Modern methods of diagnosis and methods of treatment of intervertebral hernia
In this article we will discuss effective methods of diagnosis and methods of treatment of intervertebral hernias of various localization. Will be determined by the treatment algorithm in acute. Not to mention the contraindications to the use of any methods of treatment. Answer the question, how is it treated inter disc pathology during remission? Talk about specialized rehabilitation centers for patients with hernias of the spine. We list recommendations, the observance of which will improve the quality of life of patients with diseases of the back.
Intervertebral (intervertebral) hernia is a violation of the state of anatomical and physiological consensus between the disc and surrounding vertebrae. The intervertebral disc is a homogeneous substance with nucleus pulposus in the middle and is completely dependent on the surrounding tissue: spine and back muscles perform mechanical protection, blood and lymphatic vessels delivering nutrients. In the composition of the intervertebral disc has no nerve fibers. Back pain arises from irritation of spinal nerves formed by spinal disc hernia.
What to do to the patient with suspected hernia of intervertebral disk? Urgently to diagnose the location, size, extent of the damage. To figure out what kind of doctor treats herniated spine. Then find a specialist with whom to choose methods of treatment.
Location and symptoms of herniated discs
Hernial protrusion can be divided into:
- front (ventral hernia);
- back (midline; lateral (lateral, paramedian); foraminal (lateral holes of the vertebrae) hernias).
This has important diagnostic value when choosing the method of operative access and type of surgery.
What could be spinal pain? It is, as a rule, never local. The clinical picture corresponds to a certain irritation of the spinal nerve. The pain radiates to arm, neck, shoulder, leg, groin. Sometimes to get rid of it helps to change the position of the body (antalgic posture of the patient). This does not apply to the acute phase.
This condition (exacerbation) is urgent (urgent), and hence, it becomes necessary:
- around the clock to monitor and treat a patient in a hospital;
- to conduct urgent diagnosis using magnetic resonance imaging MRI (hernial SAC may increase or necrotic);
- to follow the doctor's appointments (to relieve the pain, stop the inflammation).
How is spinal pain? The defeat of the intervertebral disc does not happen in one day. This condition is chronic. Against the background of significant diffuse degenerative disc disease in any region of the spine formed a hernia. To join pain syndrome, movement disorders, sensitivity, pelvic functions. The patient is unable to perform bending, squatting, turning, which greatly reduces its adaptability in everyday life and leads to mental and physical imbalance.
herniated disc Treatment will not bring positive results without a plan of diagnostic measures compiled by the neurologist. How can you identify the pathology of the discs? In modern medicine there are different methods of diagnosis. Assessing the clinical picture, duration of disease and severity of pain, the doctor refers the patient to the diagnosis vertebral disease.
Modern diagnostics rezonance:
- conventional laboratory methods (blood tests, urine, biological fluids sowing on flora and sensitivity to drugs and so on)
- magnetic resonance imaging (MRI): done without preparation, you can take pictures of different parts of the spine, harmless (no x-ray stress), informative (assessed the condition of all structures), there are additional techniques (contrast enhancement, angiography and others);
- measurement of the pressure of the cerebrospinal fluid: lumbar puncture procedure supplemented by the measurement of CSF pressure in millimeters of mercury; this method allows to determine the degree of narrowing inside the spinal space (in the place of deformation of the pressure increases three times), and further, to choose the type of decompression operation;
- electromyography: detects the origin of motor deficits
- ultrasound: non-invasive method, requires no special training, allows to suspect the presence of intervertebral disorders;
- duplex scanning of neck vessels: with the development of vertigo of cervical origin;
- electrocardiogram: to exclude cardiac pathology
- ultrasound of internal organs: to excludepancreatitis, peptic ulcer disease, pathology of the pelvic organs.
To the treatment of intervertebral hernias were effective, doctor-neurologist, if necessary, are attracted to diagnosis and therapy for physicians of other specialties (neuro, orthopedist, physical therapist, chiropractor, reflexologist).
Chiropractors and iglorefleksoterapevta able to work only when there are two certificates (major and neurological).
How to cure intervertebral hernia?
Effective treatment for herniated discs is a long process. It requires patience from the patient and the desire to escape not only from pain but also from the pathological state of his spine.
How to cure hernia of the spine and whether you can achieve success in treatment? You should do the following:
- to relieve pain and reduce swelling of tissues;
- to get rid of spasm of the back muscles;
- to improve the spine and nerve conductivity
- to establish trophic (nutritional) function;
- reverse the signs of inflammatory process;
- to restore the physiological intervertebral space.
The Treatment of intervertebral disc herniation is carried out in several ways:
- Conservative treatment:
- drug therapy;
- non-drug therapy.
Drug therapy is the main provision in the treatment of diseases of the spine:
- non-steroidal anti-inflammatory drugs (ortofen, nimesil, meloxicam, xefocam, etc.) – reduce inflammation, pain;
- muscle relaxants (mydocalm, sirdalud, baksolan, xeomin, memantine and others) – reduce reflex muscle spasm
- hemorheologic funds, angioprotectors (Actovegin, pentoxifylline) – improves peripheral circulation, promotes good nutrition damaged intervertebral disc;
- anticonvulsants (carbamazepine) – eliminate neuropathic pain ;
- vitamin therapy (group b) – restores the nervous conductivity;
- chondroprotectors (teraflex, alflutop, hondroksid, and others) – improve the condition of cartilage.
To non-drug types of conservative therapy include:
- physiotherapy (magnetic therapy, ultrasound, diadynamic currents, electrophoresis, amplipulse therapy, darsonvalization, paraffin, mud therapy, baths, etc.);
- reflexology (introduction of disposable needles in the trigger zone or needles with drugs made by the doctor-reflexologist);
- manual therapy (reduction to normal biomechanical process of moving).
Any self-propulsion manipulation of the patient can be started after removal of the exacerbation. Such activities include training in the gym with the instructor, at the gym, fitness.
- Surgical treatment
Before the physician decides on the need for surgery, should undertake proper diagnosis of the effects of herniation of the spine (to determine the degree of stenosis of the spinal canal).
All kinds of operations aimed at eliminating irritating a spinal nerve obstacles.
- decompression of: removing the damaged disc, vertebra or fusion (the joining of two or more vertebrae to strengthen the spine);
- transplantation disc automaterialen or artificial disk.
This section is the treatment of spinal hernia include medication, physio - and psychotherapeutic methods of treatment. Psychotherapeutic correction allows patients to get rid of depression. To win the neurological manifestations of spinal herniation using annual sanatorium-resort treatment in specialized institutions.
herniated disc Treatment at exacerbation is to reduce pain. There are various methods of treatment of disc herniation of the spine and relieving pain:
- bed protective regime, hospitalization;
- traditional drug therapy (NSAIDs, diuretics, antispasmodics, analgesics, vitamins in therapeutic doses);
- good effect gives intravenous infusion of drugs (IVS): with their help reduce the effects of swelling, inflammation of the tissues; there is a possibility of prolongation of analgesia, improving nutrition of muscles and cartilage
- pharmacopuncture (blockade of trigger points by injection of medicinal substances) to be injected intramuscularly paravertebral (on both sides of the spinal column) a mixture of medicines: novocaine 0.5% solution, 5 ml (lidocaine 20 mg/LM, 2 ml), prednisolone 25 mg/ml – 2 ml, vitamin B1(thiamine) 50 mg/ml – 1 ml;
- you might consider treatment with a chiropractor (to have MRI pictures of the spine).
Contraindications for the treatment of intervertebral hernia can be absolute (is strictly prohibited) and relative (should not apply).
Neurologists are not in a hurry to appoint the procedure of therapeutic massage in acute and acute periods of illness. The patient should be on bed rest for 7 days.
Speaking about the cure of the disease disc, it should be remembered that only after 6 weeks from the onset of the disease, the disc begins to recover. But the likelihood of re-rupture of the fibrous ring remains high up to 6 months. Contraindications to exercise or fitness without special corsets.
Cure, that isto remove a hernia can only be surgically. Surgery is indicated after 4-8 weeks of absence of effect from conservative therapy.
Medical specialized centers
What if in addition to the granted rights to receive adequate therapy, the patient wants a faster cure spinal pathology? Or how to behave after the surgery? What is possible and what is contraindicated? Sometimes not every doctor outpatient service has the desire or time to make individual recommendations. Sometimes the patient can hear only the name of a center or the name of the doctor. Then the desire to defeat the disease will join professionals profile medical centers.
Specialized centers work on the original patented methods or the complex of conservative measures. All versions are based on the principles of manual therapy or physical therapy.
here are some rehabilitation centres:
- medical rehabilitation centers Dikul: provides comprehensive recovery of patients; a center website;
- the Dr. Bubnovsky center: applies a patented method of kinesiotherapy; have a center site and online consultation;
- clinic doctor Ignatieff: the center of manual therapy uses patented techniques, has its own website, where the questions patients answers online consultant, it is for treatment, duration of the course 1-1,5 months; methodology based on restoring processes of biomechanics, the violation of which entails the formation of an intervertebral disc defect
- rehabilitation center "Overcoming": the selected individual program activities (physical exercises) to strengthen bone and muscular system;
- the clinic of Dr. Blum, the rehabilitation center "Three sisters": a comprehensive approach to spinal rehabilitation patients;
- clinic doctor Bobyr: effective methods of treating problems of the spine;
- clinic of vertebronevrologii Danilova: impact on hernia is the author's method of vertebronevrologii.
How to live the patient of the insolvency of the intervertebral discs?
- physician-neurologist at the place of residence;
- courses of maintenance therapy 1-2 times per year;
- during the aggravation is required hospitalization, except of motor activity (swimming, gymnastics, massage, and so on)
- to use orthopedic furniture for sleeping (beds with orthopedic bottom, mattresses of medium hardness, orthopedic pillows) and work (orthopedic chairs physiological height);
- to monitor your posture while sitting and walking;
- to normalize the body weight, observe the rules of good nutrition
- never forget about body the diagnosis “osteochondrosis” and to learn how to live properly.
Treatment of vertebral hernia always has a positive result. Sometimes minimal, elusive. Even a small victory in the fight against the disease is far better than inaction, expectations that "it will pass". No need to wait for complete exhaustion of your resources in the intervertebral disc space. You should go to the doctor! We wish you health!