What we risk
The risk of the operation, due to which it is postponed or rejected at all, many patients consider it very exaggerated.In neurosurgery, there are technologies that allow you to carefully calculate the effectiveness of the operation and what symptoms they will disappear after it and what will remain.
The probability of renewal of pain after intervention does not exceed 1-1.5%.Herbs in other places can really appear, but this is not a complication, but the spread of the disease, which is often found in young unruly patients.As soon as the pain leaves, they return to the usual lifestyle: they guide the steering wheel, they resume training.And this is categorically impossible to do.
Is osteocondrosis responsible for everything?
Osteocondrosis is a chronic degenerative change in the intervertebral space.All people over the age of 25 have signs of osteochondrosis.It is impossible to avoid osteochondrosis, but you can protect yourself from its complications, which cause back pain.
Why so, and not otherwise?
I have to spend time, effort and money for treatment: tablets, injections, physiotherapy, if you can immediately do a small operation and get rid of pain once and for all?- Patients asked this question more and more often.The answer is usually unequivocal: yes, you need!The fact is that with an accurate diagnosis and adequate treatment, the units reach operations.The rest is getting rid of pain in the early phases of assistance - on average, 30% of patients in each phase are in production.
A mistake when people, having seen a protrusion or hernia in the photo, immediately ran to the surgeon, circumventing the specialists of the previous assistance phases.In cases where the changes are insignificant, the operation is not required.In addition, with the right lifestyle - engaged in physiotherapy exercises, swimming, monitoring the weight of his body - a person with osteochondrosis so called can feel healthy and not feel pain.
It is important that in each phase the patient has an accurate diagnosis and the correct treatment is prescribed.This can only be reached collegiate.It is also proposed, on the example of foreign experience, to introduce a new specialization, as an algologist, is a sort of therapist specialized in pain, a doctor who has the knowledge of an anesthetist neurologist and interventionist, able to treat, without led to surgery, but if the surgery never transmits the patient to neurosurgeons.