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Protrusion of spinal discs of the lumbar

Protrusion of spinal discs – what is it?

Protrusion of spinal discs is a pathological bulging of the intervertebral disc into the spinal canal, which is not accompanied by the violation of the integrity of the fibrous ring. Should not be considered a protrusion of disks as a distinct disease. Protrusion is one of the stages of degenerative disc disease, which subsequently leads to the formation of hernia.

In the lumbar often formed a disc protrusion, slightly less frequently observed in the cervical spine. Protrusion in the lumbar spine in the majority of cases is localized between the vertebrae L4 and L5, or between the first sacral S1 vertebra and the last lumbar vertebra L5. The discs are located between 3 and 4 lumbar vertebrae are less protrusion and the upper discs of the lumbar very rarely.

The age at which most often is detected protrusion ranges from 30 to 50 years. Most often affects men. As disc protrusion leads to the formation of the hernia and possible disability of patients of working age, it is necessary to detect this condition and to treat. In addition, the protrusion can cause severe pain in the back, which degrades the quality of human life and affects his health. Disc protrusion of the spine is responsible for approximately 30% of cases of spinal pain in orthopedic patients.

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Symptoms of disc protrusion of the spine

Symptoms of disc protrusion of the spine in the first place depends on the extent of its protrusion beyond the vertebrae, as well as from the location of the pathological focus.

For protrusion of lumbar disc, characterized by the following clinical picture:

  • Back pain that are localized in the lumbosacral area. Pain are chronic in nature and are present almost continuously, with varying degrees of severity. They are enhanced with the increased physical load on the lumbar belt. For example, when lifting weights, while bending atlength of time in one position (sitting or standing), when performing sudden movements.
  • When one takes a comfortable position, disc pressure on nerve roots weakens the pain go away or decrease
  • Numbness in the groin area and lower extremities.
  • Muscle weakness of the lower extremities.
  • The feeling of "pins and needles" and tingling in the legs.

  • The development of sciatica.

  • A feeling of stiffness in the lumbar area.
  • A decrease of range of motion in the lumbar spine. The patient is often unable to sleep on my stomach, fully straighten the waist to hoist a leg.

All of the above symptoms can have varying degrees of severity. This is especially true for pain symptoms. Often pain do not exist until such time as the protrusion of the disc enters the intervertebral hernia.


Causes protrusion of the spinal discs

Causes protrusion of the spinal discs are often hidden in such diseases as osteochondrosis. The intervertebral disk suffers from degenerative changes that occur as a result of dysmetabolic disorders. The worse the nutrition processes of the disc, the faster it loses moisture and becomes inelastic. Under these conditions, to the formation of a protrusion can lead even a minor injury or strain on the spine. The disk drive is outside of the vertebrae and until a certain time remains in this state. After rupture of the fibrous ring it makes sense to speak of a hernia of the spine.

The causes that can affect the formation of protrusion of the intervertebral disc, the following:

  1. The lack of exercise. Insufficient physical activity always has a negative impact on the structural elements of the spine.

  2. To provoke the formation of a protrusion can uneven load on the spine, which are the result of factors such as:

    • Anomalies of the vertebral column (spina vertebral syndrome plus cervical ribs, sacralization, etc.);

    • Curvature of the spine (lumbar lordosis, scoliosis);

    • Prolonged static and dynamicload;
    • Weight lifting;

    • Violations of the location of the pelvic bones (hip dysplasia).

    • The excess body weight.

  3. Cause disk protrusion capable injuries of the spine. This can include contusions, subluxation, and vertebral fractures.

  4. The formation of disk protrusion on the background of already existing diseases of the spine, for example, Bechterew's disease, calve disease, tuberculosis of the spine, etc.

  5. To the deterioration of drive power lead various dismetabolic processes in the body. This can be attributed to hypothyroidism and diabetes.

  6. The formation of disk protrusion on the background of connective tissue and systemic diseases of connective tissue.

Indirect factors that can affect the formation of protrusion discs are age-related changes in the body and genetic predisposition to diseases of the spine.


The stage of formation of protrusion of the intervertebral disc

The stage of formation of protrusion of the intervertebral disc are the following:

  • The destruction of 70% of the disc, loss of elasticity, formation of cracks in the fibrous sheath.
  • Bulging of the disc with the movement of the nucleus pulposus and stretch the fibrous ring.
  • The increase in the protrusion of the disk more than 4 mm with subsequent rupture of the fibrous ring.
  • The formation of hernias of the spine.

Treatment of protrusion of the discs of the spine

Treatment of protrusion of the discs of the spine should be timely and comprehensive, allowing you to control the pathological process and prevent the formation of hernia.

All patients must comply with the following recommendations:

  • For a period of about 4 days should stay in bed. Morelasting peace can adversely affect the performance of therapy. So if pain in humans, expressed not too much, then physical activity should remain.
  • For some time, the patient is required to abstain from lifting or from working in conditions of high vibration. No less dangerous excessive static loads, being in asymmetric positions, including prolonged sitting. To the minimum necessary to keep work at a Desk, computer, etc.
  • The implementation of complexes of therapeutic physical training. During the first 14 days the patient needs to take a daily walk, ride a bike or go on a stationary bike. In the future, you can move on to aerobics. The complex of exercises should be aimed at strengthening muscles of the spine and muscles of the anterior wall of the peritoneum.
  • Well, if physical therapy will be supplemented with aerobics and massages. This will prevent a recurrence of the protrusion and to exclude its formation in other parts of the spine.
  • Necessarily need to properly organize the place for a night stay. The mattress should choose a semi-rigid, it is best if this will be orthopedic mattress. Possible a complete rejection of the pillow.

As for locking devices such as back belts, they can be used not more than four hours a day. Doctors recommend the use of such devices before the upcoming dynamic or static load.

Medication protrusion

As for the medical correction of protrusion of the disc, then the patient is prescribed the following medications:

Drugs-analgesics. To reduce the pain associated with protrusion of the intervertebral disc are prescribed nonsteroidal anti-inflammatory drugs. As a rule, doctors recommend to receive Diclofenac sodium or Ketoprofen, Nimesulide. NSAIDs administered rectally if the patient has disease of the digestive tract. Nevertheless, oral ingestion is the priority. It is not excluded local application to the skin ointments containing non-steroidal anti-inflammatory agent. It is important to consider the maximum daily dose of such drugs and to take into account the dose of active ingredient in creams and ointments.

Drugs-muscle relaxants. Possible ingestion of Tizanidine, Baclofen, etc. Midokalma the Course of treatment should not exceed 3 weeks. Notice the improvement prima from muscle relaxants only at the initial stages of formation of the protrusion.

Products-chondroprotectors. These drugs don't affect the symptoms of the disease and its course. The acceptance of chondroprotectors, helps stop the process of destruction of the disk. However, to accept their need for a long time. The maximum therapeutic effect can be achieved with the use of drugs of the third generation which combines Glucosamine with Chondroitin sulfate. It tools such as: Artra, teraflex, Artrozan.

A good effect is warming of the affected area: dry heat, electrophoresis with drugs, paraffin baths, ultra-high impact and ultracasual. Procedures based on hyperthermic effect, reduce pain and relieve muscle spasm. Any physiotherapy procedures (magnetotherapy, acupuncture, UHF, etc.) can only be assigned to a doctor, as they all have certain contraindications.

When disk protrusion, a visit to the chiropractor. It is important that it was a highly qualified physician, otherwise there is a risk of complications and deterioration of health.

Relieve acute pain epidural blockade with the introduction of steroid drugs. Possible combination steroid anti-inflammatory drugs and Cyancobalamine. However, the use of blockades is limited as they have only a temporary effect and needs to be typed.

Good effect gives traction to the spine, whereby there is an increase in the distance between the vertebrae. As a result, the load from disk is removed, allowing you to stop the progression of the disease, and hernia is not formed.

If conservative treatment does not give the desired effect for 8-16 weeks, the question arises about the need for surgical intervention.

When protrusion of the disc without rupture of the fibrous ring used percutaneous discectomy or nucleoplasty. This is a minimally invasive technique that is performed on an outpatient basis. During the operation in the intervertebral disc insert a cannula, which introduces the laser or electrode applying cold plasma. With their help, it is the destruction of the nucleus pulposus, causing pressure inside the disc decreases. The fibrous ring and posterior longitudinal ligament is pulled inside the protrusion and the protrusion is removed. The whole procedure is performed under fluoroscopic control.

In 85-90% of cases it is possible from the nucleoplasty to be abandoned because conservative treatment in combination with the methods of physiotherapy produces a sufficient effect.However, the patient must understand that to maintain physical activity to ensure normal functioning of the spine will need throughout life. Otherwise, the pathological process continues to progress, and the patient formed intervertebral hernia. Therefore, it is important to engage in physical activity, gymnastics and swimming. You should also avoid finding the spine in the wrong position, to abandon lifting weights, to monitor the body weight.