Treatment of protrusion of the discs of the lumbar spine

Protrusion is a pathological process, which is accompanied by protrusion of the intervertebral discs into the region of the spinal canal, while the fibrous ring remains intact. This is one of the intermediate stages, which can subsequently lead to the occurrence of an intervertebral hernia.

The disorder is not an independent disease, the most common localization is in the lumbar region. Treatment of protrusion of the discs of the lumbar spine is carried out in a complex manner.

The following therapies are used:

1. Medications.
2. Physiotherapy.
3. Massage.
4. Yoga, therapeutic gymnastics.
5. Anti-inflammatory and analgesic blockades.

Protrusion occurs against the background of progressive osteochondrosis as a result of exposure to degenerative-dystrophic processes. This leads to a gradual decrease in elasticity and dehydration of the disc, a decrease in its height and the appearance of cracks in the annulus fibrosus. Protrusions significantly constrain the mobility of the spinal column, contribute to the development of chronic pain (chronic form of sciatica).

In severe cases, there is dysfunction of the internal organs, and even paralysis of the limbs.

Symptoms

Intervertebral protrusion is formed in several stages, depending on which characteristic signs of disorders will appear.

Typical manifestations:

• at the initial stage, microcracks form in the fibrous ring, and the intervertebral disc gradually flattens;
• at the stage of protrusion of the intervertebral discs, the discs can move in different directions;
• depending on this, it is possible to develop complaints of pain, impaired mobility;
• the risk of complications increases: the most dangerous option is the displacement of the disc to the area of ​​the spinal canal;
• at the third stage, the lack of treatment of lumbar protrusions can contribute to the development of hernias, followed by rupture of the intervertebral rings and prolapse of the intervertebral discs.

The decision on how to treat protrusion of the discs of the vertebral section is made by the doctor, taking into account the manifestations of disorders. Symptoms of protrusion are similar to manifestations of osteochondrosis and manifest themselves in the form of complaints of mobility disorders and a feeling of pain, which will increase when the disc is displaced.

Minor shifts do not manifest themselves in the form of any alarming symptoms. The severe course of the disease is accompanied by a feeling of numbness in the limbs. Complete compression of the spinal nerve root can lead to paralysis of the legs.

Therapy

The doctor decides how to treat the protrusion after an internal examination of the patient, a survey regarding emerging complaints and according to the results of a comprehensive examination: CT, MRI, radiography.

The main objectives of therapy are:

1. Eliminate the feeling of pain.
2. Normalization of the biomechanics of the spinal column.
3. Implementation of a full course of rehabilitation.

Treatment of spinal protrusion is carried out if the patient has complaints about the development of pain or impaired motor activity.

Treatment approach:

• the gold standard of medical treatment of acute back pain is the use of drugs from the NSAID group;
• massages and physiotherapy exercises can be used only after the exacerbation of the disease, which manifests itself in the form of intense pain, has been eliminated;
• elements of physiotherapy in the form of electrophoresis and dynamic currents can be recommended;
• manual and reflexotherapy has a good therapeutic effect;
• patients who are interested in the question of how to cure protrusion should know that spa treatment has a positive therapeutic effect during the remission period.

The earlier and better the pain sensations are stopped, the less is the likelihood of fixing pathological motor stereotypes with the subsequent occurrence of emotional disorders. During the period of exacerbation, patients should observe bed rest, the use of painkillers, anti-inflammatory drugs, muscle relaxants.

Medical treatment

Drug treatment of protrusion of the lumbar spine involves the use of different groups of drugs.

The following funds are assigned:

1. Medicines from the group of non-steroidal anti-inflammatory drugs : Meloxicam, Diclofenac, Nimesulide, Ketorolac. The action of drugs is aimed at stopping the inflammatory process and eliminating pain. Medicines are produced in the form of tablets for internal use, ointments for external application. To achieve a more pronounced effect, intramuscular injections may be involved. It is allowed to simultaneously use oral or injectable forms of drugs in conjunction with ointments, creams, gels for external application.
2. Additionally, drugs from the group of muscle relaxants can be used to help reduce nerve conduction and relax muscles. This group of drugs can be used for several weeks. The doctor may recommend the use of Mydocalm, Tizinidine, Tolperisone. A combination of drugs from the group of muscle relaxants and NSAIDs has a good therapeutic effect. In this case, it is advisable to use Tizanidin, which, in addition to muscle relaxant, also has a gastroprotective effect.
3. The use of enzyme preparations (Karipain, Karipazin - agents based on papaya extracts) contributes to the provision of anti-inflammatory, immunomodulatory, secondary analgesic, decongestant, antiplatelet effects. Such a drug is administered through phono- and electrophoresis. Karipain is also available as a topical cream.
4. In order to correct microcirculation disorders, it is advisable to use drugs based on Pentoxifylline.
5. In order to normalize energy metabolism, prevent the negative effects of free radicals and restore cell membranes, it is recommended to use preparations based on alpha-lipoic acid : Berlition. The drug also contributes to the provision of membrane-protective, antihypoxic, anti-ischemic action, improve microcirculation.
6. With intense pain and the development of compression disorders, the doctor may recommend the use of corticosteroids for a short period of time.
7. To enhance the anti-inflammatory and analgesic effect and reduce the severity of neurological disorders, the use of vitamin complexes based on B vitamins is recommended . Such drugs are available in the form of tablets for oral administration or injection.
8. The use of biogenic stimulants helps to reduce edema, accelerate regeneration, and provide an adaptogenic effect. A doctor may recommend a subcutaneous injection of a liquid extract of Aloe or Phibs.

Treatment of chronic pain

If the pain syndrome becomes chronic, it is advisable to use:

1. Medicines that affect the structure of bone and cartilage tissues (chondroprotectors): Dona, Structum, Teraflex. Medicines of this group are intended for long-term use (up to six months).
2. Preparations that normalize microcirculation.
3. Antidepressants.
4. Also recommended are vitamin complexes, which include calcium and vitamin D3.

The chronic course of the disease is treated with the involvement of physiotherapy, manual therapy, reflexology, spa treatment.

Paravertebral blocks

In the event that pain and a feeling of stiffness bother for a long time, patients begin to doubt whether protrusion can be cured with medication.

The use of paravertebral blockades contributes to the following positive effects:

• reduction of the inflammatory process;
• elimination of the feeling of pain;
• normalization of microcirculation;
• elimination of hypertonicity of transversely smooth muscles, which facilitates further therapy.

Paravertebral blockade involves the simultaneous use of drugs with an analgesic effect (Lidocaine, Procaine, Novocaine) in conjunction with corticosteroids (Hydrocortisone, Prednisolone). In no case should injections be done independently, at home.

The procedure can only be performed by a qualified doctor, depending on the emerging complaints, concomitant diseases, age and individual characteristics of the patient's body.

Physical activity

Often patients ask themselves how to treat protrusions of the lumbar spine through elements of physiotherapy exercises and gymnastics, they strive to start training as soon as possible.

It is important to take into account the following recommendations of doctors:

• during the period of exacerbation, efforts are directed to reduce irritation of pain receptors. For this, special belts and corsets can be used;
• the patient should move as little as possible, observe bed rest;
• the duration of the acute period is up to 5 days (in most patients 1-3 days).

Further, the inflammatory process passes into the subacute (chronic) stage. With the weakening of pain, it is necessary to abandon corsets and belts, try to lie less. Patients are not recommended to stay in a sitting position, but moderate physical activity in the form of gymnastics or morning exercises, by prior agreement with the doctor, is acceptable.

All exercises must be performed with extreme caution and under the supervision of specialists. Recommended complexes aimed at strengthening the muscles of the lumbar. If the performance of any exercise provokes pain, then its implementation must be abandoned for a while.

Prolonged sitting or lying down with a subacute course of the disease is not recommended, since it can contribute to the transformation of pain into a chronic form.

When is surgery required?

Surgical treatment for protrusion of the lumbar spine is rarely prescribed.

The reasons are the following:

• severe complications were revealed in the form of paralysis and severe disorders of the functioning of internal organs (intestines, prostate, bladder, etc. are affected);
• there are complaints of increased pain, progressing neurological disorders;
• conservative treatment of intervertebral disc protrusion does not contribute to the expected therapeutic effect.

Only a qualified, experienced specialist can treat lumbar protrusions: a neuropathologist, a neurosurgeon, a chiropractor. When the lumbar spine is affected, symptoms and treatment are closely related to each other. At the same time, modern surgery prefers low-traumatic microsurgical procedures and endoscopic interventions.

In some cases, the attending physician may recommend replacing a worn spinal disc with a hypoallergenic and safe implant.

Prevention

It is important not only to know how to treat protrusions of the lumbar spine, but also to have information on the prevention of recurrence of exacerbation.

For this it is recommended:

• protect yourself from the effects of irritating factors: lifting weights, hypothermia;
• it is necessary to lead an active lifestyle, give preference to regular moderate physical activity: yoga, exercise therapy;
• follow all the instructions of the attending physician regarding the use of vitamin complexes and medicines;
• monitor posture;
• give preference to a moderately high-calorie diet, which will contain proteins and polyunsaturated fatty acids.

At the first signs of exacerbation, you should refrain from self-medication and consult a doctor.