Protrusion of intervertebral discs ✔: symptoms, signs and causes, diagnosis and treatment

The cervical spine is the most mobile, which is why pathology such as cervical disc protrusion is a common phenomenon. It represents damage to the internal fibers of the fibrous ring (without its rupture), which is accompanied by bulging of the spinal disc into the spinal canal.

Protrusion of the discs of the cervical spine precedes the development of a hernia. If you seek professional medical help in time, you can stop the development of this process, and therefore prevent the appearance of a hernia.

You can undergo a course of treatment for cervical disc protrusion at the CELT multidisciplinary clinic. Our specialists will select an individual program that will take into account all the characteristics of the body and existing concomitant diseases. With the right approach, it will provide the desired results.

At CELT you can get advice from a neurologist.

Initial consultation – 4,000
Repeated consultation – 2,500

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Description of the disease

Intervertebral discs are elastic pads between the vertebrae that provide shock absorption and flexibility to the spinal column. They consist of a jelly-like core surrounded by a fibrous fibrous sheath. As osteochondrosis progresses, there is a gradual narrowing of the space between the vertebrae, as well as disruption of the nutrition of the discs. As a result, the outer shell becomes thinner and begins to bulge under the pressure of the core. A protrusion is formed, which, if left untreated, will turn into a hernia (if the fibrous ring ruptures).

The most common protrusions of discs located in the lumbosacral spine, since this area is subject to the greatest load when the body is in an upright position. In second place in terms of frequency of occurrence are protrusions of the cervical spine.

Why are dorsal protrusions dangerous?

As mentioned above, in the cervical vertebrae there are openings through which cerebral arteries pass, which take part in the blood supply to the brain.

The structure of the cervical vertebrae

Vessels and nerves of the neck

With the development of disc protrusion, this process is disrupted, and the functioning of brain structures deteriorates. If left untreated for a long time, patients may experience a crisis with a sharp increase in blood pressure and acute cerebrovascular accident, which often results in paralysis of the arms, legs and face. The consequences of disc protrusion in the area of the C3-C4 and C4-C5 discs can be serious dysfunction of the central nervous system - trigeminal neuralgia, visual and auditory disorders.

Trigeminal neuralgia

The most severe combination of protrusion of the C4-C5 and C6-C7 discs occurs - in women it can be accompanied by a characteristic growth of part of the C7 vertebra. Anatomically, it has fused processes, where the so-called “withers” or “widow’s hump” is often formed.

"Widow's Hump"

Representatives of the fair sex who are in the period of menopause and changes in hormone production suffer from this pathology. Finally, with serious circulatory disorders in the brain, patients with cervical disc protrusion may develop a heart attack or stroke.

Causes

The most common cause of protrusions is osteochondrosis. Without treatment, degenerative processes in cartilage tissue inevitably lead to damage to disc pathology. Predisposing factors are also:

spinal column injuries;
poor posture, scoliosis;
increased load on the spine: frequent lifting of heavy objects, excess body weight, pregnancy;
weakness of the back muscle corset due to congenital disorders or lack of physical activity;
regular vibration loads on the spinal column;
undergone surgery to remove an intervertebral disc (the load on neighboring areas increases);
sudden movements that go beyond what is usual for a person;
infections of the spine or surrounding tissues.

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What is protrusion of the lumbar spine?

As you know, there are 5-6 vertebrae in the lumbar region. Between their bodies there are fibrocartilaginous formations - intervertebral discs. They receive the necessary nutrients diffusely through the existing surfaces and blood vessels of the vertebrae. The main purpose of formations of a cartilaginous nature is to create an intervertebral layer that provides the necessary elasticity and mobility of the spinal column, and is also responsible for maintaining its stability and integrity.

Due to the aggressive influence of the external environment, age factors, physical inactivity and other negative aspects, the blood supply and nutrition of the disc can be significantly impaired. This is accompanied by the occurrence of degenerative changes and the subsequent development of osteochondrosis.

Ignoring the problem is fraught with the progression of structural and functional disorders, deformation of intervertebral discs and their sclerosis. Due to this, the process of nutrition of the nucleus pulposus is disrupted, which is accompanied by loss of moisture. This provokes the development of protrusion of the intervertebral discs of the lumbar region.

We are talking about a situation that is characterized by complete destruction of the disc, a significant change in its shape, thinning of the fibrous ring and its slight extension beyond the vertebrae. In turn, insufficient supply of nutrients and water is fraught with delamination and rupture of the collagen structures that make up the outer shell of the disc.

This contributes to a change in the position of the nucleus pulposus and its movement into the thinning zone, which is fraught with excessive load on the fibrous ring that has undergone deformation. Over time, it loses its ability to withstand increased pressure, and even more collagen structures rupture, which is accompanied by protrusion of the disc into the space inside the spinal column.

Kinds

Spinal disc protrusions are classified depending on the direction of the protrusion. The following options are available:

median: the protrusion area is located in the central part of the spinal canal; often accompanied by neurological disorders;
paramedian: a protrusion forms on the right or left relative to the spinal canal, often causing pinching of the nerve roots and severe pain;
foraminal: the formation is located in the natural openings between the vertebrae, where the nerve roots pass; even with a small defect volume they cause significant neurological impairment and pain;
diffuse: evenly distributed over the entire back side of the disc.

Symptoms

Most types of protrusions are asymptomatic for a long time. The first signs of pathology appear only when the formations begin to put pressure on the nerve roots.

The most noticeable manifestations are:

pain: intensity and duration depend on the size and location of the protrusion; there are both acute, strong, but short-lived attacks, and prolonged, aching pain;
radicular syndrome can manifest itself as a violation of sensitivity, motor function, functioning of internal organs, as well as a combination of various malfunctions depending on the type of protrusion.

Protrusion in the lumbar and sacral region

This is the most common localization of the pathological process. The epicenter of pain is located in the lumbar region, but the sensations often radiate to the buttock, leg or abdomen. When moving, the pain intensifies, and pronounced muscle spasm develops. Nerve root damage usually manifests itself:

nagging pain in the leg;
pathological sensations (paresthesias) - a burning sensation, numbness, crawling sensations in the legs or groin area;
decreased muscle strength and weakened reflexes on the affected side.

Protrusion in the cervical spine

The characteristic symptoms of this pathology are:

aching or sharp pain in the neck, which increases significantly with movements and attempts to turn the head; sensations can spread to the back of the head, shoulder, arm;
severe spasm of the neck muscles, which makes turning the head difficult;
tingling, burning in the hand on the affected side, weakening of muscle strength and reflexes;
headaches, dizziness.

Protrusion in the thoracic region

It is extremely rare due to the relatively low mobility of this area and the low load on it. Typically, protrusions form against the background of injuries and are accompanied by pain and discomfort when breathing, and a feeling of lack of air. If the protrusion is located in the lower part of the thoracic region, it can affect the functioning of the pelvic organs, intestines, and the menstrual cycle in women.

Exercises for cervical protrusion

Performing special exercises for cervical protrusion helps restore the shape and size of the vertebrae. You can do gymnastics for both treatment and prevention of the disease.

The greatest effect is obtained by performing the following exercises:

We sit on a chair and place our palm on our forehead. We press our forehead into our palm, straining our neck muscles.
We place our palm on the back of the head and press hard on it using the muscles of the neck.
We lower our chin to our neck and turn our head in different directions.
We tilt our head back and tilt it alternately to the left and right shoulder.
We clasp our heads on both sides with our hands so that our palms are on our temples. We lightly squeeze the head and at the same time strain the neck muscles.

Therapeutic exercises can be harmful if used without the advice of a doctor. Our clinic specialists create an individual training plan for each patient, which gives better results.

Diagnostics

A neurologist diagnoses protrusions of intervertebral discs. The set of mandatory examinations includes:

interview to identify chief complaints, history of symptoms, and identification of possible causes and risk factors;
neurological examination: assessment of sensitivity, muscle strength, symmetry and severity of reflexes;
visual diagnostics: x-ray, CT or MRI; the clearest result is obtained by MRI, which well visualizes not only bone structures, but also soft tissues of varying densities and allows you to clearly see the disc shape disorder;
Doppler ultrasound of the vessels of the neck and brain in case of damage to the cervical spine: allows you to identify blood supply disorders caused by muscle spasms;
examinations to exclude other pathologies with similar symptoms: general blood and urine tests;
blood chemistry;
ECG, daily ECG monitoring;
Ultrasound of the abdominal organs;
MRI of the brain;
chest x-ray;
consultations with a gynecologist, cardiologist, pulmonologist and other specialists depending on the manifestations of the disease.

The full list of examinations depends on the specific symptoms and their severity, chronic diseases and other characteristics of the patient’s body.

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Forms of protrusion and their symptoms

In a number of patients, protrusion of the thoracic region occurs without a single pronounced syndrome, gradually causing paraparesis (numbness) of the upper extremities. In this case, the violation affects both hands at once. the medial form of pathology occurs .

With the medial-lateral form, patients always experience severe pain that is not relieved even when taking powerful non-steroidal anti-inflammatory drugs. Discomfort extends to the entire back, can affect the groin area, neck and cause headaches.

The lateral type of protrusion is characterized by pain localized in one place, most often in the area of the affected intervertebral disc or close to it. With this disorder, the resulting discomfort can be confused with an attack of angina. But taking heart medications in this case will not have any effect.

Treatment of disc protrusion

Treatment of the cervical, thoracic or lumbar spine is aimed primarily at eliminating symptoms. Medications that come to the fore include the following groups of drugs:

analgesics and non-steroidal anti-inflammatory drugs (analgin, diclofenac, ibuprofen, etc.): aimed at relieving inflammation and pain relief; prescribed in the form of tablets, ointments, patches, suppositories or in injection form;
glucocorticosteroids (hydrocortisone, dexamethasone, etc.): used when milder agents are insufficiently effective; used orally, topically or by injection, including for blockades;
narcotic painkillers (tramadol, morphine): necessary for extremely severe pain that cannot be relieved by other drugs;
muscle relaxants (baclofen, mydocalm): relieve muscle spasms that occur due to compression of the roots;
anticonvulsants (pregabalin): help relieve radicular syndrome and muscle spasms;
chondroprotectors (chondroitin, rumalon): promote partial restoration of cartilage tissue in osteochondrosis;
B vitamins (milgamma): help improve the conduction of impulses along nerve fibers, necessary for radicular syndrome.

Non-drug treatment helps relieve pain more quickly and also prevents recurrent attacks of the disease. Depending on the clinical situation, the following are used:

regimen: during an exacerbation, it is recommended to minimize the load on the spinal column and wear a special support corset or collar;
physiotherapy: magnetotherapy, DDT, laser treatment, electrophoresis, phonophoresis;
spinal column stretching, underwater traction: helps relieve stress;
massage and manual therapy: relieve muscle spasms, help strengthen the muscle frame;
physical therapy: prescribed outside of exacerbation, helps reduce body weight and strengthen muscles;
spa treatment: prescribed during the period of remission.

Modern methods of surgical treatment make it possible to do without incisions and stitches. Interventions are carried out through small punctures and are aimed at complete or partial destruction of the nucleus. Depending on the situation, the following are used for this purpose: laser, radio frequency exposure, strong liquid pressure, etc.

Additional therapies

Physiotherapy

The main treatment for this disorder. Improves the condition of the muscle corset several times, stimulates the production of nutrients and increases the degree of their absorption. After therapeutic exercises, there is a decrease in pain, restoration of limb mobility, elimination of swelling and stopping further tissue destruction in the intervertebral space. The rules for performing and types of exercises for protrusion and other disorders of the thoracic spine can be found in the video.

Video - Exercises for the treatment of hernias and protrusions of the thoracic spine

Massage

It is better to carry out the procedures under the supervision of a specialist who can choose the optimal pace of massage and identify the most sore spots. Massage accelerates the blood, stimulates the absorption of nutrients, and eliminates numbness. Thanks to regular sessions, the severity of pain is completely eliminated or significantly reduced. Treatment involves at least 10 sessions with a doctor.

Acupuncture

This procedure refers to conventional acupuncture. Sessions are carried out under the direct supervision of a doctor, as it is important to place needles on certain points with nerve endings. After treatment, patients note a significant analgesic effect, stiffness and swelling in the affected area go away a little. For protrusions, 5-10 procedures are prescribed.

Acupuncture is one of the methods of treating thoracic protrusion

Shock wave therapy

When carrying out such treatment, the rehabilitator immediately sees the result obtained from the influence of the device and, if necessary, can change the strength and speed of propagation of the wave. When using the shock wave method, it is possible to suppress compression of the nerve roots, stop further destruction of the intervertebral disc, increase the strength of the muscle corset, and eliminate stoop. Additionally, recovery in case of injury is accelerated and bones are strengthened. The exact number of sessions is determined by the attending physician.

Laser therapy

It is used when it is necessary to normalize metabolic processes, increase the production of collagen and proteins in the tissues of the fibrous ring. At the same time, there is an analgesic effect and the inflammatory process is eliminated. Can only be used in combination therapy.

Magnetotherapy

Normalizes the functioning of not only the musculoskeletal system, but also all body systems. After sessions using magnets, blood and metabolic nutrition in the diseased area improves. Additionally, it has a healing, analgesic and anti-inflammatory effect.

Stages of destruction and deformation of the fibrous ring from normal to hernia

Attention! If there is a protrusion of the thoracic region, surgical intervention is not performed. Operations are prescribed only if the pathology passes into the hernia stage and only if seriously necessary.

Additionally, the method of treating thoracic protrusion can be found in the video.

Video - Disc protrusion: treatment, diagnosis and symptoms

Prevention

Compliance with preventive measures is important both for people who have already identified protrusions, and for those who do not want to allow them to appear. Rules include:

compliance with the work and rest regime, avoiding physical overload;
regular exercise (without striving for records), walks in the fresh air;
exclusion of sports associated with jumping, vibration, lifting weights (equestrianism, weightlifting, etc.);
correct posture when sitting and walking;
nutritious nutrition with sufficient amounts of vitamins and minerals, especially calcium and collagen;
normalization of body weight if it is excess;
sleep on a high-quality orthopedic mattress and comfortable pillow;
regular examinations by a doctor, elimination of chronic diseases.

Treatment at the Energy of Health clinic

Neurologists at the Energy of Health clinic will come to the rescue both at the first signs of protrusion and at an advanced form of the disease. We will conduct a comprehensive diagnosis to accurately determine the type and degree of pathology, and also prescribe adequate and effective treatment, including:

modern drug regimens for high-quality pain relief and elimination of radicular syndrome, including injections of long-acting agents;
drug blockades for quick pain relief;
physiotherapy, massage and manual therapy in the absence of contraindications;
physical therapy directly in the clinic, as well as drawing up a daily home workout plan;
organization of sanatorium-resort treatment during remission.

Advantages of the clinic

The Health Energy Clinic works so that every patient can receive qualified medical care in the shortest possible time at an affordable price. At your service:

experienced and skilled medical personnel who regularly improve their knowledge;
the opportunity to get advice from foreign experts (via the Internet);
modern diagnostic equipment;
all types of laboratory tests;
medicinal and surgical treatment methods, physiotherapy, massage, exercise therapy, chiropractor services;
individual approach to the selection of therapy;
organization of sanatorium-resort treatment;
procedures in a day hospital;
assistance in hospitalization in other hospitals in the city;
issuing the necessary certificates, conclusions and certificates of incapacity for work.

Disc protrusion seems like a minor problem compared to other diseases, but it can cause severe pain and unpleasant disorders. Do not bring the disease to its extreme stage, get diagnosed and treated at Health Energy.

How to treat effectively and inexpensively?

For successful therapy, it is necessary to combat the two main reasons described above - muscle spasm and tightening of the spine. Several processes underlie muscle relaxation:

Activation of proprioceptors (this is a signal to the brain about muscle transitions from a tense state to a relaxed state)
Creating ischemic compression (oxygen starvation, muscles do not receive nutrition and relax)
Stretching a muscle (in a tense state the muscles are contracted, in a relaxed state they are stretched).

Activation of proprioceptors is the most effective method. Since not all paravertebral muscles can be mechanically limited in nutrition or stretched. Ideally, therapy combines all three methods.

Therapy combining all three methods can be obtained either from a qualified specialist or using special devices. The specialist must not only straighten the vertebra, but also work the muscles. This cannot be done in one session - you need to be prepared for this.