Prot, hernies, osteochondrosis - when diagnosed, patients immediately hurry with the surgeon without considering conservative treatment methods, but that 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.Therefore, their damage is often accompanied by pain, which can occur after the folds or the turns of the head and the body and weaken at rest.Anatomically, the spine is represented by alternating vertebrae and intervertebral discs.The latter over time are subject to the degeneration process, which leads to the formation of protuberances and hernias.These structures can themselves cause pain and cause pain by compressing neighboring structures - nerve roots and spine ligaments.In some cases, they can cause stenosis (narrowing) of the vertebral canal (space in which the spinal cord is located).
Among other things, the vertebrae are connected by faceted joints, the structure is more rigid than the intervertebral disc.Their damage in 15 to 65% of cases cause back pain.Up to 30% of lower back pain is due to the lesion of the sacred and illegal joint - a paired structure connecting the sacrum and the bones of the basin.In the end, any irritation increases the tone of the muscles around, which over time causes a separate myofascial syndrome.
As a general rule, physical activity leads to back pain, in particular in cases where it is expressed or intense, or when produced in a non -natural installation, or when associated with a long stay in a forced position, for example, behind the wheel of a car or an office.The body weight and physical training of a person are of great importance, because 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 osteochondrosis, but a certain number of factors that contribute to the occurrence of this disease can be indicated: poor physical development, a metabolism violation in the body, genetic predisposition, incorrect posture, prolonged stay in a pose (for example, before the computer instructor), hypodynamicity and an excessive flat bed.As a rule, these reasons are combined with irrational nutrition.
What to do if there is pain in the back?
The most important rule is not to self-managed!
Initially, it is necessary to reach an appointment with a neurologist or a neurosurgeon.To establish a precise diagnosis, a complete examination of the patient is necessary, necessarily including the radiography of the spine and tomography (magnetic resonance or calculated radiography. The aim of such or this study should only be carried out by the treating doctor on a specific clinical image.
The drug care of osteochondrosis of the spine include not only the elimination of pain syndrome, but also, if possible, the elimination of deep causes.The doctor prescribes complex therapy (drug therapy, physiotherapy, acupuncture, balneotherapy)
Complete therapeutic care for osteochondrosis includes power and correction of lifestyle (healthy and active lifestyle, optimal volume of physical education), objective, in some cases - chondroprotective drugs that improve the condition of the cartilage fabric.
The main indication of surgical treatment of the dystrophic degenerative vertebral disease is the ineffectiveness of a conservative drug treatment for 4 to 6 weeks, unconscious of pain, as well as the growing weakness of the legs, which in a certain number of cases can be accompanied by urinary incontinence.Premature and incorrect treatment in such situations can lead to a number of unwanted consequences and complications, until disability.
Back pain is 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 a person's life: the very moment, he gets up in childhood until his death.The vertebral column wear out and, sooner or later, problems with it occur in almost everyone.The most common diagnoses that are made with back pain: "osteochondrosis" and "radicult", while patients often put them themselves and prescribe the treatment themselves, without asking for advice from doctors.However, even for these diagnoses, which, it seems, everyone hears, there are often reasons that only an experienced specialist can determine.
What hurts there?
In the vast majority (around 95%), pain is associated with muscles, ligaments and joints.People are called to pull their backs.These pains are unpleasant, but not Hazard and in most cases, are transmitted themselves in 2-3 days.
3 to 4% of pain is associated with radiculopathy (radiculitis) - damage to the vertebral root.It is usually damaged by hernia.The pain disappears when the edema which appeared due to the compression passes.
1 to 2% of back pain is caused by injuries or inflammatory diseases of the spine, oncological processes, diseases of the cardiovascular system or gastrointestinal tract, in which pain syndrome can enter the rear.It is the most dangerous type of back pain.To exclude these pathologies, be sure to consult a doctor.
You can't delay
The main indicator you need medical care is the regularity of pain.If you are twisted from time to time, there is probably nothing wrong.If the pain of low or medium intensity haunts you tirelessly, you cannot hesitate.It is urgent to consult a doctor if the pain is accompanied by an increase in temperature or pain develops in a treatment.
Types of pain
Doctors distinguish 3 types of pain, which are most often felt in the back.The doctor's task is to precisely determine what type of pain the patient is concerned about the patient who contacted him, because each of them will be treated exclusively in his own way.
Nociceptive painOr, more simply, pain in receptors - in the skin, muscles, ligaments, joints - is considered to be the most common.The reasons which cause it in X -rays or the use of computed tomography are generally not visible.In this case, the specialist establishes the diagnosis based on the symptoms of which the patient speaks.The causes of muscle spasms can be, for example, physical activity, when a person has raised something heavy, leaning suddenly or a temperature difference (an air conditioning with pure common).This type of pain is treated with two types of drugs.
Acute pain is treated with analgesics of anti-inflammatory drugs and relaxing drugs.In this case, there can be no other therapy.When pain syndrome is deleted, we recommend that the patient strengthens muscles with physical education.This is the treatment and prevention of the disease for the future.
Physical exercises help not only to strengthen the muscles, but also to contribute to the production of endorphins, as well as serotonin and noradrenaline in the body.These substances increase a person's pain threshold and eliminate depressive mood.
Neuropathic painOr the pain of the nerve, people are better known as radiculitis.This type of pain in humans occurs, in particular, when the vertebral hernia becomes large and tightens nerve endings.At the same time, experts warn patients and the entire professional community against inappropriate diagnosis in cases where radiography and MRI use turns out that hernia or any other type of vertebral use is available, but it is not so important to affect the nerve.It is necessary to carefully understand the real cause of pain.It is possible that a muscular spasm is to blame, and this type of pain is completely different, and the treatment also differs for this.What is considered an osteochondrosis is not only manifests itself by pain, but also by the norm.
Osteochondrosis is a sign of aging the body.But "osteochondrosis" and "pain" are not the same.Since there are practically no nerve endings in the bone tissue, the projection (the initial stage of the hernia of the intervertebral disc - Auth.) Or a hernia cannot hurt.Even studies have been carried out: MRIs were carried out groups of people - they chose, mainly those who had never addressed a doctor with complaints concerning back pain, but they found hernia and osteochondosis.
In addition, the doctor gives examples when patients received treatment - and they took place, despite the fact that osteochondrosis remained in the photo.Osteochondosis today is a concept used locally.
There are countries where the word "osteochondrosis" is not at all used.Last year, they officially declared that this diagnosis was made by past generation neurologists.Abroad, when the patient arrives at the reception and says that his back hurts, he is diagnosed with non -specific pain behind his back, but it is understood that a person has given a charge on the muscles.
Confirmation that pain is precisely caused by radiculitis, and not with spasms, for specialists, the symptom in the form of pain at the back of the back, which gives the nerve in the leg, is most often intended for specialists.
The cause of nervous pain can also be complications caused by diabetes and herpes.In diabetes mellitus, patients often complain about pain, as this disease damages the nervous system.Postherpetic neuralgia is characterized by rash bands along the damaged nerve and, therefore, of pain.There are special drugs for treatment of nerve pain.
For the treatment of neuropathic pain, anti-epileptic and antidepressants are used.The names of the drugs of this orientation of patients, I must say, is often scary, it is therefore important for them to explain that it is the antidepressants that increase the pain threshold.These are pain treatment standards.
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 just the back.
Sometimes people come and say my head, in the background.Do you ask: something heavy lifted?No!And there is no clear location.In this case, we can conclude that the patient has reduced the pain threshold and a pain analyzer, which is in the brain, is constantly felt.This can cause pain in such a patient: overwork, stress, a feeling of fear.
Anesthetic drugs in this case will not help.Specialists generally prescribe antidepressants, physical education for patients with chronic pain, but sometimes it is enough to find a reason using a psychologist or a psychiatrist.
A young woman who complained of back pain: six months, he said, was tormented.I recommended going to a psychologist and physical education.A few days later, she became completely healthy again without taking medication.The psychologist helped her understand that the cause of stress pain: she had family problems, physical education helped relax.
At homeThe most effective remedy is anti-inflammatory oral drugs.Do not do too much - they are only safe for the first time.With prolonged use, these drugs can cause ulcers and bleeding in the gastric mucosa.Traditional home treatment - non -steroidal ointments - can only be used as an additional measure.They are harmless, but ineffective.CARSSET also relieves - The fixing discharges the spine, relieves spasms and limits net movements.Only the corset must be ordinary - elastic and non -warming.
If the treatment has no effect for three days, you should consult a doctor who will have the blockade with anti-inflammatory injections.Due to the elimination of spasms and the relaxation of muscles, pain immediately leaves and often forever.
Forbidden!
Bath and massage under the strict prohibition.They improve edema and pain.
Contact manual therapists from the newspaper.Manual therapy is the field where each specialist represents three hundred charlatans.If you really want to find a good doctor, you must contact the certified clinics where graduate specialists work.
It is important to immediately determine treatment tactics properly.This should be done by a neurologist or a neurosurgeon.It is dangerous to treat your back yourself.30% of patients in the neurosurgical service have tried home treatment methods, which got into a hospital bed.
When the pills do not help
If the drug treatment prescribes a therapist or a neuropathologist does not give results within 3 to 6 months and the pain continues to torment the patient, the doctor is forced to transmit the patient to another specialist.In certain situations, physiotherapy can provide significant assistance.It is suitable for the first two types of pain: in receptors and nerves.Physiotherapy is prescribed to patients who have an allergy to medication or stomach problems.
For this reason, the treatment passes, but there is no effect, patients often come to us severe, with depression, we therefore approach their multidisciplinary treatment, with the involvement of various specialists: neuropathologists, psychologists, physiotherapists, neurosurgeons.
Among the methods that domestic physiotherapists are used, borrowed from Russian colleaguesIntracanic electrical stimulation.Its principle is that by a disposable special needle electrode, bypassing the skin barrier, to provide the current, directly in pain.Diagnostics in which this procedure is prescribed, including projection and hernia.The procedure, according to experts, is comfortable and does not require pain relief.The effect, as a rule, is felt after the first procedure.In total, they are assigned from 3 to 6.
In addition, it is usedLaser therapy.This technique is also practical in that it can be prescribed to patients with various stimulants, including cardio - and does not fear 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 complications of diabetes and herpes sugar, which have already been discussed.
The laser promotes good healing.In addition, the device improves microcirculation in the spine itself, and for that, the power of the discs improves.Consequently, edema and inflammation are eliminated and the pain disappears respectively.
Blockade
One thing such that the "blockade" in medicine is not new.With intense pain, since Soviet times, patients have been prescribed by injections in the area where pain is directly located.Since then, little has changed in the riding clinics.Meanwhile, in accordance with international recommendations, these procedures must be carried out exclusively under control, using special equipment that allows you to monitor the process in real time.The consequences of an unsuccessful injection can be very different: in the best of cases, the drug, introduced not if necessary, will not give the necessary effect, in the worst - this is responsible for serious complications.
The introduction of the drug should be carried out under radiological control: fluoroscopy, CT, MRI, ultrasound, because the drug is deliberately administered in the area where the source is of pain.In the event that the doctor obtains the wrong path, this is responsible for both the patient's respiratory judgment and total vertebral anesthesia.
The essence of the blockade is that the medication introduces from several months to six months prevents the spread of the impulse through the nerve, which is involved in the nervous pulse.Although this procedure does not guarantee a constant effect, it considerably improves the quality of life of the patient: a person temporarily forgets the pain, can sleep calmly or be done to their functions.
Operation - Elimination of pain
When drugs do not help - neither the pills nor the injections, when the physiocracy is ineffective, the neurosurgeons come to the rescue.Modern technologies allow these experts to return to the painless life of patients who suffer from them for not a consecutive year.There are many methods: manipulations with the most minimal intervention in the body to complex surgical operations with vertebral prostheses.
With hernias that have pinched the nerve, one of the most common and most effective methods is recognizedRadiofrequency removal.In fact, it is a kind of blocking, only instead of a drug that relieves pain only for a while, an electric current is used which can completely solve the problem.Often, removal is carried out after the blockade, 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 by quota.
The procedure is carried out within 20 minutes.It is called an operation, but in fact, it is a surgical manipulation which is done under local anesthesia, necessarily under the control of special devices.First, pain syndrome is reproduced and, if the patient confirms that it is exactly the pain he generally experiences, we give a pulse discharge - and the pain, so to speak, is disconnected.
In special cases, methods are usedneurostimulationsAmong them, there is the implementation of the electrode.The patient is done: the surgeon puts a small device in the center of pain, which will remove pain pulses in real time.Patients receive this procedure by quota.
There are times when they have already made different types of surgical interventions, but pain syndrome has been kept to one degree or another, we have put a stimulant - first in test mode, and if the desired effect is obtained, we have put it for good.This is an operation that is carried out with a small cut.The only thing is that the patient will have to come periodically for test control.
What we risk
The risk of the operation, due to which it is postponed or refused at all, many patients consider it very exaggerated.In neurosurgery, there are technologies that allow you to accurately calculate the effectiveness of the operation and what symptoms will disappear after it and which will remain.
The probability of pain renewal after surgery does not exceed 1 to 1.5%.Herbs in other places can really appear, but it is not a complication, but the spread of the disease, which is often found in young non -disciplined patients.As soon as the pain leaves, they come back to the usual lifestyle: they drive behind the wheel, resume training.And it's categorically impossible to do.
Is osteochondrosis responsible for everything?
Osteochondrosis is a chronic degenerative-dystrophic change in the intervertebral space.All people over 25 have signs of osteochondrosis.It is impossible to avoid osteochondrosis, but you can protect yourself from its complications, which causes back pain.
Why, and not otherwise?
Do I have to spend time, efforts and money on treatment: tablets, injections, physiotherapy, if you can immediately do a small operation and get rid of pain once and for all?- Patients have asked this question more and more.The answer is generally without ambiguity: yes, you need!The fact is that with precise diagnosis and appropriate treatment, the units reach operations.The others get rid of pain in the first stages of assistance - on average, 30% of patients at each stage have come out.
An error when people, having seen a projection or hernia in the photo, immediately realized the surgeon, bypassing the specialists in the previous assistance stages.In cases where the changes are insignificant, the operation is not required.In addition, with the right lifestyle - engaged in physiotherapy exercises, swimming, monitoring your body weight - a person with osteochondosis so called can feel healthy and not feel pain.
It is important that each step, the patient has a precise diagnosis and that the correct treatment is prescribed.This can only be reached college.It is also proposed, on the example of foreign experience, to introduce a new specialization, such as an algologist, is a kind of therapist specializing in pain, a doctor who has the knowledge of an anesthesiologist and an interventionist, capable of treating, without conduct, but if surgical intervention nevertheless inevitably transmits the patient to neurores.