The spinal column is the most important factor in maintaining the upright position of the body. The spine is the central support system of the body, the skeleton – the bony part is the basis, the joints allow movements, and the muscles realize them. The muscles maintain the vertical position of the spine, enable its movements and protect the spinal column.
Disc herniation
There are 140 muscles attached to the spinal column, which are exposed to a lot of work every day. If the muscle balance is not uniform in length and strength, their strain, during a sudden turn of the trunk, sudden bending, can cause tension, the consequence of which is a severe painful spasm, displacement of the facet joint or can even lead to disc herniation. The strength of the muscles that hold our body is very important and it affects our posture, our posture. Bad posture is one of the most important causes of back pain, especially lower back pain.
Between the spinal vertebrae are discus, elastic weight carriers that ensure movement in all directions. Discs are soft, stretchable, shock absorbing and reduce load. However, those pressures would still be great if the muscles that not only help the spine to move, but with their tension and tone reduce the load on the spine. Discs are located between the vertebral bodies, they cushion the movements of the spine, and we also call them water cushions because of the large percentage of water. They are protected by ligaments placed on the sides.
Without discs, the bony segments of our spine would not be able to withstand the effort necessary for its functioning. The disc consists of an inner soft part (nucleus pulposus) and an outer fibrous ring (annulus fibrosus). Discs age quickly, biochemical changes occur, first in the soft and then in the fibrous part of the ring. The discus loses its high water content, its mechanical properties change, it loses its elasticity. All this leads to changes, there is sequestration, splitting and changes in the nucleus, the fibrous ring becomes brittle, and through the weakened ring, a protrusion or protrusion of the disc can occur, which means that the nucleus of the disc is in the process of being pushed out of its bed, i.e. that it is a swelling of the ring that can press the surrounding structures. Disc prolapse can then occur, meaning that the core of the disc has deformed and broken through the annulus, slipping out of its socket. And the most severe degree of damage is extrusion, which means that the core of the disc has come out, and that a large part of its mass is in the spinal canal, where it fights for space with ligaments, nerves and blood vessels.
The disc ages early, the degenerative process affects several vertebrae at the same time. We cannot influence aging as a process, but we can influence factors that will not accelerate it. The early appearance of degenerative changes in our spine is influenced by bad posture, congenital or acquired anomalies, deformities of the spinal column and lower extremities that disturb the statics of the spine. Obesity, too, because the abdominal midsection of the trunk cushions about 30% of the load on the spine. Sitting for a long time, working with the head in a forced position, does not please our discussions, both in the thoracic and in the cervical part of the spine. Working for hours on the computer, poor night’s rest, lifting heavy loads, sitting for a long time in one position can be a big burden on our spine. And disc herniation as a spinal disease can occur at any level of the spine.
However, there are predilection places where we most often expect these changes. Disc herniation is most common in the lumbar spine at the level of segments L4/L5 and L5/S1, because these last two segments suffer the greatest static and dynamic pressure, and in the cervical spine C5/C6 and C6/C7, on the spine where the cervical it moves to the thoracic part of the spine, where it is the most dynamically loaded. Disc herniation in the thoracic spine is rare.
Spinal discs require a constant supply of fresh oxygen and nutrients by diffusion to stay healthy. They get it if there is normal movement and muscle strength in the spine. When moving, the disk “draws in” liquid full of oxygen and nutrients, and expels harmful substances. This process of fluid diffusion (suction) is largely determined by the internal pressure of the disk. This diffusion mechanism works well as long as the discs are not damaged and the spinal mobility is normal. But when the disc is damaged, its ability to maintain hydration disappears, it becomes dry, brittle and degenerates, leading to chronic pain syndrome.
Lumbar spine
Diseases of the lumbosacral part of the spine are numerous and generally begin as pain in the lower back that can spread to the leg (lumbar syndrome, lumboischialgia, sciatica). In advanced disease, and sometimes from the very beginning, signs of damage to the beginning of the nerves for the legs (nerve roots-radiculopathy) may appear. Radiculopathy is manifested by weakness and numbness of the legs. If numbness occurs, it is most often localized on the foot. (The patient has tingling on the inside or outside of the foot.) He also has difficulty walking on the toes or heels of one or both feet.
Neurological deficits can be in the form of radiculopathy (damage to the nerve roots for the arms due to pressure on them) or cauda equina syndrome (damage to most of the nerve roots for the legs and pelvis). Lumbar radiculopathy is most often manifested by: pain that spreads from the lower back, down the back of the leg, to the foot; numbness and tingling, most often in the foot; weakness of one or more groups of muscles on one or both legs, accompanied by muscle atrophy (the lower leg muscles are most often affected and the movement of the foot is weaker). Cauda equina syndrome is most often manifested by weakness of the legs, involuntary swelling of urine and stool, or retention. This is a difficult and very urgent situation. If any of these symptoms occur, the patient will be referred to a specialist neurologist who will perform a detailed neurological examination and then prescribe additional tests. The most common additional tests are: x-ray of the spine in various projections; electroneuromyography (EMNG), which determines the state of nerves and muscles; somatosensitive evoked potentials (SSEP), which determines the state of the spinal cord and nerves; magnetic resonance imaging (MR) of the diseased part of the spine.
If chronic pain lasts a long time, it can become a disease in itself. In those cases, even when the cause of the pain is cured, the pain remains. This is interpreted as various permanent changes in the nervous system (tissues around the spinal column, nerve roots, even in the brain). These changes are caused by the primary cause, but also by long-term suffering of pain. Therefore, it is important to prevent the pain from continuing continuously for more than 3-6 months.
Cervical spine
Diseases of the cervical part of the spine are numerous and generally begin with various painful syndromes. The most common pain is in the neck with or without spreading to the head, shoulder and arm (cervical syndrome – syndroma cervicale, sy cervicocephalicum, sy cervicobrachiale). In advanced disease, and sometimes from the very beginning, signs of damage to the spinal cord and/or nerve roots (myelopathy and radiculopathy) may appear. They are manifested by weakness, numbness and clumsiness of the arms and legs. Often there is also a feeling of dizziness and instability, especially during some movements in the neck.
Neurological deficits can be in the form of radiculopathy (damage to the roots of the nerves to the hands due to pressure on them) or myelopathy (damage to the cervical part of the spinal cord). Cervical radiculopathy is most often manifested by: pain that spreads to the shoulder and arm, numbness and tingling, most often in the fingers, weakness of one or more muscle groups on one or both arms, accompanied by muscle atrophy. Myelopathy manifests itself mostly in the legs in the form of weakness, clumsiness and numbness.
Do you have a herniated disc, multiple disc herniations, degenerative disc changes, facet syndrome, or any other spine problem? Have you had treatment with classical methods of physical therapy so far and you do not feel any improvement? You may be a candidate for spinal non-operative spinal decompression. Spinal decompression is an effective treatment for releasing nerves from mechanical compression (spinal nerve root compression) – bulging, prolapse or herniation of discs, degenerative disc diseases, posterior facet syndrome, reduced mobility, degenerative joint diseases.
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