Is protrusion of the intervertebral discs dangerous, and what to do with such a diagnosis
Such an acquired disorder as protrusion of the intervertebral discs occurs mainly at the age of 30, which is associated with a high load on the spinal column and many other factors that affect the entire musculoskeletal system throughout life. This deviation cannot be called an independent disease, because in itself it does not cause any harm, but in combination with some other deviation it will already pose a threat.
Protrusion of the intervertebral discs has several varieties, and this largely determines the symptomatic complex and approach to therapy. An important feature is that, unlike a hernia, such a violation is not accompanied by a rupture of the fibrous ring.
So what is disc protrusion? This is a protrusion of the fibrous ring of the disc into the spinal canal in combination with degenerative-dystrophic changes in the bone and cartilage tissue.
In most cases, protrusion of the intervertebral discs occurs without symptoms, but given that this anomaly is almost always combined with other disorders, some manifestations will still bother the patient.
What is protrusion
It is believed that the protrusion of the discs of the spine acts as a pre-hernial condition, because the disc is already partially out into the spinal canal, and for the formation of a hernia, a rupture of the fibrous ring must occur. A defect in the latter can appear at any time when a high load is placed on the spine, because degenerative changes are already taking place in the intervertebral disc, making it fragile.
Disc protrusion appears due to damage to the fibers of the fibrous ring without breaking it. Inside the disc contains a gelatinous body or nucleus pulposus. The intervertebral disc maintains its position and shape, and together they provide a shock-absorbing function, supporting the vertebrae during the movement of the spine, and ensuring their mobility.
When the fibrous ring is deformed, pathological changes also begin inside the disc, moisture is lost, its structure is disturbed, and it is no longer able to perform its main function. A disk that has gone beyond its anatomical limits begins to exert pressure on the surrounding tissues, which is why various symptom complexes appear.
Clinical manifestations will depend on the size of the protrusion (from 1 to 5 mm). The greater the protrusion, the more pronounced the compression of the nerve roots, which leads to the occurrence of pain, which is temporary. The inconsistency of the symptom is explained by a different degree of tissue compression at different body positions and movements.
Reasons for the appearance
What can lead to protrusion of the intervertebral discs:
- Lack of movement. Hypodynamia leads to muscle weakness, at the same time, the nutrition of the intervertebral disc is disturbed, because it will receive most of the substances from muscle tissue. It also affects the formation of a fatty layer, which gradually replaces the muscles, which has an even more negative effect on maintaining the correct position of the spine.
- Unequal loads on the spinal column. This factor leads to degenerative changes in a separate segment of the spine. More often, the lumbar region suffers from protrusions and hernias, less often - the cervical, extremely rarely - the thoracic. Several factors lead to uneven distribution of loads on the spine. The main reason is long-term dynamic and static loads. Other factors are congenital and acquired anomalies such as sacralization, splitting of the vertebrae, syndrome of additional cervical ribs. The impact is also exerted by a sharp rise in heavy objects, excess weight, curvature and deformation of the spine. Hip dysplasia in children will also be a factor in the incorrect distribution of loads, and disc protrusion can be diagnosed already at an older age.
- Injuries and operations. Spinal injuries and previous surgical interventions will be a factor in the appearance of protrusions. In particular, this applies to complicated operations, and when, after treatment, the damaged tissues healed for a long time, which could cause improper fusion. This also includes subluxations, bruises and fractures of the vertebrae.
- Some systemic diseases . Diabetes mellitus and thyroid pathology (hypothyroidism) affect metabolic processes. Failure of the latter causes malnutrition of the intervertebral disc.
- Pathologies of connective tissue and collagenoses.
What is dangerous
Protrusion of the spinal discs is dangerous because the course of this disorder occurs almost asymptomatically, which does not allow timely prevention of its complications. It all starts with degenerative changes, and if at this stage the nutrition of the intervertebral disc is improved with an integrated approach, severe protrusion can be avoided.
If, however, the protrusion is completely left without treatment, it turns into a hernia, that is, the fibrous ring ruptures with the nucleus pulposus coming out. This is followed by disk sequestration. A sequestered hernia can no longer be treated with conservative methods, and the only option to get rid of such a pathology is surgery.
In order to be able to start preventive measures in time, it is necessary to figure out what manifestations are characteristic of protrusion, and at what point it is already possible to talk about a herniated disc.
Considering that about 80% of all people have disc protrusion, the prevention of its complications in the form of spinal pathologies should be dealt with by everyone without exception. This need is reinforced by the fact that in the life of everyone there is at least one factor in the occurrence of this disease.
Stages and symptoms
Disc protrusion is formed in 3 stages:
- At the first stage, the structure of the disk is broken, microcracks appear on it. Already at this stage, symptoms may appear in the form of periodic pain of a local nature.
- At the second stage, the protrusion of the disc begins, it bulges into the spinal canal by 2-3 mm. The pain in this case acquires an irradiating character, and spreads to the surrounding tissues. In the area of the defect itself, the patient is constantly worried about discomfort. If a violation is detected at this stage, there is the possibility of non-surgical treatment by changing lifestyle and exercise therapy.
- In the third stage, the disc extends significantly beyond its anatomical limits . The patient is worried about numbness of the limbs, spreading pain and other neurological symptoms. This stage precedes the rupture of the annulus of the disc, which can happen at any time due to increased stress on the spine.
In addition to being specific to each department, disc protrusion has common symptoms:
- drops in blood pressure;
- aching pain in the area of the diseased disc;
- numbness of fingers and toes;
- soreness in the legs.
There are several types of protrusion, depending on the direction of the protrusion of the disc:
- foraminal protrusion - in the posterolateral direction, which is accompanied by compression of the spinal roots;
- median - to the center of the spinal canal;
- circular - uniform output of the disk in all directions.
Foraminal protrusion is considered the most dangerous, when nerves are compressed. This type of pathology is almost always accompanied by pain, which is acute in nature, and occurs, depending on the position of the body.
When the spine is in a natural position, that is, straightened, there is no symptom. If a person sits for a long time, stoops, takes a forced uncomfortable position, the tissues begin to compress, and pain appears.
In the cervical region
Protrusion of the spine in the cervical region gives the following symptoms:
- pain in the shoulder blades and shoulders;
- headache and dizziness;
- decreased performance, apathetic state;
- tingling of the skin of the arms and back.
In the chest
Protrusion in the thoracic region is characterized by:
- stiffness of the spine;
- dull pain between the shoulder blades;
- decreased muscle mobility;
- increasing discomfort while sitting.
In the lumbar
Symptoms characteristic of lumbar protrusion:
- pain in the lumbar region;
- numbness and tingling of the skin of the buttocks, back, legs;
- muscle weakness of the lower extremities;
- aggravation of symptoms during walking.
How to treat protrusions
Spinal protrusion is treated comprehensively. The choice of methods will be carried out by the attending physician after studying x-ray images and laboratory tests. Treatment is based on an individual approach, depending on the size of the protrusion and the presence of aggravating factors in the form of excess weight, trauma, spinal curvature.
The regimen will differ depending on the period of the disease:
Treatment methods for spinal protrusion:
- Prescribing medications . These are non-steroidal anti-inflammatory drugs, painkillers, muscle relaxants, antispasmodics, antidepressants, sedatives.
- Stretching of the spine. It is carried out on special devices, it can be performed in water, which is considered safer. Its purpose will be to increase the distance between the vertebrae to reduce the pressure on the surrounding tissues.
- Physiotherapy. Classes are conducted according to the author's methods, or an individual set of exercises is selected by the doctor to perform at home. Physical education is necessary to strengthen and stretch the muscles of the back, as well as for general recovery.
- Physiotherapy . Physiotherapeutic procedures are prescribed during the period of remission, when there are no acute pains and no inflammation. Useful for protrusion will be magnetotherapy, drug electrophoresis and phonophoresis, treatment with currents.
- Massage and manual therapy . These techniques are indicated in order to return the vertebrae to their place and to relax the muscles, because their spasm leads to compression of the nerve roots, which causes pain.
Is an operation needed
The help of a surgeon with protrusion is extremely rare. This disorder is easily amenable to conservative therapy, and correctly selected methods exclude complications. If the expected improvement in the condition does not occur, the patient is scheduled for surgery. More often, minimally invasive techniques are used in the form of puncture and laser vaporization.
Minimally invasive methods of treatment of intervertebral disc protrusion:
- Cold plasma nucleoplasty. It is carried out by introducing cold plasma into the damaged disk, which makes it decrease in size.
- Laser vaporization . This operation involves "cauterization" of the disc at the initial stage of its protrusion.
- Bone block . This is a method of instant pain relief with the simultaneous elimination of muscle spasm and tissue swelling.
- Hydroplastics . A special agent is introduced into the disk to cleanse it of ischemic areas and nourish the undamaged part.
The goal of drug therapy is to relieve symptoms. With protrusion, the main problems are pain, muscle spasm, and malnutrition of the disc.
To eliminate the symptoms, the doctor prescribes the following groups of drugs:
- Analgesics . To reduce pain, the doctor will prescribe non-steroidal anti-inflammatory drugs such as Nimesulide, Nimesil, Diclofenac, Ketoprofen, Ibuprofen. NSAIDs can be prescribed in the form of rectal suppositories when long-term therapy is required, but the patient has gastrointestinal pathologies that are a contraindication to oral medication. Additionally, they are prescribed in the form of creams and ointments, therefore it is important to monitor the concentration of the active substance in the blood, observing the exact dosage of all drugs.
- Chondroprotectors . A prolonged-release drug that is prescribed in the form of tablets, injections and ointments. They are needed to improve the condition of bone and cartilage tissue. Their main task is to stimulate regenerative processes in the intervertebral disc. Representatives - Teraflex, Artra, Dona, Glucosamine, Artrodan.
- Muscle relaxants . Shown at the initial stage of protrusion, when the protrusion does not exceed 1-2 mm. The standard course of treatment is 21 days. Representatives - Baclofen, Mydocalm (in the form of tablets and injections), Tizinidin.
- Vitamins of group B. Needed to restore the functioning of nerve endings. In order to restore the balance of vitamin B in the body, Milgamma, Pyridoxine, Neuromultivit are used.
- Diuretic . According to indications, diuretics are used to reduce the load on the diseased back. Such a need is with a strong swelling of the tissues.
- With protrusions, preparations for topical application are also important. The doctor will recommend NSAIDs, local irritants and chondroprotective agents in the form of ointments and gels. Such drugs are safe for long-term use, and at the same time they have a good effect in combination with drugs for oral administration and intramuscular administration.
Therapeutic exercises for disc protrusion will be a mandatory preventive measure. Exercise should be done daily in terms of exercise and simple movements. A special complex is performed under the supervision of a coach. Exercises are selected, depending on the localization of the protrusion and its manifestations.
The general set of therapeutic exercises for the spine with protrusion:
- Lying on your back, arms lie directly along the body. Raise the pelvis, leaning on the socks and shoulder blades. Fix the position for 10-20 seconds, repeat 5 times.
- Lying on your stomach, hands under the chin. Lift the opposite arm and leg off the floor at the same time. Hold for a few seconds, repeat 10 times.
- Lying on your back, arms straight along the body. Slightly raise the upper body without lifting your legs from the floor. Hold for 10 seconds, repeat up to 15 times.
- Lying on your back, arms straight along the body, legs slightly bent at the knees. Holding your breath, tighten your abdominal muscles as much as possible. Hold as long as possible, repeat until fatigue appears.
- On all fours, leaning on the palms and knees. Lift the opposite leg and arm off the floor at the same time. Hold for a few seconds, repeat 5 times.
Therapeutic massage is indicated at the initial stage of the disease and during the rehabilitation period. The patient is prescribed sparing techniques for a gentle effect on the spinal column. Not in every case, massage during protrusion will be useful, on the contrary, there are conditions when any influence on the diseased disc from the outside can cause complications. In connection with the risks, before visiting a massage therapist, you should discuss with your doctor the features of its implementation, the duration of the session and the duration of the entire course.
Treatment by a chiropractor is often carried out in parallel with a visit to a massage therapist. This combination creates favorable conditions for restoring the mobility of the spine and improving the nutrition of the intervertebral discs. Manual therapy, like massage, has contraindications. So, it is impossible to perform the procedure during a period of acute pain, and when the ring is already ruptured with the pulp coming out.
Manual therapy involves the elimination of functional blocks, by influencing the weight of the patient's own body on the spine. This technique also allows you to return the position of displaced vertebrae, because such a violation often accompanies protrusion.
Water and dry traction of the spine is carried out on special devices. The essence of the procedure lies in the traction effect on the spinal column, which causes stretching of the muscles and ligaments, which is necessary to reduce pressure on the damaged disc and surrounding soft tissues.
Traction eliminates pain in the back, and is more effective than pain medication.
The procedure is performed on the couch. To control the pressure, a computerized apparatus controlled by a doctor is used. Load parameters are set individually for each patient.
Symptoms for which spinal traction is indicated:
- aching pain in the neck, chest and lumbar region;
- increased pain during movement;
- numbness of fingers and toes;
- violation of the sensitivity of the lower and upper extremities;
- headache, noise and ringing in the ears, dizziness.
In case of protrusion, the following procedures are carried out to prevent complications:
- ultrasound therapy;
- mud baths;
- non-traditional methods: acupuncture, hirudotherapy, apitherapy.
The purpose of these techniques will be to stimulate metabolic processes in the area of the diseased disc. At the same time, the procedures help to improve the nutrition of muscles and cartilage tissue, which is also achieved by increasing blood circulation. Unconventional methods contribute to the overall health of the body.
UHF therapy involves exposure to dry heat. This helps to speed up the metabolism, which allows the tissues to recover faster.
Medicinal electrophoresis with non-steroidal anti-inflammatory drugs and chondroprotectors is performed in order to deliver the drug directly to the pathological focus.
Magnetotherapy is indicated to accelerate regeneration and enhance metabolism. It involves the impact on the spine of magnetic fields, which also leads to muscle relaxation.
Mud therapy is more often prescribed during the rehabilitation period. Applications with therapeutic mud reduce tissue swelling, relieve muscle spasm and stimulate regeneration processes.
Acupuncture for protrusion will be a good addition to exercise therapy and massage. Acupuncture promotes relaxation, improves blood flow, strengthens muscle tissue. During the session, the specialist inserts needles directly into the area of \u200b\u200bthe diseased department, as well as arms and legs. The procedure is permissible only in the absence of infection and inflammation of the skin.
A change in nutrition is necessary to compensate for the deficiency of vitamins and trace elements that are involved in the formation of bone and cartilage tissue and are responsible for normal nerve conduction.
Microelements and vitamins necessary for the spine:
- B vitamins - liver, fish, dairy products, mushrooms, barley, soybeans, oranges, kidneys, brain, buckwheat;
- magnesium - natural cheese, nuts, cucumbers, spinach;
- vitamin D (produced only under the influence of ultraviolet radiation) - butter, milk, eggs, fish oil;
- calcium - cheese, nuts, heart, kidneys ;
- vitamin A - liver, fruits, fish;
- phosphorus - lettuce, fish, cheese, soy, bran;
- vitamin C - cheese, citrus fruits, herbs, vegetables.
Not only the diet is changing, but also the diet. So that the spine continuously receives nutrients, and the body can resist the pathological process, the diet is followed for life. It does not imply strict restrictions, and all that is required is to eat healthy food often and in small portions.
If you follow this principle, you can eliminate several risk factors at once: overeating, dysfunction of the organs of the gastrointestinal tract, metabolic disorders and the accumulation of toxic substances in the body.
Do they take to the army
With a protrusion of the disc, military service is possible, but it all depends on the severity of the disease. Due to the state of health, there is a higher probability of being assigned to the railway or tank troops, that is, where the load on the spine is relatively lower.
Those who, according to Article 66, suffer from pathologies in which they become unfit for military service receive a reprieve.
In other cases, they will be taken into the army, but during the service it is possible that problems with the spine will arise, which will no longer allow it to continue.
It is known after reviewing the documents whether they take the army with a protrusion of the disc:
- Certificate of re-treatment to a medical institution about the disease.
- Discharges from the hospital.
- Certificates fixing the occurrence of pain after physical exertion, followed by an appeal to a medical institution.
- Information about the presence of a pathological process in the disc, which is aggravated and requires regular treatment.
- The conclusion of X-ray studies, MRI or CT, confirming the presence of pathology of the spine.
To prevent the occurrence of protrusion, risk factors must be eliminated by:
- regular physical activity, daily exercise;
- strengthening the muscular corset of the spine, which will help running, swimming, brisk walking, strength exercises, therapeutic exercises;
- posture control from childhood;
- proper nutrition, providing a full supply of vitamins and minerals;
- timely access to a doctor with the appearance of even moderate symptoms;
- refusal of self-treatment for back injuries.
Protrusion without treatment ends with a hernia, and even then the patient may at any time face life-threatening conditions, up to disability. The pulp of the disc that has fallen out of its limits begins to migrate along the spinal canal, and this threatens to damage the spinal cord.
More often, irritation of the nerve roots occurs, which causes problems with internal organs. In severe cases, surgical treatment is indispensable, while the initial protrusion is easily amenable to conservative methods of therapy.