the main > Drilling types > Spine problems. Psychological roots of problems with the spine Lesions of the thoracic spine

Spine problems. Psychological roots of problems with the spine Lesions of the thoracic spine

The vertebral column runs down the middle of the back and contains the spinal cord, which, like a superhighway of nerves, connects the brain to all tissues of the body. Needless to say, spinal health is of utmost importance. On the lateral, or lateral, side, the spine has three bends that are necessary for flexibility and stability. However, if viewed from the back, the spine should be straight and not deviate strongly from side to side. Some people are born with abnormally curved spines, but poor health, poor posture, and poor diet are more common causes of spinal abnormalities.

Steps

Part 1

How to take care of your spine health

Maintain good posture. Probably the most important thing you can do for spine health is to maintain good posture while you are sitting, walking or sleeping. Since most people have sedentary work, which means they do not move most of the day, height, comfort and good support of chairs are critical for them. It is advisable to have an adjustable office chair (so that it can be adjusted to your size) with lumbar support for the lower spine. At home, use pillows to support your back and to raise your legs while watching TV.

Avoid crossing your legs or feet when you are sitting because this bends your hips and puts stress on your lower back.
Make sure the computer screen is at eye level and in the center of the front of the chair, otherwise you will strain your neck, which can lead to curvature.

Wear quality shoes. The legs are crucial for good posture because they are the foundation for the whole body. Therefore, wear stable shoes with a good instep support, a slightly raised heel (1.5 - 1.9 cm), and enough room for your toes. At the same time, try not to constantly wear shoes on high heels because they affect the body's center of gravity and cause compensatory body alignment - they can cause excessive curvature (hyperlordosis) in the lumbar spine.
- If you are overweight, have flat feet, or have one leg shorter than the other, then you should consider purchasing orthopedic insoles (custom-made shoe inserts). Orthopedic insoles improve spine health by supporting the arch of the foot and improving biomechanics when running or walking.
- Orthopedic insoles are made on the recommendation of an orthopedist, specialist doctors and some chiropractors.
Sleep on a hard mattress. You will most likely spend at least 1/3 of your life in bed, so pay more attention to the quality of the mattress and how you sleep on it. For most people, a firm mattress is the best way to provide the spine with the support it needs. A memory foam mattress cover may also be helpful. Mattresses need to be changed every 8-10 years. The thickness of the pillow should match the distance from the side of your head to the tip of your shoulder - this is very helpful in aligning your neck while you sleep.

Avoid carrying heavy backpacks or bags. Even if you only carry a heavy backpack from class to class or home from school, it can seriously affect the health of your spine, as the heavy weight compresses the vertebrae. This can cause a curvature of the spine and prevent you from reaching your full height. Even worse, if you only carry your backpack or bag on one shoulder, and from this, your spine can begin to curve.
- When carrying a bag or backpack, make sure the weight is evenly distributed over your shoulders. If you are carrying a very heavy suitcase or briefcase, remember to change sides.
- Consider buying a rolling briefcase.
Exercise and be more active. Moderate exercise has many health benefits, including weight loss and increased muscle strength, which can also have positive effects on the spine. Carrying weights creates excessive pressure on the joints of the back, making them more susceptible to abrasion and curvature. In addition, strong muscles keep bones and joints in a normal position. Strength training is in a great way develop muscles, but be careful not to overload only certain muscle groups, while ignoring other muscles, as this can lead to poor posture. Get the help of a personal trainer if you are unsure of how to exercise properly.
- Every morning after waking up, lie on your back and slowly do the "snow angels", moving your arms and legs for 3-5 minutes. These movements are great for warm-up and gentle stretching of many muscles that are important for maintaining correct spine position.
- Working out in the gym with a rowing machine can strengthen the muscles between your shoulder blades and improve your upper body posture.
- Pilates and yoga is another type of exercise that stretches and balances the body, especially the major muscles (abdomen, pelvis, lower back), which are the basis for good posture.
Get the nutrients you need. For bones to be strong, smooth and healthy, certain nutrients are needed. Minerals such as calcium, magnesium and boron form the mineral matrix of the bone, and a deficiency can cause bones to become too fragile and prone to fracture (called osteoporosis). Vitamin D is also essential for bone health, and lack of it causes bones to become too soft and easily deformed (called rickets in children or osteomalacia in adults).

Part 2
Assessment of the condition of the spine
1. Check for scoliosis. Scoliosis is a lateral curvature of the spine, most often in the thoracic region (the area between the shoulder blades), which can cause back pain and limited movement. For reasons unknown, some people are born with scoliosis, while others develop it during adolescence. Scoliosis is usually diagnosed by nurses at school examinations, but most healthcare providers will also be able to tell you whether you have scoliosis. On examination, it is usually necessary to bend forward to hip level to determine if one shoulder blade is protruding more than the other.
  
  See a specialist doctor. If, as a result of the examination, you have scoliosis or there is reason to believe that your spine is not normal, then visit a specialist doctor. An orthopedic surgeon will take a close look at your spine and will likely refer you for an x-ray to help you better understand the situation. The specialist will look for fairly common pathologies of the spine, such as osteoarthritis, osteoporosis and herniated discs - all of which can lead to abnormal curvature of the spine and impairment of biomechanics.
  - Doctors may also order CT scans, MRI scans, bone scans, or more advanced x-ray studies to examine your spine in more detail.
  - Surgery is rarely used to repair and treat diseases or abnormalities of the spine.
2. See a chiropractor or osteopath. Chiropractors and osteopaths who specialize in spinal problems use more natural treatments for the spine and other parts of the body, rather than drugs or invasive methods such as surgery. They may examine your spine for any abnormalities, including unusual curvature, restricted movement, or tight muscles.
  
  Know about the structure of your pelvis. Your pelvis is made up of two bones that are connected by ligaments. If one of these bones is smaller than the other, it may cause you to lean towards the smaller bone when standing or sitting. This can lead to a crooked spine and other health problems. If you begin to notice that you often sit tilted to one side, ask your doctor about the pelvic bones.
Part 3
Therapeutic procedures
1. Make an appointment with a massage therapist. Massage your back, shoulders and / or neck with a suitably qualified therapist. If you have tense muscles surrounding or adjacent to the spine and supporting it, then massage will reduce this tension, which will help align the spine. The massage also effectively relieves tension that contributes to the development of poor posture, especially in the upper body.
  - Massage helps to get rid of lactic acid, toxins and compounds that cause inflammation in muscles and other soft tissues. They enter the bloodstream, so be sure to drink plenty of water to flush them out of your body.
  - Some massage therapists practice reflexology - stimulating areas of the foot to improve health. Ask a therapist to stimulate points related to spinal health.
2. See physical therapy. A physical therapist can show you how to do specific exercises to strengthen your muscles and stretch your spine. Also, if required, he will perform electrotherapy for the muscles of the back, such as therapeutic ultrasound or electronic muscle stimulation. Exercises for the extensors of the back, flexors of the neck, and the pelvic muscles are crucial for correct posture.
  - In some cases, progressive weight gain training can help stop or reverse bone loss to improve spine health and alignment.
  - If your muscles ache after a workout or massage, take an Epsom salts bath. The magnesium in salt is great for relaxing tense muscles and relieving pain.
3. Get a prescription for medicines. If you have osteoporosis or low bone density in your spine and fear fractures or deformities, ask your doctor for a prescription for bone-strengthening medications, such as the many bisphosphonates available on the market (Boniva, Reclast, Fosamax). TO hormonal drugs that increase bone density include raloxifene, calcitonin, and parathyroid hormone.

Treatment for pain in the spine. Answers to the most popular questions

What treatment may be needed for back pain? Which doctors should I see?
How to treat back pain caused by a spinal injury? When is surgical treatment necessary?
Pain appeared after spinal surgery. What to do?
What are the basic principles of conservative treatment of back pain in spinal lesions? Will exercise help with back pain?

The site provides background information for information only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. A specialist consultation is required!

Back pain in the spine: epidemiological significance
symptom

People often complain about backache in area spine... Statistics say that about 70-80% of people experience at least one episode of such pain during their life. Therefore, this is an unusually topical problem in medicine.

Therefore, medical statistics have collected a large amount of epidemiological data on this. symptom... It is known that 40-80% of people experience back pain in the lower spine. The percentage of patients seeking help for pain in the thoracic and cervical regions is slightly lower.

In 10-20% of patients of working age, acute back pain transforms into chronic. It is this category of patients that often has an unfavorable prognosis relative to complete recovery, so that health care costs for the treatment of people of working age with chronic back pain in the spine are about 80% of all funds aimed at treating this symptom.

The reasons

The most common so-called nonspecific back pain associated with muscle strain caused by uncomfortable posture or stereotypical movements. Often the impetus for the occurrence of such pain is hypothermia. Typically, nonspecific back pain goes away within 1-3 months after onset. However, in 10-30% of cases, the pain syndrome recurs throughout the year, and in 10% of patients, nonspecific back pain becomes chronic.

The second most common cause of back pain in the spine is radiculopathy - a lesion of the nerve root at the site of its exit from the spinal canal. The syndrome of radiculopathy accompanies many lesions of the spine, the most common of which is osteochondrosis.

Less commonly, back pain in the spine is caused by a direct lesion of the spinal column.

The most common spinal pathologies that cause back pain are:

osteochondrosis;
injuries (bruises, fractures, dislocations or subluxations of the vertebrae, ligament ruptures, etc.);
hormonal spondylopathy (climacteric, postmenopausal and senile);
tuberculous spondylitis;
ankylosing spondylitis (ankylosing spondylitis-Strumpel-Pierre Marie disease)

Finally, back pain in the spine may indicate damage to many internal organs. In such cases, the pain syndrome radiates along the nerve fibers, while the radiating pain can be stronger than the primary one, and even mask it.

Irradiation of back pain to the spine is most common in the following pathologies:

lesions of the heart and great vessels (angina pectoris, myocardial infarction, dissecting aortic aneurysm);
lung diseases (pleurisy, malignant neoplasms);
liver disease (acute and chronic cholecystitis);
lesions of the esophagus;
diseases of the pancreas (acute and chronic pancreatitis, pancreatic cancer);
diseases of the kidneys and upper urinary tract.

Thus, back pain in the spine can indicate diseases of various organs and systems, so even experienced doctors who have all the achievements of modern medicine in their arsenal sometimes find it difficult to make a diagnosis.

In order to resolve the issue of the cause of back pain in the spine, one should, first of all, know the main syndromes accompanying lesions of the spinal column.

Causes of back and spine pain - video

Back pain with a lesion of the spine. Major vascular syndromes
and neurological disorders

The vertebral column and its departments: structure and function

To understand the mechanism of development of vascular and neurological disorders in spinal lesions, it is necessary to know its basic anatomical and physiological features.

The spinal column is an elastic connection of the vertebrae that provides several vital functions at once:

the main axis that gives the body stability and mobility;
a spring that guarantees shock absorption for all tissues and organs during movement;
the receptacle of the spinal cord and the conductor of nerve fibers from the center to the periphery;
protection for a part of the vessels supplying the brain.

The spine consists of five sections, each of which has its own functional characteristics:
1. Cervical.
2. Chest.
3. Lumbar.
4. Sacral.
5. Coccygeal.

The structure of the upper spine is more fragile and thinner. The function of the conduction of nerves and blood vessels prevails here over the function of support and shock absorption.

Downward, the vertebrae are becoming more and more massive. So the five sacral vertebrae form a single bone - the sacrum.

The main functions of the sacral region are to provide support and participate in the creation of the pelvis - a protective container for internal organs. The tailbone, consisting of five accrete vertebrae, is a tail rudiment, and its participation in the work of the spinal column is minimal.

Therefore, lesions of the sacral and coccygeal spine cause pain in the lower spine in the sacral spine, but are not accompanied by severe vascular and neurological disorders characteristic of the pathology of the upper spine.

The cervical, thoracic and lumbar regions are composed of individual vertebrae - seven, twelve and five, respectively. The structure of all vertebrae, except for the first and second cervical, is the same - they distinguish between the body located in front and the arch of the vertebra that limits the spinal canal from behind.

The vertebral bodies are interconnected by intervertebral discs, which give the spinal column strength and elasticity at the same time. The fact is that each intervertebral disc has a nucleus pulposus inside, capable of elastic compression. Therefore, the spine is often compared to a spring.

The joints formed by the paired articular surfaces of adjacent vertebrae give additional mobility to the spinal column.

The whole structure is reinforced with a powerful ligamentous apparatus. In addition, the back muscles play an important protective and supportive role, serving as a kind of corset for the spine. Therefore, people who suffer from back pain due to a lesion of the spine are advised to do exercises that develop the muscles of the back.

The mechanism of development of vascular and neurological disorders in spinal lesions

Pain in spinal injury is often accompanied by neurological disorders associated either with damage to the roots of the nerves leaving the spinal canal at the level of damage, or with damage to the spinal cord, or circulatory disorders in the spinal cord caused by vascular infringement in the affected area.

The nerve roots run in the holes between the vertebral bodies, and supply certain parts of the body - the segments. Therefore, by the localization of neurological disorders, it is possible to determine the level of spinal lesion.

Regardless of the level of damage to the spinal column (cervical, thoracic or lumbar), damage to the nerve roots is characterized by the following features of the pain syndrome:

shooting character;
spread along the innervation along the segment;
increased by coughing, sneezing, sudden movements in the affected spine;
night pains.

In addition to pain, radicular syndrome is characterized by symptoms of a violation of the basic functions of the radicular nerves in the corresponding zones:
1. Sensory disturbances (creeping sensation, decreased sensitivity up to complete anesthesia).
2. Movement disorders (muscle weakness, paralysis).
3. Trophic disorders (tissue hypotrophy and atrophy, the development of degenerative changes in the joints, etc.).

Spinal cord injury is manifested by the development of paralysis and impaired sensitivity below the level of the lesion. Such disorders are most typical for lesions of the cervical and thoracic spine. At the level of the first lumbar vertebra, the spinal cord passes into a terminal thread, accompanied by a bundle of nerve fibers (the so-called cauda equina).

The blood vessels supplying the brain and accompanying the spinal roots also pass through the spinal canal, therefore, in case of damage to the upper spine, violations of the blood supply to the tissues can be expressed.

Lesion of the spine in the cervical spine

Increased lability and relative vulnerability of the cervical spine causes a high frequency of injury (whiplash fractures of motorists, diver's injury, etc.). Often, the consequences of a seemingly insignificant spinal injury remind of themselves with headaches all their lives.

However, the most common cause of pain in the cervical spine is osteochondrosis and other degenerative changes in the spine. Less common are tumors and congenital anomalies of the structure of the spinal column.

Pain in the cervical spine caused by a lesion of the spinal column may be accompanied by:
1. Compression of the spinal cord with total paralysis of the limbs, and impaired sensation below the level of the lesion;
2. Circulatory disorders of the brain;
3. Radicular syndrome.

Severe damage to the spinal cord at the level of the cervical vertebrae, as a rule, occurs with injuries of the spine, and leads to paralysis of the diaphragm and disruption of vital internal organs, which often leads to death.

The development of cerebrovascular insufficiency is characteristic of chronic degenerative lesions of the spine. The causes of circulatory disorders in such cases are evidenced by the connection between headache and other symptoms with movements in the cervical spine, or prolonged static load (uncomfortable head posture, including during sleep).

The following symptoms are most typical:

headache;
visual disturbances (flickering flashes, etc.);
cochleovestibular pathology (tinnitus, slight persistent hearing loss, rotational dizziness);
laryngeal-pharyngeal symptoms (impaired swallowing, choking, cough, sometimes taste perversion);
changes in the mental sphere (sleep disturbances, tearfulness, irritability, sometimes hysteria).

Pain caused by radicular syndrome in the cervical spine, as a rule, radiates from the cervical spine through the shoulder girdle, and further along the outer surface of the shoulder.

The most common injury is the lower cervical spine. In this case, the irradiation of pain reaches the fingers. The pain is accompanied by sensory disturbances in the same segment, and paresthesias in the most distant places of pain irradiation. The weakness of the innervated muscles (biceps or triceps) is expressed, and their hypotrophy develops over time.

Lesion of the thoracic spine

Pain with lesions of the thoracic spine is extremely rarely accompanied by radicular syndrome. The fact is that the physiological corset of the ribs prevents the displacement of the vertebrae.

However, quite often with some diseases of the spine, for example, with ankylosing spondylitis, there is a pain syndrome in the chest area, which is strongly reminiscent of the radicular in nature.

In such cases, pain is associated with damage to the small joints of the spine that connect individual vertebrae to the ribs (costo-vertebral and costo-transverse joints). In this case, there is a sharp soreness in the region of the costal-vertebral joints (at a distance of half a finger from the spinous processes of the spine). An additional symptom is soreness when pressing on the ribs in the affected segments.

Spinal cord compression due to thoracic spine abnormalities is also rare. The defeat of the spinal cord in the area of the thoracic vertebrae is manifested by paralysis of the lower extremities, impaired sensitivity below the area of damage, delayed discharge of feces and urine, as well as trophic disorders in the lower half of the trunk and lower extremities.

The most common compression lesion of the spinal cord in the thoracic region develops in severe spinal injuries (including gunshot), and oncological pathology. With traumatic injury, the compression syndrome develops sharply, with spinal tumors - gradually.

Both acute and chronic disorders of cerebrospinal circulation caused by pathology of the thoracic spine can occur.

However, regardless of the cause, the development of symptoms of severe spinal cord injury in the thoracic spine is an alarming symptom that requires medical intervention.

Pain in the lumbar spine. Lumbar syndromes

Pain in the lower part of the spine with lesions of the lumbar spine with the development of radicular and compression syndromes, as well as a syndrome of vascular insufficiency of the spinal cord.
As a consequence heavy load and lack of rib protection, the lumbar region is most often affected. This is a favorite place for the appearance of herniated discs of the spine and displacement of individual vertebrae.

Radicular syndrome is the main and most striking sign of damage to the lumbar spine. Lesions of the last lumbar vertebrae are typical.

As a rule, a vivid picture of compression of the nerve roots in the lumbar spine develops after periods of "lumbago", and is characterized by severe pain in the affected vertebra with irradiation to the buttock, down the outer edge of the thigh to the antero-outer surface of the leg, and then to the foot to the toes. In this case, the localization of radiating pain in the toes (mainly in the first or fifth toe) is of diagnostic value for determining the level of the lesion.

Compression of the cauda equina is manifested by severe pain spreading to both legs, violation of the acts of defecation and urination, loss of sensitivity in the anogenital zone and on the inner thighs like "rider pants".

Circulatory disorders of the spinal cord with lesions of the lumbar spine are quite common, and in typical cases are manifested by pain in the leg and lower back, as well as weakness of the foot.

Sharp pain in the lower spine with characteristic irradiation in reflex lumbar syndromes.
With lesions of the lumbar spine, radicular syndrome is very common, but reflex pain is even more common. In this case, a sharp pain that occurs acutely is called lumbago, chronically occurring - lumbodynia.

In both cases, sharp pain in the lower spine with characteristic irradiation to the lower extremities occurs reflexively, due to irritation of the receptors of the annulus fibrosus of the affected disc, joints and ligaments of the spine.

A typical attack of lumbago occurs in a tilted position of the body, most often during heavy lifting. Acute pain in the lower spine is usually shooting in nature ("lumbago"); it is very strong, bursting. Patients say: "as if a knife was stuck in the lower back." So the patient cannot straighten out, and any attempt to move, coughing or sneezing increases the pain many times over, forcing the patient to freeze in one place.

With lumbago, natural immobilization of the affected segment occurs, which is manifested by smoothing of the lumbar lordosis (natural anterior bending of the spine), and often by scoliosis (curvature of the spine).

Lumbodynia occurs, as a rule, after awkward movement, physical strain or hypothermia. However, unlike lumbago, it develops over several hours or days. The pain is not so sharp, it can increase in a standing or sitting position, especially with a change in body position.

Deformation of the lumbar spine in this case is less pronounced. with intensive palpation of the spinous vertebrae, it is possible to reveal a particular soreness in the area of the affected segment.

Spine pain with osteochondrosis

Osteochondrosis is the most common cause of back pain caused by damage to the spinal column. About 95% of patients presenting with pain in the neck or lower back suffer from osteochondrosis.

The causes and mechanism of the development of this pathology are still not fully understood. Some researchers consider osteochondrosis to be a natural result of the aging of the body, which occurs ahead of time in the presence of certain genetic defects (hereditary predisposition). Hypodynamia or, conversely, hard physical labor associated with frequent bending and lifting weights contribute to the development of osteochondrosis.

To understand the essence of pain in osteochondrosis, it is necessary to know the mechanism of the development of pathology. At the first preclinical stage of the disease, degenerative processes occur in the intervertebral disc, leading to a displacement of the nucleus pulposus. As a result, the stability of the spinal segment is impaired.

At the second stage, the instability of the spinal segment is compensated by reactive changes in the bodies of neighboring vertebrae, as well as in their joints and ligaments. At this stage, radicular symptoms appear, and sometimes signs of impaired blood supply, or compression of the spinal cord.

At the next, third stage, the intervertebral disc ruptures, often with the formation of a hernia of the spine. And finally, the fourth stage is characterized by the exit of the pathological process beyond the limits of the intervertebral disc.

Dyscalgia is most typical for osteochondrosis - acute pain in the spine caused by degenerative changes in the intervertebral disc. Dyscalgia is characterized by the spread along the nerves of the affected segment, and the addition of radicular symptoms (motor, sensory and trophic disorders).

It should be noted that the symptoms of osteochondrosis are polymorphic. Radicular pain is often accompanied by pain syndrome caused by overstrain of the muscles that support the spinal column. Constant hypertonicity of muscles, in turn, leads to clamping of nerves and blood vessels by overstrained muscles, and the occurrence of corresponding symptoms.

So, with osteochondrosis of the cervical spine, a syndrome of the scalene muscle occurs, which is manifested by characteristic symptoms of compression of the subclavian artery and brachial plexus (swelling and pain in the hand, aggravated in a horizontal position, decreased sensitivity and movement disorders in the zone of innervation of the ulnar nerve). By the same mechanism, the piriformis syndrome occurs, which manifests itself as symptoms of damage to the sciatic nerve clamped by the muscle (pain and trophic disorders in the lower leg and foot).

A very common symptom in osteochondrosis of the spine is visceral pain. Dull aching pains in the heart that occur with osteochondrosis of the cervical spine are especially characteristic. Another typical sign of damage to this part of the spine is headaches and other signs of impaired blood circulation in the brain.

Salient feature visceral pain, regardless of their localization - the occurrence or increase during movement, or prolonged static load on the affected spine.

All the pain syndromes described above will help to correctly diagnose and determine the localization of the affected segment.

Spinal hernia

A herniated disc, as a rule, is a consequence of osteochondrosis. The impetus for the onset of pathology is any awkward movement or excessive physical effort. The most characteristic anamnesis: acute pain in the spine, which arose after lifting a weight. Statistics show that most often a hernia of the spine occurs during the vacation period, during travels associated with heavy lifting. That is why some researchers call the hernia of the spine "suitcase disease".

Pain with a hernia of the spine increases with movement, coughing, sneezing. In the case of damage to the lumbar spine, pain often occurs when straining during bowel movements. The pain syndrome is often one-sided, so that in the case of a typical hernia of the lumbar spine, it is necessary to carry out differential diagnosis with kidney damage.

Most often, spinal hernias occur in the lumbar spine, less often in the cervical, and extremely rarely in the thoracic. Among the complications of spinal hernias is the development of spinal cord compression syndrome with the development of paralysis and sensory disturbances below the lesion site. Often there are circulatory disorders of the spinal cord caused by constriction of blood vessels.

Spine fracture

The nature of the pain in a fracture of the spine depends on its type. So, with isolated fractures of the spinous processes of the spine, localized soreness occurs in the fracture zone, and for fractures of the transverse processes, pain is characteristic that radiates to the sides along the ribs.

With fractures of the vertebral bodies, the pain syndrome depends on the degree of stability of the fracture. For example, sometimes stable fractures of the vertebral bodies are almost asymptomatic and grow together on their own. In severe cases, against the background of severe pain syndrome, signs of spinal cord compression develop, requiring immediate surgical intervention.

Aching and pulling pain in the spine with spondyloarthrosis

Spondyloarthrosis is a disease of the small joints of the spine, which belongs to the group of arthritic diathesis. It is often combined with other hereditary disorders - atherosclerosis, obesity, diabetes mellitus.

The pain in the spine with spondyloarthrosis is vague in nature, increases after periods of prolonged immobility (in the morning, after severe illnesses with bed rest, etc.), with trauma, hypothermia, after an infectious disease.

With a prolonged course of the disease, reactive growth of bone tissue occurs, leading to a narrowing of the holes through which the spinal nerves pass. In such cases, radicular syndrome develops.

Severe pain in the spine after sleep with ankylosing
spondyloarthritis (ankylosing spondylitis-Strumpel-Pierre Marie)

The pain in the spine with ankylosing spondyloarthritis is in many ways similar to the pain syndrome in spondyloarthrosis, especially with regard to morning pain. However, the pain in ankylosing spondylitis is more intense, the disease from the very beginning of development disrupts the performance of patients, and quickly leads to immobility of the affected areas of the spine. As a result, there is a characteristic curvature of the spine ("supplicant pose").

Ankylosing spondylitis refers to systemic diseases of the connective tissue, with a predominant lesion of the small joints of the spine, therefore, other signs of this group of diseases (increased ESR, low-grade fever, increased fatigue, weight loss, general weakness) will help in the diagnosis.

Hormonal spondylopathy (climacteric, postmenopausal and senile)

Pain in the spine with hormonal spondylopathies is caused by degenerative changes in the intervertebral discs, and the leaching of calcium from the bones. Spontaneous fractures of the spine are not uncommon.

Pain syndrome resembles pain in the spine with osteochondrosis. But hormonal spondylopathies are characterized by impaired posture, an increase in thoracic kyphosis (in some cases, the costal arch can descend to the pelvic bones), pain in the bones of the extremities.

Aching, pulling or boring pains in the spine with tuberculous
spondylitis

Most often, the tuberculous process affects the thoracic spine, less often the lumbar localization of the process is observed, and tuberculosis of the cervical spine is extremely rare. The disease can develop at any age, most often in the second or third decade of life.

The initial stages of tuberculous spondylitis are asymptomatic, so that pain appears even with an advanced process.

Characterized by pain in the spine, aching or boring in nature, often radiating to the extremities, aggravated by coughing, sneezing, flexion-extension movements of the trunk. The pain syndrome is accompanied by sensations of tingling, creeping, fever, pulsation. At the same time, the pains are constant, sometimes they can be weakened by walking.

Pain radiating to the spine

As damage to the spine often leads to visceral pain, so damage to internal organs often causes pain that radiates to the spine. Diagnostic assistance will be provided by additional symptoms characteristic of the defeat of certain organs.

Pain in the chest and in the spine with pathology of the heart and great vessels. Sharp pain
descending along the spine with dissecting aortic aneurysm

Wide irradiation of pain is characteristic of coronary heart disease. Pain in the chest and spine is especially severe in acute myocardial infarction. In this case, the pain is localized behind the sternum, and radiates under the left scapula and into the spine, as well as up along the vessels, into the left supraclavicular region, into the jaw, and down into the left hand, up to the little finger.

Severe night gnawing pains in the spine are specific for pancreatic body and tail cancers. However, pain syndrome appears in the late stages of the disease, when the so-called minor signs of cancer are expressed (weight loss, general weakening of the body, etc.).

Severe pain in the spine and lower back with pathology of the kidneys and upper sections
urinary tract

With unilateral radicular syndrome in the lumbar spine, it is necessary to carry out differential diagnosis with damage to the kidneys and upper urinary tract in urolithiasis.

The fact is that pain syndrome in typical renal colic is also characterized by the sudden onset of severe pain in the spine and lower back.

However, there are times of signs to distinguish these diseases.

Firstly, exacerbation of pain in the lower back and in the spine with urolithiasis cannot be associated with a sharp change in body position, weight lifting, and other typical factors that provoke an attack of sciatica.

Secondly, pain in urolithiasis radiates along the ureters to the abdomen, groin, genitals and inner thighs. For the defeat of the lumbar spine, irradiation is characteristic downward and backward - to the buttocks, the outer surface of the thigh, up to the lower leg and foot.

Thirdly, with renal colic, patients rush about the room or in bed, while patients with lesions of the lumbar spine, on the contrary, freeze in place, since any movement causes excruciating pain.

Treatment for pain in the spine. Answers to the most popular questions

What treatment may be needed for back pain? Which doctors should you go to
to apply?

In order to properly prescribe treatment for pain in the spine, it is necessary to undergo a complete examination and establish the cause of the pain syndrome.

Back pain in the area of the spine can be the result of diseases of the internal organs, in such cases, contact the appropriate specialists.

If the pain is caused by a lesion of the spine, then treatment is prescribed in accordance with the disease and the stage of the pathological process.

The problem of pathologies of the spine has recently become so popular that a special branch of medicine has arisen - vertebrology. So in difficult cases they turn to a narrow specialist.

If this is not possible, then, most likely, you will need the help of two specialists - an orthopedist and a neurologist.

In cases where the lesion of the spine is caused by tuberculosis (tuberculous spondylitis), the treating doctors will be three - a phthisiatrician, an orthopedist and a neuropathologist.

If spinal pain is a consequence of menopausal spondylopathy, an endocrinologist may need to be consulted.

If back pain in the spine area occurs during pregnancy, consult a antenatal clinic.

How to treat back pain caused by a spinal injury? When is surgical treatment necessary?

There are the following indications for surgery:

severe persistent pain in the spine, resistant to conservative therapy;
complicated herniated disc (manifested by persistent radicular syndrome, as well as symptoms of compression of the spinal cord or cauda equina);
suspicion of an uncontrolled spinal hernia or swelling;
instability of the spinal segment with a pronounced threat of complications;
some forms of scoliosis (progressive deformity of the spine in childhood and adolescence).

It should be noted that in each specific case the question of surgical treatment is decided individually, taking into account all contraindications to the operation.

Pain appeared after spinal surgery. What to do?

Unfortunately, pain syndrome complicates the postoperative period in many patients. In such cases, you should seek advice from the surgeon who performed the operation.

Most often, pain after spinal surgery is caused by the formation of a postoperative scar and disappears over time. However, in some cases, the pain syndrome may indicate complications for which a second operation is recommended.

What are the basic principles of conservative treatment of back pain in spinal lesions? Will exercise help with back pain?

The basic principle of any therapy is an individual approach. In the case of back pain caused by a lesion of the spinal column, not only the nature of the disease is taken into account, but also the stage of the pathological process, as well as the features of the clinical course in this particular patient. In addition, attention is paid to concomitant diseases that can aggravate the pathology, or become a contraindication to the use of one or another method of therapy.

Today, for back pain caused by a lesion of the spine, a gentle regimen is mandatory. In the acute period, maximum caution is prescribed when moving (especially when moving from a horizontal position to a vertical one and back, when bending, etc.), during the period of remission, heavy physical labor and heavy lifting are contraindicated.

Drug therapy includes a wide range of drugs. With severe pain in the spine and severe radicular syndrome, novocaine blockade, non-steroidal anti-inflammatory drugs, muscle relaxants and glucocorticoids are used. Often, they use products containing elements necessary for the restoration of the spine (the Swiss drug Rumalon, the German drug Osteochondrin, etc.).

How to relieve spinal hernia pain?

In severe cases, to take off severe pain with a hernia of the spine, novocaine blockade is used. In the acute period of the disease, rest is necessary, drug therapy with drugs from the group of non-steroidal anti-inflammatory drugs and muscle relaxants, in the future - supervision by a specialist.

How to treat spinal pain during pregnancy?

The following factors contribute to the development of complications from the spine, and the occurrence of pain during pregnancy:
1. Increased stress on the spine associated with weight gain and uneven distribution.
2. Physiological loosening of connective tissue associated with prenatal preparation.
3. Forced upright position of the body ("proud posture of pregnant women").

How to reduce stress on the spine during pregnancy

Every woman has her own rhythm of life. It is due to the personal nature and characteristics of the work. But there comes a moment when a woman finds out that she will soon have a baby. And the question arises before the expectant mother: how much will she have to limit her physical activity, taking care of the safety of the child? How to move correctly during pregnancy to avoid excessive stress on the spine?

The total weight of a woman during pregnancy increases, which, in turn, leads to an increase in the load on the spine. Normally, during pregnancy, the expectant mother adds 10-12 kg, for some this figure increases to 20-25 kg. In the later months of pregnancy, a special hormone, relaxin, begins to be produced. It is designed to relax the pelvic ligaments to facilitate the upcoming labor. At the same time, it also relaxes the ligaments of the spine in the lumbar region, making this part of the back more vulnerable. What happens when a woman stretches out her arms and tries to reach, for example, a clothesline with clothes?

The fulcrum is changing: instead of the whole foot, body weight is transferred only to the heads of the metatarsal bones. It does not promote stability and negatively affects the ligaments of the foot and ankle. The load on the spine changes, the center of gravity shifts forward, the muscles of the legs, pelvis and lumbar spine are strained. As a result, this action can also cause pain and loss of balance in a pregnant woman.

To reduce pain in the spine, you need to heed the following tips.

You need to monitor your weight. Excessive weight gives additional stress to the spine.

Do not wear high-heeled shoes (over 3 cm). The heel should be wide and stable.

Don't stand for a long time. To prevent excessive tension of the sacrum muscles during long standing, you need to rest one leg on a low stool and bend at the knee.

Sleep on a firm mattress or place boards under a soft mattress.
Getting out of bed, place both feet on the edge of the bed and lower them to the floor. You can not, standing up, roll over on your side.

To relieve back pain, you can wear a maternity belt after talking with your doctor.

Do not raise your arms high when hanging clothes, pictures, since stretching the shoulders strains the muscles of the back. In this case, you must use a stool.

During a long tilt, for example, when washing floors, intra-abdominal pressure rises, the tone of the muscles of the uterus increases, which can provoke an abortion. There is also compression of blood vessels, which leads to a decrease in the blood supply to the fetus. Therefore, you need to do this on all fours.

Do not carry older children in your arms. If it is necessary to take the child in your arms, lift him calmly, without sudden movements and do not hold him in your arms for a long time.

To avoid back pain, you must follow certain rules.

You should not cross your legs. This disrupts blood circulation and causes great strain, and the forward bending of the pelvis increases back pain.

A footrest must be used.

The chair you are sitting on should have a straight back, as a support for the spine, handrails on which you will lean when standing up, a solid seat so as not to "fall through". Don't sit too long. After sitting and resting for no longer than one hour, you need to take a break, take a walk or do stretching exercises.

Not only back pain, but also diseases of the internal organs, especially the pelvic organs, metabolic disorders, and severe headaches can occur from the burdens that are carried.

The weight of the bags that most women carry over their shoulders should not exceed two to three kilograms,

If the bag is heavy, transfer some of the contents to the bag and carry it in your other hand.

Weight over three kilograms, even if it seems insignificant to you, should be evenly distributed on both sides.

If it is not possible to carry bags in two hands, then change hands every three minutes.

You need to lift bags of any weight without bending forward, but squatting, leaving your back straight, straining your pelvis and legs. Approximately how weightlifters take weight. If, for some reason, it is uncomfortable for you to squat, then bend over, but do it with your whole body, keeping your back straight and holding your head high.

Hand position is very important when carrying bags. When we hold our bags, we naturally clench our fingers into a fist. The outer part of the fist should be
turned forward, respectively, bent fingers should "look" back.
In this case, the hands involuntarily move slightly away from the body, the shoulders are spread back. In this position, any weight is easier and more harmless to carry.

If you have to carry bags every day that weighs up to five kilograms, then get an elegant backpack or bags that are worn from the back and fixed with a thick strap along the chest, back and opposite shoulder.

For older women, it is better to use a bag on wheels. To lift such a bag should be like this: first, lift the bag with both hands and put it on the steps, and only then go up yourself.

When going to the market for shopping, be sure to wear comfortable, comfortable shoes without heels. With a load, you will strain your back and arms anyway; you should not shift the center of gravity of the body with high-heeled shoes. Double loading can cause relapses even in young and healthy women.

In order to transfer a heavy object a short distance, for example, from one room to another, you need to squat down, pick up the "weight", press it to the body, hugging it like a child, and not carry it on outstretched arms. Putting it in a new place, squat down again.

After carrying bags or other heavy objects, raise your arms above your head, stretch your neck and spine, and stretch upward. This exercise, which relaxes the spine, should be repeated two to three times. If you are back home, stretch out on your bed for a few minutes or stretch out in a chair. A comfortable horizontal position will relieve tension.

A brace should be worn to reduce stress on the spine.

To prevent excessive stretching of the abdominal wall

Designed for Optimal Abdominal Support

Reduces stress on the lumbar spine during pregnancy.

Significantly reduces the recovery time of normal muscle and skin tone of the abdomen after childbirth

The bandage is put on in the morning, lying down, before getting out of bed.

They are worn all day long.

The vertebral column in humans consists of 34 vertebrae: cervical - 7, thoracic - 12, lumbar - 5, sacral - 5, coccygeal - 5 (Fig. 1). Each vertebra consists of a massive, cylindrical vertebral body, a thin arc and 7 processes: paired upper and lower compound, paired transverse, single spinous process. The vertebral body has a spongy structure, its anterior, posterior and lateral surfaces are covered with a thin layer of compact bone, the upper and lower surfaces are speckled with small holes. After the completion of the growth period, the upper and lower surfaces of the vertebral body are framed by an annular compact limbus, to which the fibers of the fibrous ring of the intervertebral disc are attached.

The first cervical vertebra - atlas - does not have a body, articular and spinous processes, it consists of anterior and posterior arches, lateral masses and costal-transverse processes.

The second cervical vertebra is distinguished by a massive odontoid process. The upper surface of the bodies III-VI cervical, in contrast to the thoracic and lumbar vertebrae, has a saddle shape.

The semilunar processes of the vertebral body are in close relationship with the intervertebral disc, the intervertebral foramen and the vertebral artery: they limit the lateral flexion of the cervical spine.

Fig. 1. Sections of the spine

The transverse processes are formed by a rib rudiment and a true transverse process. The vertebral artery with accompanying veins and nerve plexus passes through their holes.

The size of the bodies of the thoracic vertebrae increases in the lower direction. The surfaces of the bodies are even. On the lateral surfaces of the bodies, in front of the root of the arch, there is an articular cavity for the head of the rib. The transverse processes are directed to the side and back; their length increases from I to IX of the thoracic vertebrae, then decreases. At the ends of their transverse processes there is an articular cavity for the rib tubercle (Fig. 2).

Fig. 2. Thoracic vertebra

The articular processes are located in the frontal plane. The articular surface of the upper processes is turned backward, the lower ones - forward.

The spinous processes cover each other in a tiled manner. The vertebral foramen of the thoracic vertebrae in shape approaches an oval.

The bodies of the lumbar vertebrae are massive. Their sizes grow up to IV lumbar inclusive. The body of the V lumbar is shaped like a wedge. The transverse process of the V lumbar vertebra is involved in the formation of an accessory joint with the upper part of the lateral part of the sacrum; in the presence of deforming arthrosis, pain may occur in it.

The upper articular processes of the lumbar vertebrae are concave and facing the middle and downward, backward and downward, the lower ones are convex and turned outward, forward. The configuration and size of the right and left articular processes can be different. The spinous processes are located horizontally, they are short and massive.

Fig. 3. Sacrum

The sacrum has a base, apex, middle and two lateral sections, formed by the fusion of the transverse processes of the sacral vertebrae. On the lateral part there is a tuberous surface for articulation with the ilium. The base of the sacrum has two superior articular processes, facing backward and somewhat to the side. The anterior surface of the sacrum is concave, the posterior one has protrusions: the middle sacral ridge (rudiments of the spinous processes) and the articular ridge (rudiments of the articular processes). The sacral canal is formed by the junction of the vertebral openings of the sacral vertebrae. It ends with a sacral foramen, the size of which varies sharply (Fig. 3).

The tailbone consists of 3-5 rudimentary vertebrae. Some signs of the vertebra were preserved only in the 1st coccygeal vertebra. In addition to a small body, for articulation with the sacrum, the I coccygeal vertebra has a coccygeal horn on the posterior surface on each side. Pain syndrome occurs due to the bending of the tailbone forward or to the side.

The chest is formed by the sternum, 12 pairs of ribs and 12 thoracic vertebrae. The rib consists of bone and cartilaginous parts. The first rib is the most massive. Each rib, passing into the cartilage, is attached to the sternum. The cartilages of the 8-10th ribs end freely. The upper part of the chest cavity is formed by the first two ribs and the handle of the sternum. Blood vessels, windpipe, esophagus and nerves pass through it. The lower part of the abdominal cavity is separated by a diaphragm, through which the esophagus, blood vessels, lymphatic vessels and nerves pass.

The ribs in children extend from the spine almost horizontally, they have a higher ribcage and the sternum is located higher than in adults. The movement of the chest is provided due to the elasticity of the cartilage and the movable connection of the ribs with the vertebrae. Thanks to this, the ribs can move up and to the sides, increasing in depth and width, providing an increase in the volume of the chest and an increase in the vital capacity of the lungs.

Basically, there are two types of chest deformities.

When viewed, the "chicken breast" is defined by a sharply protruding sternum, the ribs attached to it lie not in the same plane, but at an acute angle. As a result, the chest narrows and flattens, its volume is significantly reduced. The lungs, heart and blood vessels are in more cramped conditions, which impairs their normal functioning and development.

The "sunken chest" is characterized by the fact that the sternum and ribs, by their depression into the chest, form a "funnel".

The joints of the human body, being connecting and protective anatomical structures, provide a varying degree of mobility of the musculoskeletal system, while simultaneously preserving the contacting bone surfaces from wear and tear.

From a functional and clinical point of view, joints are inseparable from the muscular sphere, ligaments and the nervous system that controls movement. When transmitting information to the brain, 70% of its total volume is analyzed at the lower levels of the nervous system and only 30% reaches the cerebral cortex. At the same time, every muscle, even the smallest, is represented in the cerebral cortex. This indicates a particularly important connection between the nervous and muscular systems in the life of the human body.

The following basic elements are distinguished in the structure of the joint: articular surfaces, articular capsule, articular cavity and ligaments. The articular surfaces are the smooth surfaces of the bony zones through which connections are made. The degree of freedom of movement is in direct relation to their shape and size. The shape of these surfaces is different, they are flat, spheroid (articular head), ellipsoidal, saddle-shaped, block-shaped, concave.

The articular surfaces are covered with articular cartilage, which consists of cartilaginous hyaline tissue. Cartilage is devoid of blood vessels and nerves, protects the articular surfaces of bones and at the same time facilitates their movement in the joint.

The destruction of cartilage, caused by severe wear due to the lack of synovial fluid, as well as due to excessive muscular efforts and various pathological processes, restricts movement, and sometimes leads to immobility.

The articular surfaces are in contact thanks to the articular capsule, which is lined from the inside with a thin tendinous synovial membrane, and from the outside it is represented by a more dense fibrous membrane consisting of bundles of fibrous connective tissue.

The nature of the attachment of the joint capsule affects the range of motion. In cases where the attachment is near the edge of the joint, there is a restriction of movement, and when the capsule is attached further from the edge of the articular surface, the amplitude of these movements becomes much larger.

The articular capsule contains a dense vascular and nervous network. Arteries diverge from branches adjacent to the capsule, forming a very developed network adjacent to the synovial membrane. The arterial network passes into the capillaries at the edge of the articular cartilage, where they connect to the venous network. Nerves accompany the arteries, forming plexuses that end freely or in sensitive lamellar or bulbous nerve bodies located in the thickness of the articular bag.

Articular ligaments are fibrous formations with a predominance of tendon collagen fibers that attach to the articular bones. Their role is to increase the tensile strength of the capsule. Depending on their location, the articular ligaments are divided into three groups: interosseous ligaments, bursal ligaments, peripheral, or distant ligaments.

The interosseous ligaments are located between two bones, that is, inside the joint. The bursal ligaments are located on the outside of the joint - they strengthen the capsule. Peripheral ligaments are located at the periphery of the capsule and do not have contact with it.

The synovial membrane is a thin, smooth and shiny plate that lines the inside of the joint capsule. The synovial membrane is in the form of a sleeve with two sides - external and internal. The outer layer of the synovial membrane consists of dense connective tissue, the inner layer of soft, low-fiber connective tissue. The synovial membrane has dense vascular and nerve networks. Absorption through it is limited, so accumulations of fluid (pus, blood) in the articular cavity do not dissolve.

The articular surfaces are constantly lubricated with a colorless, viscous, low-flowing synovial fluid (synovia), which facilitates the sliding of the articular surfaces and provides a nutrient medium for vascularized cartilage. The synovial fluid is secreted by the epithelium of the synovial membrane, and its presence facilitates the work of the muscles.

The joint cavity contains a relatively small amount of synovial fluid. The contact of the articular surfaces is provided by the existence of negative pressure inside the articular cavity.

Articular discs are fibrous-cartilaginous elements located between two articular sides.

Articular menisci are also fibrous-cartilaginous formations, the structure of which is similar to discs, but with the difference that they have a central opening through which both articular cavities created by the meniscus communicate.

Both the articular menisci and the articular discs contribute to the correct articulation of the two articular surfaces.

Joint movements are divided into rotational and sliding. The axis of movement, or the axis of the joint, is defined as an imaginary line passing through the joint, around which rotational movement occurs, as a result of which it is called the axis of rotation. The axis can be vertical (longitudinal), sagittal (anteroposterior), or transverse. The degree of mobility (freedom) of the joints is the higher, the greater the number of axes of rotation.

The types of articular movements are determined depending on the position of the articular segments. For example, flexion of the upper limb and extension of the lower limb is a movement by which two articular segments approach each other. Extension of the upper and flexion of the lower - a movement in which the segments move away from each other. Flexion and extension are characteristic of both movements of the transverse axis.

With the adductive movement of the limb, the segments approach the midplane. The abduction movement is carried out by moving the limbs away from the median plane. Adduction and abduction are lateral movements. In both cases, the axis has a sagittal direction.

A complex movement consisting of a combination of these movements is circumduction. Lateral and medial rotational movements occur around a vertical axis rotating inward or outward, thus moving this segment of the limb or trunk.

The vertebral column consists of two bone systems, different from an architectonic point of view: sequentially located vertebral bodies and intervertebral discs, bearing static and supporting functions, and the posterior cruciate vault (two crossing arcs: one longitudinal, consisting of strung legs of the arches of the vertebrae and articular processes, the other is transverse, resulting from the imposition of one vertebral plates on top of the other and reinforced by midline spinous processes), which carries a dynamic function, which is provided by the tendon apparatus and the muscles connecting the arches of the cruciate arches.

The loads acting on different segments of the spinal column increase as they approach its base and reach the greatest value at the level of its lower sections. Therefore, the vertebrae of different parts of the spine have different shapes.

Intervertebral discs consist of cartilaginous plates covering them from above and below, annulus fibrosus and nucleus pulposus. Cartilaginous endplates protect the spongy substance of the vertebral bodies from excessive pressure, and also act as an intermediary in the exchange of fluids between the vertebral bodies and intervertebral discs.

The fibrous ring of the intervertebral disc consists of concentrically located fibrous, separated from each other plates, thickening towards the periphery, and as it approaches the center, passing into a more developed fibrous cartilage, penetrating into the nucleus pulposus and uniting it with the intercellular stroma, in connection with which there are clear boundaries between the annulus fibrosus and nucleus pulposus is not observed (Fig. 4).

Fig. 4. Intervertebral disc

Anteriorly and laterally, the fibrous ring is fixed to the vertebral body. In addition, in front it is tightly fused with the anterior longitudinal ligament, which runs from the occiput to the sacrum and forms an expanding strong tape in the lumbar region. Behind, in the lower lumbar spine, there is no such fusion of the vertebral bodies with the posterior longitudinal ligament. In some areas of the spine, the posterolateral and median parts of the annulus fibrosus are not covered by the posterior longitudinal ligament. In this regard, the most frequent localization of intervertebral hernias is observed in these areas.

The intervertebral discs have a slightly larger diameter than the vertebral bodies. The discs have different thicknesses in different parts of the spine - from 4 mm in the cervical to 10 mm in the lumbar. The lateral areas of the annulus fibrosus are 2 times thicker than the anterior and posterior parts of the annulus. Thus, the annulus fibrosus surrounds the nucleus pulposus and forms the elastic rim of the intervertebral disc.

The nucleus pulposus has the shape of a lenticular biconvex and is the most functionally important part of the intervertebral disc. By its composition, the core is a gelatinous gel of a polysaccharide-protein complex, connected by fibro-cartilaginous collagen bundles and loose connective tissue with a fibrous ring. These fibro-cartilaginous bundles, if they do not undergo degeneration, do not allow the nucleus pulposus to leave the annulus fibrosus when it ruptures.

The main function of the nucleus pulposus is to absorb various loads during compression and stretching of the spine and to evenly distribute pressure between different parts of the annulus fibrosus and the cartilaginous plates of the vertebral bodies. The gelatinous nucleus under the influence of strong compression as a result of hypohydration can flatten by 1-2 mm, and when stretched, it can increase its height as a result of hydration. The absorption of water and nutrients in the intervertebral discs, as well as the excretion of metabolic products, occurs by diffusion through the vertebral bodies.

The pulpous gelatinous nucleus, like a mercury ball, adjusts to the center of gravity.

Two vertebrae with facet joints and an intervertebral disc, with the surrounding muscles and ligaments are called motor segment of the spine.

The capsules of the intervertebral facet joints are resilient and elastic. Their inner layer forms flat folds that deeply penetrate the joint space - the articular meniscoids containing cartilage cells.

The yellow ligaments connect the back of the joints and arches of the adjacent vertebrae and consist of a large number of elastic fibers, therefore, they oppose the reverse force of the nucleus pulposus, which is trying to "push the vertebrae apart", as it were.

The interspinous and transverse ligaments do not contain so many elastic fibers, are hard, and therefore, during traumatic impact, they can be damaged at the attachment points.

The anterior and posterior longitudinal ligaments consist of longitudinally located tendon fibers and are tightly connected to the vertebral bodies, and less densely at the border of the disc and adjacent vertebrae.

The intertransverse muscles consist of the median-posterior and inner-lateral independent layers of muscle fibers, between which the neurovascular bundle passes.

Interspinal paired muscles are directed from bottom to top and inward.

When pain occurs, the shift of the elements of the motor segment of the spine affects the functional state of the muscles, increasing their tension.

The generalized reaction of muscles at the initial stage of the shift of the elements of the motor segment of the spine is carried out according to the approximate type. It engages the muscles along the entire spine, and other muscles are involved. Muscle tension in the cervical, thoracic and lumbar spine sharply increases. As pain decreases and remission develops, generalized muscle tension is replaced by local muscle tension, and, finally, with the help of protective muscle contracture, only one affected motor segment of the spine is turned off from movements, that is, a functional limitation of mobility is formed - functional blockade of the joint.

The motor segment switched off from movement changes the functional state of the overlying parts of the nervous system, influencing the human motor stereotype encoded in long-term memory and forming a new one, as a result of which the higher and lower motor segments of the spinal column compensate for the volume of movement.

Functional blockages can lead to the appearance of foci of neuroosteofibrosis: thickened muscle cords containing painful dense nodules, small (pea-sized) or larger, less firm and without clear boundaries, or lamellar indurations (myogenosis). Due to the foci of muscle seals, the affected motor segment of the spine is blocked by "passive" tissues.

The spinal canal contains the spinal cord, which can normally adapt to significant changes during spinal movements. The spinal nerve roots that exit through the intervertebral foramen are initially covered with a disc and bone structures, and their compression and irritation may result from damage to these structures.

The inner and outer nerve roots start from the spinal cord and are placed in a funnel-shaped protrusion of the hard and arachnoid meninges, called radicular sacs. This prevents the nerve roots from kinking at the exit from the spinal cord and protects them during spinal movements. The root sleeve (an extension of the dura mater) extends from the base of the membrane and firmly attaches to the root. The nerve root is able to move with the intervertebral foramen. For example, the lower lumbar nerve root shifts by about 0.5 cm during passive leg lift.

The intervertebral foramen is a narrow, funnel-shaped opening through which blood and lymph vessels pass, the spinal nerve, which is formed by the inner and outer roots, and the vertebral nerve, which returns back to the spinal canal. The intervertebral foramen in front is formed by the adjacent vertebral bodies and the intervertebral disc, above and below - by the articular processes, and behind - by the articular processes.

Unfortunately, both joints - anterior and posterior - form a movable intervertebral joint, so any changes in the overlying or underlying joints reduce the cross-section of the intervertebral foramen. As a result, there may be compression of the nerve during movement of the spine.

The spine has 23 pairs of intervertebral foramen. Their sizes grow from top to bottom: in the cervical spine they are relatively small, in the lumbar spine they are large. The vertical size of the cervical intervertebral foramen is 4 mm, at level III lumbar - 11.1 mm, IV lumbar - 10.6 mm, V - 10.2 mm.

The vertebral nerve is a thin thread connected to the sympathetic trunk, which constantly sends electrical impulses to internal organs and tissues. Thanks to this, the external and internal (normal functioning of organs) appearance of humans and animals, which we are used to seeing, is maintained. As soon as the impulse from the sympathetic trunk decreases, metabolic processes slow down in the tissues and internal organs, and they begin to age, the muscles dissolve.

The vertebral nerve departs from the spinal nerve at the place of its meeting with the inner and outer roots and returns to the spinal canal through the intervertebral foramen, where it is divided into the upper and lower branches and ends with a fine mesh of free nerve filaments innervating the dura mater of the spinal cord, the posterior longitudinal ligament. blood vessels, periosteum and outer part of the fibrous ring of the intervertebral disc. The vertebral nerve extends to the upper and lower vertebral structures, connecting with the vertebral nerves of adjacent levels.

Of great importance in the occurrence of changes in the spine is the deterioration of blood circulation and, in connection with this, the premature development of aging processes. Contributing factors are trauma and microtrauma, especially repetitive ones, which cause blockage of the channels through which the vessels pass, penetrating into the endplates of the vertebral bodies.

The role of the triggering mechanism can be played by painful irritation to the spine along the nerve conductors in case of pathology of internal organs - pleurisy, pneumonia, ischemic disease heart, peptic ulcer, cholelithiasis, pancreatitis, appendicitis, etc. Reflected pain in diseases of internal organs have their own characteristics. They are diffuse, without clear localization. Pain is often accompanied by increased sensitivity with numbness in the bones, feet, and unpleasant sensations of cold in the spine. In some cases, soreness is observed when the skin of the thoracic and lumbar regions is squeezed into folds. Irradiating pains from the internal organs are often accompanied by disorders in the form of sweating, local redness and cyanosis of certain areas of the skin.

The late appearance of pain and subjective complaints with changes in the spine is associated with a lack of innervation in the intervertebral discs, and therefore the first clinical manifestations of the disease can occur when the disc is already destroyed by half or even 2/3.

Signs of early damage to the intervertebral discs and, as a consequence, limitation of the mobility of the facet joints are revealed only by manual diagnostics. With pain, the blood supply to the joint and surrounding tissues deteriorates, which can also lead to early and late forms of intervertebral disc degeneration.

The circulation of blood in the spinal canal has its own characteristics. Almost every intervertebral foramen includes an arterial branch, which divides in the spinal canal and forms 5 longitudinal trunks. Venous outflow of blood from the spinal cord occurs through the internal and external venous plexuses. The internal venous plexus forms two longitudinal networks connected by venous rings, each of which enters separate vertebrae on the border between the vertebral body and the intervertebral disc. The internal venous plexus is connected to the external one with the help of vertebral veins passing through the vertebral bodies.

There are no venous valves in the veins of the spinal cord and they are not surrounded by muscles. As a result of these anatomical features, constant stagnation occurs in the spinal canal. venous blood, and where there is a passive restriction of mobility (functional blockade) in the facet joint, the removal of metabolic products from the vertebral bodies and intervertebral discs slows down. This explains the sharp increase in pain in the spine during attacks of coughing, sneezing, when there is compression of the cervical and abdominal veins and the venous outflow from the spinal canal is sharply impeded.

In order to ensure sufficient venous drainage from the spinal canal, it is necessary that all facet joints move freely. Any limitation of the mobility of the facet joints slows down the venous outflow in this area of the spine. The concomitant spasm of the muscles surrounding the joints with partial or complete blockade of the joint also contributes to the deterioration of venous outflow from the spinal canal.

HEALING MOVEMENT: RELAXING INSTEAD OF TENSION

Until now, physical activity in physical education lessons in schools, in sports clubs, in remedial gymnastics is evenly given to all muscle groups. This has always been considered a positive development. However, something else is being revealed today. If a person, every day, for 3-5 years will perform exercises with the same load on all muscle groups, then this will make him sick!

In the human body, the entire muscle sphere is divided into two groups according to its function. The first group - skeletal muscles (or tonic), which retains the modern appearance of a person (“on which bones are held”), is constantly in tension, even when a person is asleep. It is closely related to the midline structures of the brain and the old cortex, which are responsible for the autonomic, neuroendocrine and emotional functions of the human body. Have modern man these muscles are constantly in a state of pathologically increased tonic tension.

The second group is the muscles responsible for the instantaneous application of force (phasic). In modern man, they are pathologically weakened, as a result of which they reduce the force of their contraction.

The muscles responsible for the instantaneous application of strength are of secondary importance in the human body, but it is precisely to strengthen them and increase their strength that exercise has been directed over the past 100 years. But in the course of scientific research, it became clear that thoughtless waving of hands and feet does not benefit, but harm. Why? For example, we begin to pump the abdominal press, getting up from a prone position to a sitting position, that is, we train the rectus and oblique abdominal muscles, which are responsible for the instant application of force, which are weakened in a modern person. Everything seems to be correct, but what is done at this time with the tonic muscles of the back, which, on the contrary, need relaxation? Nobody ever thought about it.

Together with the abdominal muscles, which we strengthen, the back muscles increase their tonic tension and acquire a stony density, straightening the physiological curves of the spine.

Sometimes you look at a young man - the muscles are pumped up, it's easy to see, and behind you you can find a single muscle cord from the back of the head to the sacrum. You touch a stone with your finger, and nothing more! The spiral shape of the spine with physiological curves is smoothed, and in its curvature the spine approaches the concrete pillar.

If, as a result of various reasons, the muscles responsible for the instantaneous application of force disappear, then nothing terrible happens - the person continues to live (in overweight women after childbirth, only tendon helmets remain from the rectus and oblique muscles of the abdomen, many people have tendon helmets in place of the interscapular muscles). When any skeletal muscle is cut, a person immediately turns into a disabled person: he cannot move or turn any part of the body.

As a result of the factors listed above, from the moment of birth and in the process of manifestation of motor activity, a purely individual motor stereotype is formed in each person. The motor stereotype is the totality of the entire mosaic of muscle tension and relaxation, encoded in short-term and long-term memory.

Currently, in the modern human population, there are no people with an unchanged motor stereotype. When pathology of the spine occurs, undifferentiated motor activity constantly enhances the pathological motor stereotype. The pathological motor stereotype adapts and makes the patient more resistant to the disease, helps to reduce pain syndrome or to avoid it and other clinical manifestations of osteochondrosis of the spine. During traditional physical education "to strengthen the muscles", a person replaces the muscles that he wants to strengthen with others. As a result, he exercises his lack of coordination instead of eliminating it and thereby reinforces the pathological motor stereotype. For example, a person trains the back muscle of the thigh by lifting the leg up in the prone position. But since there is a weakness of the posterior thigh muscle group, the abductor thigh muscle group is included in the motor act, leading to the simultaneous rotation of the lower leg and foot. The tonic tension of other muscles increases. When walking, rotation of the foot appears outward, pain in the buttocks. The man trained his lack of coordination.

Such physical education "to strengthen muscles" is absolutely contraindicated for patients with clinical manifestations of osteochondrosis of the spine.

Functional blockages (passive limitation of mobility) in the joints of the human body, which maintain a stable pathological motor stereotype, cannot be eliminated by such methods. In this case, all movements of the patient and his posture are distorted, therefore it is impossible to determine even the true strength of the muscles and to establish which symptoms are a consequence of a spondylogenic disease, and which are associated with violations of central regulation as a result of training their lack of coordination.

We've revisited our idea of what physical exercise should be.

The basis of physical exercise for a person should be the effect on skeletal muscles, which increase their tension in pathology. The impact should be relaxing.

The principle of yoga - not to strengthen, but to relax - is also quite suitable for solving the main problem, however, it must be borne in mind that in yoga gymnastics there are many harmful exercises for human health that must be excluded from classes.

First of all, you need to learn how to relax the back muscles that carry the main load. Exercises should be carried out according to the method of "relaxation through concentration" in several types:

Slow rhythmic movements that stretch the tonic muscle (repeat 6-15 times, 20-30 seconds break);

Under the influence of gravity, create a stretching position for the tonic muscle, the stretching phase lasts 20 seconds, a break for 20 seconds, repeat 15-20 times;

Tension of the tonic muscle against resistance for 9-11 seconds, then relaxation and stretching for 6-8 seconds, repeat 3-6 times;

Tension of the tonic muscle group against resistance from the opposite side for 9-11 seconds, relaxation for 6-8 seconds, stretching the muscle group, repeat 3-6 times.

SPINE BEGINS WITH LEGS

Everyone believes that when standing, a person rests on his feet. In fact, this is not the case. When standing, a person rests only on the outer and transverse arches of the foot. Inner part the foot that does not touch the surface of the ground is called the arch of the foot. The main function of the arch of the foot is to ensure balance with the vertical position of the human body.

It is no exaggeration to say that the pathology of the spine begins with the feet. The influence of modern civilization - daily contact with the hard surfaces of sidewalks, poor shoes that cause sprains and dislocation of the bones of the foot - have led to the fact that up to 80% of the world's population suffer from flat feet.

Flat feet are divided into longitudinal, when the longitudinal arch of the foot is flattened, and transverse - when the transverse arch of the foot is compacted. When lowering the transverse arch of the foot, the big toe turns inward. Transverse flat feet can be expressed in the presence of a so-called wide foot with thumbs turned outward.

Man was created by nature as a harmonious being, while the symmetry of the right and left halves of the body is of great importance. The slightest unevenness in this symmetry - and the spine suffers. Irregularity of the arches of the right and left feet, different lengths of the legs, skewing of the pelvis, which should stand symmetrically due to the vertical position of the body in space, - and a compensatory curvature to the side in the lumbar spine is formed, that is, scoliotic disease is gradually formed.

Fig. 5. Self-massage of the foot in case of leg fatigue

Walking barefoot is the best way to strengthen all tissues of the foot. It is especially useful to walk on sand, repeating all forms of the sole and arch of the foot. If this is not possible, then it is recommended to walk barefoot around the apartment in the morning after sleep and in the evening after work.

There are active points on the foot that stimulate the work of the internal organs and tissues of the human body.

Change your position approximately every 10 minutes;

Lean in turn on each leg so that the body weight falls on them alternately;

Change the position of the legs - walk in place, alternately move the legs, transferring the weight of the body from heels to toes.

HOW TO REMOVE FATIGUE LEGS

Cross the legs, with the middle finger, perform slow circular rotational movements counterclockwise (like screwing in a screw) at a point on the inner arch of the foot, as shown in Fig. 5. "Screwing in" should be carried out for 1-1.5 minutes, break for 1-2 minutes, repeat 3-6 times.

RUNNING TO US ADD KILOGRAMS

Running causes severe concussion. In every stride, there is a flight phase when both feet do not touch the ground and the body seems to float in the air.

When one leg lands, it is loaded with a load 5 times the body weight. If a person weighs 75 kg, then the load on the foot upon landing will be 315 kg!

With each step, the spine is "thrown" upward as if an accordion is being stretched, the Achilles tendons, ankle muscles, other ligaments and tendons are strained, and a huge load falls on the knee joints.

If rhythmic movements are beneficial for blood vessels ("running for life"), then degenerative changes very quickly occur in the joints of a person. Not so long ago, we observed a patient who turned to the doctor of his clinic with complaints of pain in the cervical spine. The doctor mistakenly recommended that the patient bend and extend the neck with dumbbells weighing 2 kg! After 2 years of such exercises, a repeated X-ray when contacting our clinic already showed the complete disappearance of one of the intervertebral discs in the lower cervical spine. This is a good confirmation of the fact that cartilage in the human body wears out quickly. Hence, such a high prevalence of arthrosis of the knee and hip joints.

Fig. 6. Running on tiptoes

Fig. 7. Jogging in the way of walking

ABOUT THE DAMAGE OF FORWARD TILES

The human body as a biological machine has no analogues in the animal world of the Earth. But this perfect apparatus also has weak points, and with incorrect, non-physiological movements, a "breakdown" can occur. For example, non-functional, antiphysiological movements include rotation and forward flexion of the trunk in the lumbar spine. In the erect position, rotation in each motor segment of the lumbar spine is carried out only by 1 °. An increase in the angle of rotation to more than 8-10 ° is possible only in combination with lateral tilt, forward and backward tilt. Therefore, the awkward excess of the angle of rotation instantly leads to twisting of the intervertebral disc, cracks and hernias! This happens especially often with rotational movements during shaping exercises.

Behind and in front, the human spine is tightly covered by the posterior and anterior longitudinal ligaments - powerful connective tissue cords that prevent the prolapse of the intervertebral disc during its destruction. In the lower lumbar region at the level of the IV and V lumbar vertebrae, the posterior longitudinal ligament bifurcates and does not cover the two lateral and median parts of the intervertebral discs, therefore, at these levels, cracks are most often formed, intervertebral hernias occur, which can appear even with the usual sharp forced tilt of the trunk forward or uncoordinated movement.

Particularly dangerous are static turns of 15-45 ° without additional support, so pain and "lumbago" often appear during brushing your teeth or replacing a flat tire. To relieve the load on the lumbar spine, you need to brush your teeth without bending the spine (Fig. 8, 9).

To unscrew the bolts at the car wheel, you need to squat down without bending your torso in the lower back (Fig. 10, 11).

HOW TO RIGHTLY LIFT OBJECTS OFF THE FLOOR

The load on the intervertebral discs in the lumbar spine increases 10 times when lifting objects from the floor due to flexion in the lumbar spine. When lifting a floor cloth moistened with water weighing 2-3 kg, the load on the lumbar intervertebral discs increases to 4,0-6,0 kg, therefore it is recommended to lift objects from the floor by bending at the knee joints or leaning with the knee on the floor (Fig. 12, 13, 14, 15).

HOW IT IS CORRECT TO LIFT AND MOVE WEIGHT

The intervertebral disc in the lumbar spine withstands a load of 420 kg / cm 2 ... And this means that every healthy person could lift and rearrange a passenger car without harm to his health! But the question is how he will do it. If he bends his legs at the knee joints and without bending the lower back he straightens them, rearranging the machine, nothing bad will happen. If he lifts the car due to flexion and extension in the lower back, a breakdown will occur in the intervertebral disc.

When flexing, the load on the intervertebral disc in the lumbar spine increases 20 times.

Fig. 8 Correct position of the spine when brushing teeth

Fig. 9 Incorrect position of the spine when brushing teeth

Fig. 10 Correct body position when loosening the wheel nuts

Fig. 11. Incorrect body position when loosening the wheel nuts

Fig. 12. Improper lifting of objects from the floor

Fig. 13. Improper lifting of objects from the floor

Fig. 14. Lifting objects from the floor especially dangerous for the lumbar spine

Fig. 15. Correct lifting of objects from the floor

Lifting something heavy, you should bend your legs at the knee joints, not your back (Fig. 16, 17, 18);

It is safer to keep the load as close to you as possible - with this method of action, the load on the spine is the smallest;

It is inadmissible to sharply bend forward or unbend back when carrying heavy loads;

When lifting weights, avoid turning the torso (Fig. 16), since such a combination of movements is one of the most common causes of "lumbago";

In the absence of a back bend in the thoracic spine (kyphosis), it is not recommended to wear a backpack on the back;

It is advisable to lift and carry loads one or two people using available means - a stretcher, wheelbarrow or trolley help to avoid harmful overloads of the spine.

Fig. 16, 17. Improper weight lifting

Fig. 18. Correct lifting of weights

Fig. 19. Correct carrying of weights

Fig. 20. Incorrect carrying of weights carrying weights

A tragedy of ill-conception: the paralysis of a loose hand

During prolonged work with arms raised upward or when sleeping on the stomach with a hand behind the head, under normal physiological conditions, compression of the anterior scalene muscle of the subclavian artery and the lower part of the brachial plexus occurs.

The man slept for several hours with his hand clasped behind his head, woke up in the morning– hand does not move, paralysis has occurred.

Fig. 21. Incorrect position when working with high-lying objects

Fig. 22. Correct posture when working with high-lying objects

In order not to injure the neurovascular bundle of the subclavian artery and not to squeeze the lower part of the brachial plexus, it is not recommended to work with arms raised high. If you need to hang a shelf or watch high above your head, it is more convenient to stand on a stable bench or chair. This will make it possible not to lift the load above shoulder level (Fig. 21, 22).

A NIGHT WITHOUT PAIN: HOW TO WAKE UP HEALTHY

Some clever guy about 60 years ago declared that it is useful to sleep on a solid, or even better on a board. And now everyone is repeating his words. But the spiral shape of the spine from a solid bed bends and approaches the shape of a concrete pillar. In addition, blood circulation is disturbed due to squeezing it out of the vessels in the place where the body adjoins the bed. After 1.5-2 hours of sleep, a person feels numbness and "goosebumps" in that part of the body, which is located on the hard part of the bed.

But if you sleep, observing certain rules, you can not only get rid of pain, but also help the body to restore and increase vitality during sleep!

You need to sleep on a semi-rigid bed: below - a solid wooden board, on top - a soft part with a height of at least 15-18 cm, that is, 2-3 new cotton mattresses - not all orthopedic mattresses have such qualities;

With pain in the spine, it is often difficult to sleep lying on your stomach, however, getting used to this position, it is difficult to find another, more comfortable one; you can use a pillow by placing it under the abdomen - this straightens the forward bend in the lumbar spine and can sometimes reduce pain;

In some cases, it is convenient to sleep on your side with one leg on the other and your hand under your head - this position is suitable for most people suffering from back pain;

When reading lying down, it is necessary to try not to bend the neck too much - it is better to settle in bed half-sitting so that the load on the cervical vertebrae is minimal;

It can be difficult to get out of bed without hurting yourself in the acute period of the disease, so it is recommended to facilitate this procedure - first turn on your side, then move as close as possible to the edge of the bed and gently lower your legs to the floor, while resting on the couch with your elbow, and you should get up without tilting the upper body forward;

During sleep, the head should be on a rectangular soft or orthopedic pillow so that the shoulder lies on the couch, and the pillow fills the distance between the shoulder and the head;

When lying on its side, the head should be parallel to the couch.

SPECIALLY DANGEROUS BODY POSITIONS IN SLEEP

In no case should you sleep on various bolsters.– this can lead to a lateral tilt of the cervical spine and often to compression of the neurovascular bundle of the vertebral artery with all the ensuing consequences!

Fig. 23. Compression of the vertebral artery in the cervico-occipital joint when the head is tilted to the side

In the upper cervical spine, through which the vertebral artery passes, under normal physiological conditions, when the head is turned to the side, the opposite vertebral artery is compressed, when the head is tilted to the side, the vertebral artery on the same side, and when the head is tilted back, both vertebral arteries (Fig. 23). This entails a decrease in blood flow in the vertebral arteries, which in healthy people is a training factor, and in patients it causes symptoms of cerebral ischemia. It is harmful to sleep on the stomach, since in this position the head is turned. This position can be recommended only during the period of acute pain in the spine. It is also dangerous to sleep on your stomach with your hand behind your head, as the anterior scalene muscle of the subclavian artery and the lower part of the brachial plexus is compressed.

A large number of deaths, cerebral and heart attacks occur at 4-5 o'clock in the morning in a dream, when, against the background of already existing unfavorable factors (atherosclerosis, increased blood pressure, etc.), the blood supply to the brain worsens due to an incorrect position in bed in time to sleep.

CAUTION SNORING!

Snoring during sleep occurs when the tissue at the back of the throat relaxes during sleep and vibrates as you inhale. This effect is very similar to playing wind instruments. As a rule, snorers are overweight, middle-aged people. Men snore more often than women.

People who snore heavily often have periods of no snoring during which breathing can stop!

A person literally stops breathing for some time - this is a condition called in medicine "apnea attacks". During respiratory arrest, collapse, impaired cerebral or cardiac circulation, and death can occur.

If you snore in such a way that you can be heard in the neighboring rooms, you should urgently see a doctor. Currently, there are hundreds of "anti-snoring" devices that relieve patients from snoring. In case of their ineffectiveness, surgical intervention is sometimes required.

Snoring is exacerbated by colds, allergies, alcohol, sleeping pills taken at night. In moderate snorers, snoring appears only on the back, for them it is recommended to sew a rubber tennis ball into the pajamas on the back. It is uncomfortable to lie on it, so the person will be forced to roll over on his side. The correct position of the pillow is of great importance. The cervical spine should be straight during sleep!

MORNING WITHOUT CHARGING - THE BEST RECIPE OF VIVILITY

All people by their psychophysiological characteristics are divided into "larks" who fall asleep early in the evening and get up early in the morning, and "owls" leading an active lifestyle in the evening, and in the morning with great difficulty getting out of bed. This is due to the difference in psychophysical characteristics and biological rhythms in different people, formed from birth and fixed in the process of subsequent life. Their violation leads to a stressful situation for the human body, and then to illness.

And "larks" and "owls" in no case should jump out of bed and do physical exercises right away - this violates the physiological rhythms of the human body. It is even more harmful to rush into an ice shower after charging. The body experiences stress from this, and after a short-term artificial increase in strength, a person begins to decline in activity, and with frequent repetition, even depression.

In order to get a real boost of vivacity, it is better to get out of bed no earlier than 8-9 in the morning, slowly, slowly, lying down for another 6-15 minutes, during which several times stretch, raising your arms up and stretching your feet, thinking about what a beautiful day ahead. It is recommended to sleep at least 9-11 hours, muscles do not relax in 8 hours. The saying “Who gets up early, God gives” does not stand up to scrutiny.

It is recommended for "owls" to do any physical exercises not earlier than 4-5 pm, for "larks" it is better to choose daytime for this. Start off physiotherapy exercises follows from the simplest exercises, then you can move on to more complex ones. The main rule in the practice of remedial gymnastics should be the correspondence of the chosen complex to its purpose.

Sometimes the patient chooses the exercises that are suitable for himself, guided by the absence of a feeling of discomfort and pain during classes. If the patient notes that the exercise is beneficial, he should include it in the complex.

Physical education should not be associated with pain and, especially, with its intensification. At first, training may be accompanied by some pain, which should gradually subside. After 2-3 sessions, the body will get used to the stress, and it will be easier to perform the exercises. However, it should be remembered that pain is a danger signal that cannot be neglected. You should always start very carefully, avoiding sweeping movements and great efforts. It is necessary to gain the amplitude and dynamics of movements gradually. It is important to constantly monitor the course of classes in order to avoid unpleasant surprises in the form of pain or another surprise.

FACTORS CAUSING DISEASES OF THE SPINE

In the process of reproduction of human generations for many centuries, changes in the transmission of traits (in the special literature they are called mutations) have accumulated, which are also inherited. Some people are born with underdevelopment of the skeletal system - with anomalies, the absence of any articular processes, their incorrect location, etc. These congenital changes are the root cause of the appearance of spinal diseases and complications in the early period of life.

The nagas' human way of being born is not a gift. According to special literature, 80-90% of children at birth receive a traumatic effect on the spine.

Passage through the birth canal, strong compression, possible mistakes of the midwife - all this is "deposited" on the skeletal system and after a while it manifests itself. Only 10% of newborns after all these tests remain normal in the back! During the passage through the birth canal, the junction of the skull with the 1st vertebra with head diligence suffers, which precisely determines the statics of all subsequent life. And with gluteal diligence, the articulation of the sacrum with the pelvic bone suffers, which also determines the statics of the human body when the child begins to walk. In this joint, a functional limitation of mobility is formed (in the special literature it is called a functional blockade of the joint). Up to 40-45% of children are born with a small anatomical difference in the length of the legs (3-7 mm), and up to 40% of it is obtained as a result of asymmetric development of the muscles of the right and left half of the body. According to statistics, 90-95% of our children have different leg lengths. It is not noticeable to the eye, but the skeleton is in great trouble!

The pelvis from the point of view of bipedal locomotion in the conditions of the Earth's gravity should be located strictly symmetrically. With different lengths of the legs in the lower back, a curvature is initially formed to the side. And if the difference is large, then a curvature in the opposite direction is formed in the thoracic region - S-shaped thoracolumbar scoliosis. And scoliosis is a lateral curvature of the spine leading to early appearance severe complications: by the age of 20-25, the occurrence of herniated intervertebral discs is very likely, which "should" appear in no way earlier than fifty, are displaced internal organs and their diseases begin - asthmatic bronchitis, gastritis, pancreatitis, colitis, etc.

If a child comes to us with different lengths of legs, we put an insole under the short leg in order to align the pelvis. The thickness and size of the insole is determined by the specialist. Any amateur activity here is fraught with irreversible consequences! And parents must make sure that the insole gets into every pair of shoes in which the child walks, otherwise all this does not make sense. With the constant wearing of insoles for up to 19 years and the use of therapeutic methods for aligning the arches of scoliosis, it is possible to correct the skew of the pelvis caused by different leg lengths. If a child is put on insoles at 13, he should wear them for 6-7 years, that is, until 19-20 years old, when the skeleton finally ossifies, and the treatment of scoliosis becomes meaningless.

When you bring a child from the hospital, remember - his life and health are in your hands! The bed, in which the baby spends all his time, should be hard enough, not bend or sag. When the baby walks, the mattress should be changed to a softer one. Often, young parents are inattentive and awkwardly pick up the baby who is not yet holding the head. Any load that is not programmed by nature on the skeleton and on the head of the child will negatively affect the cervical spine. So please hold the crumb under the head very carefully!

Parents should remember that any head injury or concussion will cause functional limitations of the passive spine. Particularly dangerous is the fall of the child supine, head down. You can not leave the baby unattended for a minute - this is the responsibility of the parents. It must be remembered that any injuries, even arm fractures, the imposition of a splint, plaster of Paris increase the load on the skeleton many times over and, accordingly, "overwork" the spine, often leading to the formation of cracked discs and diseases of the spine.

When a child begins to walk, physiological curves form in the spine. Normally there are two of them: forward in the cervical and lumbar regions and backward in the thoracic and sacrococcygeal regions. These curves form a unique spiral shape of the spine, which allows it to support 18 times more weight than a concrete pillar of the same thickness. Imagine how wisely everything is arranged!

An experiment was carried out: the spiral spinal column withstood 18 tons of load, and the concrete one broke at 1 ton!

Unfortunately, this wonderful initial data inherent in nature does not always work like this. We have very sad statistics - as a result of multiple studies, it was found that today humanity is defective in this matter. Paying for upright walking, our population has come to the conclusion that 90-96% of people have smoothed physiological bends, and 6-10%, on the contrary, have excessively increased bends, and this is already the first stage of spinal disease. If we continued to run on all fours, nothing would have happened. And so, they got on their feet - and the cartilages and vertebrae, which were not programmed for longitudinal loads, began to fail, fail.

We recently underwent a medical examination at a special language school. Scoliosis was found in 98% of students from the first to the tenth grade, requiring immediate correction. For all these students, individual complexes of physical education and medical gymnastics are needed. Until the age of 19, much can be improved in a child, and he will enter adulthood without complications.

There are many negative things at school today. The causes of many illnesses are in the school schedule, senseless workloads, a psychologically unpleasant background, stupid organization and much more. The existing problems of the spine at school "get stronger", leading to serious problems. Ugly school furniture undoubtedly leads to poor posture. It is outrageous to force children to sit at a desk for 40-45 minutes motionless, especially in the first grades! There is tension in the muscles of the back and neck, ventilation of the lungs decreases, and inflammatory processes easily occur there.

Trouble can be avoided by taking frequent breaks, giving children the opportunity to get up, stretch, move. Instead, schoolchildren, who have already served their lesson at a desk, are put along the walls at breaks, forbidding them to run and jump. You say discipline, but I say - a crime! And it is good that many "idiots", as if obeying a powerful instinct, still turn around in the classroom and, receiving comments, and sometimes cuffs, find any reason to save themselves from immobility. And rightly so!

The teacher should explain that children should move when they need to - thus, they intuitively carry out the prevention of many diseases. A child must gain his physical activity by any means, and if he is disturbed, then this activity will just result in hooliganism and pranks. Therefore, from the point of view of health, lessons should be 20-30 minutes long, depending on age, and during breaks it is necessary to give the students the opportunity to “have fun”.

Mothers often drive their children into a frenzy, constantly urging them to "not slouch, straighten your back." Usually such concern does not lead to anything other than neurosis. Constant stress, forced uncomfortable positions, discomfort in the spine force the child to look for a comfortable position, twist and even bend over in order to “unload” the spine. Children intuitively look for the correct position in which they are comfortable, comfortable, and sometimes find it in very extravagant positions. It is necessary to leave the child alone, not to pull him down constantly, especially in public, to give freedom of movement and not to scold him for restlessness. What is more important - a publicly impeccable stately sufferer or a healthy, vigorous, even a little stooped person?

Imagine a child sitting and doing homework. Here my mother comes up with her usual: "don't hunch down", slaps on the back. An obedient child freezes in an uncomfortable, non-physiological position for him. After a while, pains appear, the muscles stiffen, the head begins to work poorly. The kid wants to lie down and doesn't give a damn about tomorrow's math test. Here they are, mother's worries! Maybe this child has a smoothed spine in the thoracic region, and he is forced to look for a position that is acceptable in this case. And if there is an arch of scoliosis, he straightens it at the same time. Nature itself always correctly suggests the necessary unloading posture, teaches to relieve discomfort.

By the way, it should be borne in mind that, according to the classification of some authors, flattening or an increase in physiological bends is stage I of osteochondrosis of the spine!

OSTEOCHONDROSIS AND INTERVERTEBRAL DISC HERNIATIONS: OPERATIONS CAN BE AVOIDED

The spine consists of vertebral bodies with facet joints and elastic layers between them - intervertebral discs. Two vertebrae with facet joints and an intervertebral disc together with the surrounding muscles and ligaments are called the motor segment of the spine. The intervertebral disc consists of a tendon ring with spirally twisted fibers, gelatinous contents and a nucleus pulposus, which, like a mercury ball, adjusts to the center of gravity. With the formation of functional limitations of passive mobility (functional blockages) as a result of various reasons in some motor segments of the spine, immobility occurs in the facet joints, the nucleus pulposus cannot adjust to the center of gravity, shifting to the posterior, anterior or lateral parts of the intervertebral disc, increasing the pressure in these sections on the tendon ring. In response to pressure, the tendon ring at stage I is twisted due to the spiral shape of the fibers.

The structure of the intervertebral disc with its spiral tendon ring was used by the engineers in the capsule to neutralize explosive devices, replacing, of course, the tendons with metal plates. The force of the explosion is extinguished in this structure, without causing harm to others.

Despite the enormous resistance of the intervertebral disc to intradiscal pressure, provided by nature, over time, in the presence of a functional blockade, cracks gradually appear in the tendon ring, which are called osteochondrosis of the spine in everyday life. Fissures of the tendon ring cause local pain - in the neck, lower back, thoracic spine. Sometimes there may be a "lumbago" - the inability to turn the head or some part of the body to the side. In the special literature, this is called cervicalgia, lumbodynia, dorsalgia, arising against the background of osteochondrosis of the spine.

In the future, the contents of the intervertebral disc gradually penetrate into the cracks. This is accompanied by an inflammatory reaction, and small (1-2 mm) protrusions are formed (at the initial stage, most often from behind), which irritate the posterior longitudinal ligament. There is pain radiating to the leg or arm. The pain can be aching, bursting, but most often of a shooting character with a certain position of the body.

The pain resulting from protrusions of the disc radiating to the arm or leg occurs when the intervertebral disc is destroyed by 2/3, and is a complication of osteochondrosis of the spine.

"Pain is the watchdog of health." Like an SOS from a sinking ship: take action, take action! But a person does not accept them, hoping that he will pass, continues to engage in physical labor and physical education. To relieve pain, he will still go to the bathhouse to take a steam bath, not knowing that the mechanism of clinical manifestations of complications of osteochondrosis of the spine is vascular.

There are no venous valves in the veins of the spine. Where there is a restriction of functional mobility, stagnation of venous blood instantly occurs, therefore, any influx of arterial blood will lead to an exacerbation of the disease. During this period, thermal, electrical procedures, massage, even local rubbing are contraindicated.

And the exacerbation of the disease leads to an increase in the hernial protrusion up to 4-5 mm, sometimes more, the edema of the surrounding tissue increases like an avalanche, a nerve or vessel is compressed, a sharp unbearable pain occurs with irradiation to the arm or leg. The intensity of the pain is such that it seems to the patient that the nerve has been placed on an anvil and is beaten with a hammer. Such pain is very difficult to stop with medication, the patient is exhausted physically and psychologically. Absolute helplessness in everyday life (it is impossible not only to get out of bed on your own, but also to turn in bed), increased pain with any awkward movement and sleepless nights - all this leads to hospitalization, and in order to get rid of this, a person agrees to surgery.

With the defeat of the root between the I and II sacral vertebrae, pain is given in the groin, along the back or inner surface of the thigh into the popliteal fossa, intensified when the body is tilted to the painful side, forward or backward. Feeling may reveal soreness of the iliac crest and inguinal ligament on the affected side. There is a tension in the muscles of the thigh from the inside with corresponding symptoms.

In order to suspect a hernial protrusion in the lumbar spine, you need to know its characteristic signs. Typical signs are pain with irradiation along the "stripe".

With the defeat of the root between the V lumbar and I sacral vertebrae, pain from the lower back and buttocks radiate along the outer-posterior edge of the thigh, the outer edge of the leg to the outer edge of the foot and little finger. It is difficult for the patient to stand on the toe of the sore leg. Sensory disturbances are manifested in the form of numbness, increased or decreased sensitivity in the described area. Hypotension and a decrease in muscle strength in the triceps muscle of the lower leg, flexors of the toes can be determined.

With the defeat of the root between the IV and V lumbar vertebrae, pain is given from the lower back to the buttock, along the outer edge of the thigh, the antero-outer surface of the lower leg to the inner edge of the foot and big toe. It is difficult for the patient to stand on the heel with the foot extended. There may be a decrease in muscle strength and hypotension of the tibialis anterior muscle, extensor longus of the big toe.

The defeat of the root between the III and IV lumbar vertebrae is less common than other lumbar roots. The pains are usually not so sharp, but with a tinge of burning, bursting and radiating along the inner-front parts of the thigh to the knee and below, not extending to the very foot. The pain can be associated with the tension of the root as a result of compression of the adjacent root. Weakness and hypotension in the quadriceps femoris may occur.

Radicular syndromes in herniated intervertebral discs are listed in Table 1.

Surgical methods of treating discogenic disease have become widespread both in our country and abroad. The operation seemed justified in any case, since the disease is based on an intervertebral hernia, which is removed, resolving the "discoradicular conflict".

However, according to the literature, scientists who studied the immediate and long-term consequences of surgery for intervertebral hernias: the lumbar spine, register pain syndrome after surgery in 72.9% of cases.

Among the reasons for the disability of neurological patients in Belarus, lumbosacral radiculitis ranks second, and specific gravity disability group II reaches 40%.

The most common disc in the lumbar spine squeezes the root in the spinal canal at the hardest lining of the spinal cord, in the middle. An exception is the disc, where, due to the narrowing of the posterior longitudinal ligament and the presence of free space on the sides of it, posterolateral hernias are more often observed.

The clinical picture of the disease with a median hernia of the spine is characterized by the fact that the patient cannot bend back, and in bed takes a position with the raised head end of the body and the lower limbs bent at the knee and hip joints. When walking, the patient's torso is tilted forward, sometimes up to 90 °.

The clinical picture of the disease with a posterolateral hernia in the lumbar spine is characterized by the fact that the patient has a sharp pain when trying to tilt the body forward. In bed, the pain is often reduced in the position of the patient on his stomach. When walking, the patient tilts the body to the side, sometimes up to 45 °.

Do not rush to be operated on! In our Center for Manual Therapy, methods of non-surgical treatment have been developed. More than 60,000 such critically ill patients have been successfully treated. With the help of certain therapeutic movements (manipulations) according to the scheme developed by us, we reduce the pain syndrome, gradually restore the volume of active and passive movements.

Over time (2-6 years), the disc is completely destroyed, replaced first by cartilage, and then by connective tissue. Two vertebrae grow together, the overlying sections take over the functions of movement, a person can again run and jump.

Nature has provided for the healing process– sanogenesis! And your task – create conditions for the body in which it will be able to heal itself in the shortest possible time.

During pregnancy, the entire body of a woman is under severe stress. This also applies to the spine, because not only the fetus, but also the internal organs exerts pressure on it. It has been proven that over time, the female spine adapts to increased stress. However, very often the woman herself feels severe discomfort and pain, especially in the lumbar region.

Features of the spine in women during pregnancy

Due to the fact that the female spine during pregnancy adapts to additional loads, the back muscles do not get tired so quickly, and the likelihood of getting a back injury decreases. The changes themselves do not affect the entire spine, but only a few vertebrae of the lumbar spine, which experience the greatest stress, especially when a woman leans back. The size of these components of the spinal column is much larger than that of men. The shape of the vertebrae is such that when moving to other parts of the spine, they narrow and form a wedge-shaped structure of the vertebral region. Women have three vertebrae that have this shape, while men only have two. When joined together, these vertebrae form a natural arch that reduces the shear stress that occurs during pregnancy.

The reasons why there are pains in the spine during pregnancy and in the postpartum period

As mentioned above, during pregnancy, the spine is exposed to strong mechanical and hormonal loads. The fetus, the place where it is located and the amniotic fluid, which is in front of the spine, increase the body weight of the expectant mother from 10 to 20 kilograms. As a result, the pregnant woman leans back slightly to maintain balance. This position of the body is not very favorable for the intervertebral discs, joints and vertebrae.

During pregnancy, various hormonal changes occur in a woman's body, during which some skeletal ligaments and joints soften. In order for the baby to pass through the pelvic bones during childbirth, the ligaments and joints between the pubic bones soften. In the prenatal period, such changes lead to an increase in the mobility of the sacroiliac joints, which leads to pain in this area. The lumbosacral ligaments are also subject to hormonal changes. In combination with additional weight, this leads to painful sensations.

According to statistics, up to 50% of women experience pain in the lower back, in the pelvic area and in the spine. There are several reasons for the appearance of such pain:

The spine adapts to the stress: the center of gravity of the body mixes, the muscles experience additional stress and the spine changes its curves - the back bends back, and the stomach bulges forward.
During pregnancy, the hormone relaxin is produced, which acts on the hip-sacral joints, relaxes them and makes them more elastic. Also, this hormone makes the pelvic bones mobile. Such changes lead to a shift in balance, and this entails the appearance of discomfort in the lumbar region.
During pregnancy, progesterone is also produced intensively, which improves blood circulation. A large blood flow to the vessels leads to a slight swelling of the roots of the spinal canal of the spinal cord, which also causes pain in the spine.
Part of the nutrients from the body of the expectant mother goes to the baby. Therefore, in the body of a pregnant woman there is a lack of certain substances that are responsible for the normal functioning of the musculoskeletal system. As a result, there are pains in the joints, spine, and so on.
An uncomfortable posture during work, uncomfortable shoes, and weakening of muscles can also lead to pain in the pelvis and back. Under heavy loads, sharp pains appear, which can make it difficult to extend the spine. In such cases, you need to see a doctor.
Pain can occur due to various diseases of the spine, which were before pregnancy. Pain in the pelvis and back can be symptoms of intervertebral hernia, scoliosis, osteochondrosis, and the like.
Pain may not be related to spinal problems or physical / hormonal changes. There are several reasons for such pain:

Risk of miscarriage. A pulling pain in the lumbar region may occur due to the threat of miscarriage. Sometimes this pain is accompanied by a pulling pain in the lower abdomen and frequent urination. Such symptoms can also appear after physical or psychological stress. After such symptoms, you must immediately take a sedative, lie down and relax. You also need to see a doctor.
Kidney disease. If pain in the lumbar region is accompanied by the appearance of edema, fever, increased blood pressure, headache, frequent urination in which the urine becomes cloudy, then you should immediately consult a doctor. These symptoms are common in kidney disease. Such diseases, as a rule, are treated in a hospital and have an adverse effect not only on the health of the woman, but also on the condition of the fetus. They can also lead to serious complications.
Urolithiasis is manifested by sharp, cramping and intense pain in the lumbar region. Such pains are accompanied by urination disorders and may indicate urolithiasis or renal colic. The stone, passing through the ureters, injures them, pain and spasms occur. Therefore, doctors prescribe pain relievers and antispasmodics. The doctor conducts a full diagnosis, prescribes treatment and a therapeutic diet.
False contractions. Sometimes lower back pain, in which a woman feels tension in the uterus, occurs with false contractions. Such contractions, as a rule, appear on later dates pregnancy. However, if the gestation period is less than 37 weeks, and the pain is accompanied by discharge from the genital tract, and the interval between contractions is shortened, this may indicate a threat of miscarriage. Therefore, a woman should immediately consult a doctor.

Prevention during pregnancy

A pregnant woman should definitely monitor her weight. Excessive weight puts stress on the spine, which leads to pain.
It is imperative to consume a sufficient amount of calcium, as well as foods rich in this element: fish, meat, dairy products, herbs.
Starting from the twentieth week, with sudden movements and heavy loads, it is recommended to wear a special bandage.
While sitting, you should not cross your legs - this leads to impaired blood circulation. It is also not recommended to sit for too long without a break.
You can't stand too long. Do not wear high-heeled shoes while walking.
You need to sleep on a firm mattress.
Do not carry out heavy loads, raise your arms high.
Stress should be avoided.
You need to eat right.

Articles by topic:

What can and cannot be done for the Annunciation What date is the Annunciation celebrated in 2019? What is the history and background of this holiday? Read about it in the article Pravda-TV. Annunciation in 2019 - April 7 The beginning of our salvation Annunciation in Orthodoxy is included in the list of twelve feasts	Basal exchange. Basic metabolism. Calorie needs determination methods 0 4078 2 years ago When considering drawing up their own meal plan for losing weight or for gaining muscle mass, people begin to count the calorie intake. Earlier we have already considered that for weight gain, you need about 10% overabundance,
International Day of Human Space Flight Purchase of the Sea Launch floating cosmodrome MOSCOW, December 15 - RIA Novosti. The outgoing year 2016 in the Russian space industry was remembered for a number of victories and a series of failures. The Soyuz carrier rocket was launched for the first time from the new Russian Vostochny cosmodrome, and the first ever collaboration was launched to Mars.	Is protein harmful for men's health: reviews Protein is good or bad Often, protein is understood as a sports supplement in the form of a powder from which cocktails are made and drunk in training, mainly by athletes to build muscle or lose weight. There is still debate about the benefits and dangers of this supplement, many are often confused

Popular

2021-07-13 05:15:39	Diet Oatmeal Cookies
2021-07-13 05:15:39	Parent's Saturday: when it comes, where to go, what to say and do
2021-07-13 05:15:39	Eating the Right Bodybuilder - The Scientific Approach to Nutrition Bodybuilding Diet
2021-07-13 05:15:39	L-glutamine: what is it, what is it for, how to take it?
2021-07-13 05:15:39	Raises the body on the bench
2021-07-13 05:15:39	Healthy dinner: what is better to eat in the evening?
2021-07-13 05:15:39	When, how and what kind of sports nutrition is best to take for gaining mass
2021-07-13 05:15:39	Training programs for girls
2021-07-13 05:15:39	Lunar calendar of manicure and pedicure by days of the week
2021-07-13 05:15:39	Nutritionist advice - where to start correct weight loss?

New

2021-07-13 05:15:39	Sports nutrition for gaining muscle mass
2021-07-13 05:15:39	How to build a beautiful abs at home
2021-07-13 05:15:39	Bodybuilding porridge Protein shakes for weight loss: features
2021-07-13 05:15:39	classification of food by groups
2021-07-13 05:15:39	Lavender - composition, useful properties, application
2021-07-13 05:15:39	Diet for weight loss, eat tasty and healthy
13.07.2021	What is the difference between protein and protein: description and differences Proteins and everything about them
02.07.2021	Red currant - benefits, harm and contraindications Red currant is useful for women
02.07.2021	The effect of beer on the female body: benefits and harms
02.07.2021	Carrots: benefits and harms to the body, useful properties of juice and boiled carrots
02.07.2021	Pros and Cons of Neck Tattoos Cons of Color Tattoos
02.07.2021	Ten foods to reduce muscle soreness and accelerate recovery from a tough workout

Spine problems. Psychological roots of problems with the spine Lesions of the thoracic spine

Steps

Back pain in the spine: epidemiological significance symptom

The reasons

Causes of back and spine pain - video

Back pain with a lesion of the spine. Major vascular syndromes and neurological disorders

The vertebral column and its departments: structure and function

The mechanism of development of vascular and neurological disorders in spinal lesions

Lesion of the spine in the cervical spine

Lesion of the thoracic spine

Pain in the lumbar spine. Lumbar syndromes

Spine pain with osteochondrosis

Spinal hernia

Spine fracture

Aching and pulling pain in the spine with spondyloarthrosis

Severe pain in the spine after sleep with ankylosing spondyloarthritis (ankylosing spondylitis-Strumpel-Pierre Marie)

Hormonal spondylopathy (climacteric, postmenopausal and senile)

Aching, pulling or boring pains in the spine with tuberculous spondylitis

Pain radiating to the spine

Pain in the chest and in the spine with pathology of the heart and great vessels. Sharp pain descending along the spine with dissecting aortic aneurysm

Severe pain in the spine and lower back with pathology of the kidneys and upper sections urinary tract

Treatment for pain in the spine. Answers to the most popular questions

What treatment may be needed for back pain? Which doctors should you go to to apply?

How to treat back pain caused by a spinal injury? When is surgical treatment necessary?

Pain appeared after spinal surgery. What to do?

What are the basic principles of conservative treatment of back pain in spinal lesions? Will exercise help with back pain?

How to relieve spinal hernia pain?

How to treat spinal pain during pregnancy?

HEALING MOVEMENT: RELAXING INSTEAD OF TENSION

SPINE BEGINS WITH LEGS

HOW TO REMOVE FATIGUE LEGS

RUNNING TO US ADD KILOGRAMS

ABOUT THE DAMAGE OF FORWARD TILES

HOW TO RIGHTLY LIFT OBJECTS OFF THE FLOOR

HOW IT IS CORRECT TO LIFT AND MOVE WEIGHT

A tragedy of ill-conception: the paralysis of a loose hand

A NIGHT WITHOUT PAIN: HOW TO WAKE UP HEALTHY

SPECIALLY DANGEROUS BODY POSITIONS IN SLEEP

CAUTION SNORING!

MORNING WITHOUT CHARGING - THE BEST RECIPE OF VIVILITY

FACTORS CAUSING DISEASES OF THE SPINE

OSTEOCHONDROSIS AND INTERVERTEBRAL DISC HERNIATIONS: OPERATIONS CAN BE AVOIDED

Back pain in the spine: epidemiological significance
symptom

Back pain with a lesion of the spine. Major vascular syndromes
and neurological disorders

Severe pain in the spine after sleep with ankylosing
spondyloarthritis (ankylosing spondylitis-Strumpel-Pierre Marie)

Aching, pulling or boring pains in the spine with tuberculous
spondylitis

Pain in the chest and in the spine with pathology of the heart and great vessels. Sharp pain
descending along the spine with dissecting aortic aneurysm

Severe pain in the spine and lower back with pathology of the kidneys and upper sections
urinary tract

What treatment may be needed for back pain? Which doctors should you go to
to apply?