Those who sit a lot: How to keep your back healthy
Intervertebral discs are located between the spinal bones. - these are cartilaginous structures that are well absorbed and make the spine flexible. In the center of each disc is a soft core, surrounded by a dense ring of fibrous - or fibrous - tissue. If this ring is damaged, the nucleus can go beyond it - this is accompanied by back pain and is called herniated intervertebral disk. We found out what to do to prevent the development of the disease and how to live with a diagnosis from experts: the neurologist of the Evidence-Based Medicine Clinic "Rassvet" Yuri Eliseyev, MD, head of the spinal neurosurgery department of the NICT Neurosurgery Center Burdenko Nikolai Konovalov and certified FPA coach Vladimir Kuksov.
Where does the hernia come from
Herniated disc may appear in the cervical or thoracic spine, but most often it occurs in the lumbar region - this department has the greatest burden. When a person is lying or standing, the pressure on the intervertebral discs is distributed evenly, but in a sitting position it is often necessary to round the loins or to bend forward much. As a result, a non-characteristic bend appears in the spinal column and the inner core of the vertebra begins to press on the fibrous ring.
If this happens too often - for example, a person sits at a computer or behind the wheel for hours every day - a hernia of the disk is gradually formed. Lifting weights with an indirect back, overweight or long high-heeled walks can have the same effect. But most often, the problem is faced by those who move a little during the day and spend a lot of time sitting, especially on the leg.
When to do an MRI
Neurologist Yuri Eliseev notes that back pain in only three to five percent of cases is associated with a herniated disc. Sometimes discomfort in this area is mistakenly called osteochondrosis, when the real reason is age-related changes in the intervertebral discs, which most people over forty years old have. But most often the discomfort in the back is the "suffering" of the muscles, joints or ligaments caused by excessive stress.
According to the doctors, it usually happens like this: the patient complains of back pain the day after a long monotonous physical work - like cleaning the snow on the site. The discomfort may become worse when bending and turning, and decrease at rest. If during the examination the doctor does not find the so-called red flags - data indicating serious pathology, he will offer a conservative therapy, including a course of painkillers and exercises physical therapy.
Magnetic resonance imaging of the lumbar spine should be done no earlier than four to six weeks of such treatment, if it does not produce results. An MRI may be preceded by regular radiography — for example, to see a displacement of the vertebrae or a fracture. If acute back pain is accompanied by loss of sensation or movement disturbance in the leg (this is called a neurological deficit), MRI is usually prescribed immediately.
Who needs surgery
According to Yuri Eliseev, the opinion that the larger the hernia, the closer the operation, erroneously. The doctor notes that a large hernia may not at all bring discomfort if it does not affect the surrounding nervous structures. Surgical treatment can be effective when conservative therapy (drugs and exercises) does not help or the benefits of the operation exceed its risks - and they exist. For example, you need to be prepared for the fact that after installing a metal structure between the vertebrae, the tasks of motion and depreciation will fall on the adjacent vertebrae and discs, which will cause them to wear out faster.
Every year, neurosurgical techniques are becoming safer, and for a serious operation it is often enough to make only a few small incisions on the skin. However, surgical treatment, appointed by mistake, will not relieve from unpleasant symptoms - pain, numbness and other discomfort. Nikolai Konovalov notes that lately, doctors have begun to prescribe less frequently. The reason is the recurrence of hernia and other unpleasant consequences; some complications after removal of a herniated disc lead to disability.
What load is useful
Therapeutic exercises, the complex of which must be chosen by the doctor, experts advise to perform from the first days of the appearance of discomfort in the back, not forgetting to drink the prescribed medications. Initially, it is necessary to perform the exercises under the supervision of a specialist in order to work out the correct technique and, if necessary, correct the complex, if the pain increases with some movements.
This load helps to strengthen the muscles that support the spine, and restore joint mobility. But peace in this case, on the contrary, will not give any improvements. When there is no pain, that is, in remission, regular physical exertion is also necessary, and almost any kind of activity - swimming, Pilates, yoga, training in the gym - but with some restrictions. For example, yoga lovers in most cases will be contraindicated asanas with overextension in the lumbar region.
According to trainer Vladimir Kuksov, an important condition during any exercise is not to give an additional axial load on the spine, to refuse from jerking movements and working with large weights, so as not to provoke hernia exacerbation. Being engaged in the gym, squats should be replaced with a bench press, visas on the crossbar - with pull-ups in the gravitron, and the classic hyperextension - the reverse (when there is no load on the lower back and buttocks are well used).
How to unload the spine
Back health depends on lifestyle. With a balanced and varied diet, body weight remains normal, and without extra weight, there is no increased load on the spine. Regular workouts are also very important - physical activity forms a strong muscular corset. Those who are in the office for hours need to remember about short breaks - just warm up a little, walk along the corridor, or just get up and stand for a couple of minutes.
If you do not get rid of the habit of sitting on your feet and slouching with the help of willpower, you should decide on an experiment: replace your office chair with a special corrector chair. It differs from the usual one in that when sitting the pelvis is not pushed forward, and the ischial tubercles are in the same plane with the spine. In such a chair it is impossible to sit back and relax. You have to keep your back flat all the time - and it doesn't numb.
Photo:Andrey Bandurenko - stock.adobe.com, Kalim - stock.adobe.com
