In literal translation from Latin, protrusion means protrusion, protrusion. This term is used to designate one of the stages of dislocation( displacement) of the intervertebral disc with the subsequent formation of disc herniation. Although this statement from the anatomical point of view is not entirely correct. The protrusion is the same intervertebral hernia, only at the initial stage, when the inner part of the disc, gelatinous nucleus, does not yet go beyond the outer membrane, the fibrous ring. In the future, as the pathology progresses, the displaced core hangs outside the disk in the form of a droplet( extrusion), after which the envelope may burst, the liquid nucleus flows outward or in the form of fragments enters the lumen of the spinal canal( sequestration).
Protrusion can occur in any part of the spine. But the most clinically significant is the protrusion in the cervical region, since it is through the neck that the main vital communications pass( trachea, esophagus, cervical spinal cord, large arteries and veins).In addition, in the immediate vicinity is the brain, which can be involved in this pathological process. Therefore, adequate treatment of the protrusion of the cervical spine plays an important role in maintaining the health, ability to work, and sometimes the life of the patient.
Mixing of discs in any part of the spine, including in the cervical spine, is not an independent disease. Protrusion always develops as a complication of degenerative - dystrophic processes, one way or another leading to thinning of the cartilaginous tissue of the intervertebral discs. Most often in the role of such a process is osteochondrosis, which most often affects the lower back and neck. In addition, the disks can move due to congenital and acquired deformities of the spine( scoliosis).The hernia can develop due to osteoporosis( dilution) of the bone tissue of the vertebrae, as well as due to injuries and tumor processes.
Among the predisposing factors leading to the protrusion of disks in the cervical region, the following are distinguished:
- Defective food
- Weak immunity
- Aggravated heredity
- Excessive motor activity
- Frequent hypothermia
- Long stay in an uncomfortable position.
In terms of symptoms of protrusion of the cervical spine, the following anatomical and physiological features of this department should be considered:
- Absence of discs in the 1st and 2nd cervical vertebrae
- Relatively high height of the cervical vertebrae
- Anatomical heterogeneity of the structure of the cervical vertebrae
- Passing through the spinous processes of the cervicalvertebrae vertebral artery, which nourishes the blood of the brain
- Nasal complex movements with a large amplitude
- Necessity of constant nMaintain the head in the desired position
- Narrow spinal canal in the cervical section of
- Presence of lordosis( physiological bend anteriorly).
From all this it follows that even the minimum displacement by 1 mm.cervical intervertebral disc will entail certain clinical manifestations. These manifestations are represented by two groups( neurodystrophic and vegetovascular), which include:
- Neck pain, cervicago or cervicalgia
- Restriction of cervical movements, headache
- Sensation of dizziness, noise or ringing in the ears
- Sensitivity, loss of movement in theupper limbs and in the shoulder girdle against the background of cutaneous paresthesias( specific unpleasant sensations)
- Blood pressure fluctuations
- Sleep disorders
- Personality and behavior changes - cryingspine, irritability, fatigue.
Types of treatment - medicines and physiotherapy
Treatment of protrusion of the cervical department should be comprehensive and include:
- Physiotherapeutic procedures
- Manual therapy, acupuncture.
Drug medication for disc protrusions is unlikely to eliminate the causes of this pathology. The use of medications in this situation is symptomatic, and therefore is only an addition to the above methods. As a rule, analgesics( analgesics) and non-steroidal anti-inflammatory drugs( NSAIDs) are used as medications. These remedies eliminate pain and inflammation in the nerve roots and in the surrounding muscles. In various dosage forms( tablets, injections, ointments) use analgin, renalgan, diclofenac, orthophene. Some drugs( immunostimulants, complexes of vitamins and minerals) can be used for general strengthening of the body and enhance its protective forces.
Physiotherapy treatment of spinal disc protrusion is aimed at enhancing local circulation and metabolic processes in the affected tissue. Among the physical procedures, magnetotherapy, electrophoresis, phonophoresis, paraffin therapy, amplipulse and myostimulation are effective. As a rule, these procedures are appointed after withdrawal of an exacerbation. With severe pain with dizziness, decreased movement in the cervical region and in the upper limbs, they are contraindicated.
Massage and exercise therapy
Neck massage, as well as physical procedures, should not be performed during an exacerbation. When exacerbating, you can massage only the chest, shoulder girdle and upper limbs. After relieving the exacerbation, the massage therapist goes directly to the neck, which is massaged in a sitting or lying position on the side. Smooth movements from the back of the neck to the neck and back, the masseur strokes, pokolachivaet and kneads the neck muscles. Each element of massage is carried out for about 5 minutes.with increasing duration in the future. During the massage, the neck muscular skeleton is strengthened, and this contributes to the formation of the disc in its original position and to a decrease in protrusion.
To strengthen the muscles of the neck can be through health gymnastics. During the exercises with protrusion of the spinal discs, static loads are mainly performed by pressing the frontal or temporal areas of the head onto the palm supported with resistance. In addition, the maximum inclination to the sides, tipping the head back or bringing the chin to the chest. With increased pain, the appearance of nausea, dizziness, gymnastics should be discontinued. Too vigorous and sharp movements in the cervical region, the rotation of the head is unacceptable.
Therapeutic physical training is not only gymnastics, but also treatment by position. Such treatment can be conducted during the period of exacerbation. A typical example is the immobilization( immobilization) of the neck with the help of a special collar of Shantz. In the interstitial period, traction( extension) of the spine can be performed with the help of special devices.
During manual therapy, the displaced discs can be manually adjusted. However, in the case of the cervical department, this method is associated with considerable risk to health. Therefore, if there is even the slightest doubt in the qualification of the performer, this method, despite all its effectiveness, should be abandoned. But acupuncture can be done even for yourself. It is enough to lay for half an hour needle applicator Kuznetsova in the form of a roller under the neck, and the effect will be akin to massage and physical procedures.
If the above methods are ineffective, when the protrusion can become worse and go into extrusion, surgical intervention is indicated. At the present time, a qualitatively new method has been developed - laser disk valorisation. Its essence lies in the fact that under the action of a laser fed to the disk through the lightguide, the gelatinous nucleus is partially evaporated, decreases in size, and the disc becomes in its original position. Given the features of the cervical department, this method is used in exceptional cases, when there is a possibility of irreversible changes in the spinal cord, in the heart and in the vessels.
Treatment of cervical protrusions will bring the desired result only if it is appointed and controlled by experienced specialists. Before treating protrusions of the spinal discs, it is necessary to consult a neurologist, vertebrologist, physiotherapist, exercise therapy specialist. Self-medication and an attempt to save on medical services can do not only increase financial costs, but also a loss of health with subsequent disability.
- Causes of
- Symptoms of
- Types of treatment
- Massage and exercise therapy
We recommend that you read why the backbone in the cervical region hurts.