Exercises for protrusions of the thoracic spine: indications and contraindications, selection of exercises

Protrusion of intervertebral discs is a physiological pathology consisting in bulging of the disc without compromising the integrity of the fibrous ring. Often occurs against the background of osteochondrosis. A healthy ring does not extend beyond the boundaries of the disc, but as this disease develops, it begins to bulge. Treatment of protrusion must begin immediately after detection. According to statistics, I diagnose it more often than a hernia.

Localization of the disease is the lumbar, cervical and thoracic regions. That is, the most mobile parts of the spine. Without treatment, the protrusion develops into a hernia, which can interfere with quality of life and seriously reduce a person's ability to work.

Prevalence of the disease

Statistics show that protrusion is a fairly common disease, especially in people over thirty years of age. Half of the documented evidence of the disease is that the most common type of protrusion is localized in the lower back. It occurs less often in the thoracic region. It is extremely rarely diagnosed in the cervical region.

Often, hernias develop from protrusions of intervertebral discs, for this reason it is necessary to undergo timely examinations and monitor your health.

Causes

Protrusion does not develop out of nowhere; first of all, stable morphological and pathological changes in the column occur, which can last up to several years. Other deformities of the spine and intervertebral discs lead to protrusion.

The disc consists of a fibrous ring and its immediate center, the nucleus pulposus. The core surrounded by a ring is protected. However, under the influence of various circumstances, the tissue of the ring can be damaged and suffer from micro-tears. This gives rise to the development of the disease.

Then the following happens: the vertebrae put pressure on the core, so it, avoiding this pressure, begins to slowly shift into the newly formed micro-tears. The center begins to produce additional resistance to the periphery, which subsequently leads to protrusion of the intervertebral disc. Treatment for bulging discs involves pushing the annulus fibrosus back into place before it ruptures.

What factors cause disc protrusion?

Most often, the key cause of the disease is osteochondrosis. The appearance and progression of the disease also contribute to:

• Physical inactivity, prolonged stay in one position (drivers, office workers, etc.);
• Violation of metabolic processes;
• Increased loads on the spinal column associated with sports activities or heavy physical labor;
• Weakness of the muscle corset;
• Spinal injury;
• Overweight;
• Pathological change in the configuration of the spine;
• Disorders associated with aging of the body;
• Wrong diet.

Symptoms

The pathology develops and lasts for a long time due to the influence of provoking factors and risk factors, sometimes it can last for decades. For this reason, at first the patient may not notice the disease.

The protrusion forms and progresses without any obvious symptoms. Since people do not know about the pathology, they do not seek treatment. And the ring begins to protrude more and more until it ruptures and forms a hernia. But what is happening still has a clinical manifestation. Among the characteristic symptoms are the following:

• numbness of the limbs;
• tension in the spine;
• headache;
• discomfort in the spine;
• sleep problems;
• fast fatiguability;
• chronic pain in the spine;
• chilliness of the limbs;
• movements are limited.

These signs must be carefully monitored in order to begin treatment on time. If you notice that new symptoms have appeared or old ones have begun to develop in strength, do not delay in contacting a doctor.

Degree of progression of protrusion

Conventionally, the degree of neglect of the disease can be conditionally attributed to one of three stages. Depending on how long the disease has progressed, treatment and rehabilitation are prescribed. Let's look at each of the stages.

First stage

At this stage, the fibrous ring, which is the shock absorption of the spine, begins to suffer from disturbances in its structure: cracks may form, the shape of the core may change, and so on. Patients with mild protrusion can be treated quickly and without further consequences.

Second phase

After this, the ring continues to deform. The core begins to protrude to a distance of approximately 3-4 millimeters. This leads to pressure on blood vessels and nerve endings that lie nearby. Patients at the second stage complain of lumbago in the spine and developing pain in the area where the ring was deformed.

Third stage

If the protrusion is not treated, the disease will move to the next stage. The ring begins to protrude to a distance of at least 5 millimeters, which leads to rupture of the core. The patient develops a hernia as a result.

Possible consequences

And although at first glance the disease seems imperceptible and harmless due to its mild onset and virtually asymptomatic nature, it can still cause truly terrible consequences after itself. Among them are lower back pain, disability, paralysis of the lower extremities, serious disorders of the pelvic organs (for example, the development of incontinence), and the appearance of disability. Therefore, it is so important to start treatment of disc protrusions on time.

The main danger of this pathology lies in the possibility of progression to large sizes and the formation of a hernia in the future. A small deformity will not cause discomfort, but already developed protrusion and hernia lead to the following problems:

• chronic and severe pain;
• chronic and severe pain;
• blood vessels and nerve endings are compressed in the sleeve or hole.

Kinds

Depending on the location of the protrusion, three types of protrusion are distinguished. They are most often formed in one of three sections - cervical, thoracic, lumbar. This happens because these segments of the spine are characterized by the greatest mobility.

Cervical protrusion

Despite the rarity of the formation of protrusions in the cervical spine, we must not forget about the possibility of its occurrence in you. First of all, you need to pay attention to localized pain in the neck and shoulder area. The pain in this place is usually aching and sharp. As the disease progresses, the pain begins to increase. In addition, your hands may also begin to suffer.

Often, cervical protrusion leads to numbness, tingling of the skin, a noticeable loss of sensitivity of the skin, muscle weakness, “jumping” blood pressure, problems with coordination and dizziness.

The cervical region is where the brain begins and where the main blood vessels are located that provide blood flow to the brain. Therefore, deformation of the rings in this segment can lead to really serious health problems. The first signs of this are high fatigue. The neck often begins to become numb when sitting for a long time, it is uncomfortable to lie in bed (the pillow seems uncomfortable), the head is held only with great tension in the neck. These signs should alert you, after which you should immediately consult a doctor.

There are seven vertebrae in the cervical region, separated by IVDs. The main difference between this segment of the spine and others is mobility, high mobility thanks to the discs. Therefore, neck movements are easy for us, and the head is kept quite stable without additional problems in a healthy state.

Excessive mobility can lead to wear of the intervertebral discs and the appearance of a bulge. And this leads to pinching of nerve endings, roots, and also the spinal cord.

Another factor that makes cervical protrusion the most dangerous is the severity of detection without examination. Unfortunately, it is often discovered only after the ring has ruptured. During the progression of the disease, myelopathy, one of the types of chronic damage to the spinal cord, may develop. The syndrome is characterized by an irritating effect.

The main consequences of the pathology: hearing loss, loss of vision. Reflexes may disappear, and patients suffer from invincible muscle weakness. In the worst cases, paralysis of the entire body is possible.

Thoracic protrusion

It is rare to see protrusion of the intervertebral disc in this region. This is due to the relatively low mobility of the chest and spine in this segment. But they can still form. Why is this happening?

This can occur with general pain in the spine or incorrect diagnosis of a heart attack (the symptoms are quite similar). The disease most often manifests itself in the form of neuralgia in the intercostal space with varying strength. Pain is accompanied by muscle weakness and noticeable stiffness in the chest and back.

Not only pain can become an important signal about the development of thoracic protrusion: thus, another flag should be discomfort that appears when sitting or standing. Also, an eternal, persistent feeling of fatigue in the back muscles, a negative effect on the spine in the form of irritation of local places. Unpleasant sensations in the thoracic region. The body uses these signals to tell you that the IVD is in poor condition.

Let's highlight the main symptoms of the development of pathology, which indicate the need for treatment of spinal protrusion in the thoracic region. You should never give them little importance, everything is important. So the list is like this:

• the middle of the back suffers from constant pain;
• numbness and lumbago appear in the chest and abdomen;
• intercostal pain;
• the tone of the abdominal muscles noticeably decreases;
• stiffness in the back.

This variant of the pathology becomes dangerous for the internal organs of the body. First of all, the kidneys and liver come under fire, which can lead to permanent diseases, pathologies and problems with the gastrointestinal tract. The pain can become chronic and intense.

Lumbar protrusion

The most defenseless section of the spine, which is most often susceptible to protrusion formations, is the lumbar and lumbosacral sections. This occurs due to the large number of loads on this area, the greatest amplitude in movements and mobility. With age, protrusions can only get worse. Intervertebral discs noticeably wear out over time, especially under the influence of provoking factors. In this case, the characteristic features are pain in this region, which spreads to the lower limbs and significantly complicates coordination, up to the loss of the ability to move the legs.

There are other markers that need to be considered for the possible formation of a bulge. This is tension and aching pain in the lumbar region before going to bed (the syndrome is relieved by lying down), lack of comfort in a sitting position. It is difficult for patients to spend at least a few minutes without changing their position; sitting without leaning on the back of a chair becomes difficult. These and other signs indicate deeply developed protrusions that need to be treated urgently. Don't delay this, especially if you have the following symptoms:

• pain in the central part of the lower back, which spreads horizontally and covers the entire lower part of the torso;
• there is noticeable stiffness in the affected area;
• radiculitis develops;
• the muscle frame in the legs noticeably weakens, especially in the thighs and calves;
• constant feeling of numbness in the toes;
• tingling feet;
• from time to time the process of urination is disrupted, the body’s false urge to urinate appears;
• leg reflexes noticeably decrease and disappear;
• the body is difficult to rotate along the vertical axis;
• when sitting, the lower back suffers from severe pain;
• the body reacts sharply to changing weather conditions.

In the future, lack of treatment leads to paralysis of the lower limbs. Don't delay going to the doctor.

Treatment of protrusion of the lumbar spine

Drug treatment

• Over-the-counter analgesics - Intended for mild to moderate pain.
• Anti-inflammatory medications - Designed to reduce nerve root inflammation caused by irritation and impingement (aspirin, ibuprofen (Motrin, Advil), and naproxen (Aleve).

Prescription analgesics

• Tramal - prescribed for persistent pain syndrome.
• Opiates—recommended when other medications do not relieve pain.
• Opioids are useful in the treatment of chronic intense pain.

Muscle relaxants

• Mechanism of action: Stimulates Locus Ceruele in the brain stem. Muscle relaxants stimulate the ceruleus locus and cause an increase in the release of norepinephrine in the spinal cord. Norepinephrine inhibits alpha motor neuron and leads to decreased spasm in skeletal muscles.
• Most Commonly Used Muscle Relaxers
  Cyclobenzaprine (Flexeril)

  Soma

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  Skelaxin

  Robaxin

Antidepressants

• Effective as an analgesic in the treatment of chronic neuropathic pain.
• Prescribed as an analgesic in cases where taking other painkillers (NSAIDs, tramadol or opioids) causes severe side effects.
• For neuropathic pain associated with depression, it is used as an analgesic and antidepressant.
• Most commonly prescribed antidepressants
• Duloxetine
• Milnacipran
• Tricyclic antidepressants (Elavil)

Sedatives

• Sedatives (such as benzodiazepines) are prescribed to reduce anxiety caused by pain. In addition, they help to reduce muscle spasms to some extent and normalize sleep.

Antiepileptic drugs

• The analgesic effect of these drugs is used in the treatment of chronic neuropathic pain.
• Prescribed as an analgesic when taking NSAIDs, tramadol or opioids is associated with severe side effects.

The most commonly prescribed antiepileptics for the treatment of pain are:

• Gabapentin (Neurontin).
• Pregabalin (Lyrica).

Interventional Pain Treatments

• Translaminar epidural injection of corticosteroids. An epidural injection of corticosteroids helps reduce inflammation of the disc and nerve root.
• Caudal Corticosteroid Injection—Caudal epidural injection is an alternative method of administering corticosteroids into the epidural space.
• Trans-foraminal epidural injection is a targeted injection of cortisone into the area of ​​root compression due to disc protrusion.

Diagnostics

The main obstacle and problem in diagnosing and treating spinal protrusion is the weak manifestation of the disease at the clinical level in the early stages of development. Often the patient notices the problem and seeks help already at the third stage, when the ring breaks and the formation of a hernia begins.

People who are suspected of having bulging intervertebral discs are prescribed a variety of diagnostic tests by various specialized doctors. In addition, the patient undergoes a number of additional measures to more accurately determine the disease:

1. A life history is collected, which is needed to determine why the protrusion formed and the pain began to intensify;
2. Inspection and further palpation of the spine (column), making it clear about the tension of the nerve roots and the position that brings more pain. At this stage, it is possible to notice low reflexes, weakness in the muscles, decreased skin sensitivity, which indicates progressive protrusion;
3. An X-ray image that provides a huge amount of information about the condition of the spinal column: structural features of the vertebrae and discs, the distance between them, pathologies, signs of osteochondrosis, sustained injuries, the level of neglect of the disease;
4. MRI of the spine, which makes it possible at the first stage of the disease to determine whether a person is more protrusive, as well as provide information about the size and strength of compression of the roots and tissues.

The patient is also required to undergo examination for impaired functionality and efficiency of the spinal roots and other neurological problems.

During diagnosis, it is important to distinguish the disease from osteochondrosis, radiculitis, myositis (they all have similar external symptoms with protrusion of the vertebral discs). In the thoracic region, gastritis, pancreatitis and angina must also be excluded.

Exercises with a fitness ball

Fitness is another opportunity to restore modified spinal discs. However, it should be used, like other physical activities, only after the approval of the attending physician. Training always begins under the guidance of an experienced trainer. Then, when the patient receives the necessary experience and knowledge about the complex performed correctly, they can be “transferred” to home conditions.

Massage will have a positive effect on the overall tone of muscle tissue during lumbar protrusion. It is performed immediately before training.

We list the most popular and simple exercises with a ball that will help restore spinal discs.

• №1

Stand up straight, holding the ball in both hands. Spread your elbows wide and begin to roll the ball so that your right and left hand are alternately at the top.

• №2

Sit on the ball. Begin to slowly bend forward and backward, as if you were doing abs. Your hands can be placed on your belt or placed on your knees. After a few sessions, to increase the load, they are placed behind the head.

• №3

Lie down on a fitball (that's what a big ball is called) and start rolling on it right and left, forward and backward. They “roll” on their backs and stomachs until the first signs of fatigue appear.

• №4

Place the ball against the wall, resting your lower back on it. While in this position, roll it left and right, up and down.

Such simple movements help stretch the spine, increase blood flow and enhance metabolic processes. A well-chosen set of exercises together with drug treatment will help eliminate pain and discomfort in the spine, as well as return the spinal discs to their correct shape. Only advanced stages of pathology will not “retreat” to exercise therapy and will require surgical intervention.

Treatment

To begin with, the patient is subjected to a comprehensive examination and diagnosis of the root cause of the complaints. If a protrusion has been identified, the specialist develops a course of treatment adjusted for the characteristics of the patient’s body, the location of the pathology and its size. The most optimal option for removing a victim from protrusion is a set of measures that will prevent the nucleus pulposus from being further injured and reduce the overall pressure in the painful segment. The following specialists provide treatment:

• Physiotherapy doctor (in private situations);
• Traumatologist;
• Surgeon (in worst situations);
• Orthopedist;
• Neurologist.

Fortunately, intervertebral discs are able to return to a healthy state on their own, but to do this they need help. In this regard, the main task of treatment is to launch this mechanism, allowing the body to restore everything on its own. The methods and courses that have now been developed make it possible to stop the development of protrusion and relieve chronic pain.

The main direction in treatment is the use of non-steroidal medications. The prescribed medications help not only reduce pain, but also stop the inflammation process and help return the cartilage to its previous state. The main disadvantage of this direction is the steady development of side effects with long-term use of medications.

Other main areas of treatment are conservative treatment and surgery.

Conservative

To solve the problem of protrusion it is not necessary to go under the knife. This direction represents special measures that eliminate excess load from the disk. First of all, it is necessary to stretch the spinal region and securely fix it. This also includes a medicinal method of treatment, as it helps relieve pain, reduce swelling and inflammation of tissues.

The main advantage and advantage of conservative treatment of disc protrusion is noticeable results in a fairly short time. Patients stop complaining of pain.

The approach itself can be noted as a disadvantage. It treats the symptoms, not the root cause, which can ultimately lead to a relapse. To prolong the effect, it is necessary to be treated for a long time according to the prescribed course.

Operational

The essence of the method is surgical intervention. In fact, he is approached quite rarely; a decision to operate on protrusions requires really compelling reasons. These include:

• The protrusion is too large, it is no longer possible to pull;
• Other methods do not provide improvement for a long time;
• The location and/or size of the protrusion threatens the life of the patient and can cause irreparable harm to health.

Other situations are not considered convincing enough for the surgeon to intervene. Moreover, this method cannot deal with the cause of protrusion, only with the consequences of the course of the disease. There is a certain risk of a new protrusion forming in the future after surgery. But the percentage is lower than with surgery for intervertebral hernia.

Advantages of the clinic

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

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

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

Rehabilitation

After a course of treatment for protrusion, it is important to undergo rehabilitation. This will not only help you get yourself in order, but also prevent the protrusion from forming again in the future.

It is important to give more rest to the affected area of ​​the spine and not to disturb it again. Try to pay more attention to your posture, engage in therapeutic physical training, and eat right. It is important to gradually end the course of medication, otherwise the disc will quickly return to its original position before treatment.

In addition to the classic methods of withdrawing from treatment, there are others that are beginning to gain increasing popularity. Thus, among many others, one can note the effective treatment complex of Professor Kozyavkin. He uses a precise and effective technique for treating SINR, which, among other things, allows for rehabilitation after treatment of protrusion. The abbreviation stands for “Intensive Neurophysiological Rehabilitation System.”

The foundation of this popular treatment system is the idea of ​​​​using various methods of influencing the patient. The main component is correction of a biomechanical nature, which is skillfully combined with therapeutic and rhythmic gymnastics, massage, apitherapy, mechanotherapy and reflexology.

Exercises

Gymnastics are prescribed by the specialist involved in your treatment, based on the results of MRI and other studies of the patient’s body. Physical activity will help to “set” the disc and give the body the necessary physical activity. But you should understand that this method of treatment is not suitable for every person. There are a number of people for whom exercise therapy can only harm. For example, you should not exercise if the pain gets worse in the affected area. It is also prohibited to exercise in the following cases:

• heart diseases;
• inflammatory processes;
• infections;
• opened internal bleeding.

Other cases do not prohibit physical therapy. But it is important to take into account the age of the patient, the location of the protrusion and the severity of the pathology before drawing up the program.

Localization determines the list of exercises, since each affected department has its own exercises. However, their goal is the same - to remove displacement, stretch the vertebrae, improve blood flow and increase physical activity. All this can have a positive effect on the patient.

Before starting class, choose comfortable clothes. You should also not forget about sports shoes: without them, gymnastics can only harm an already sore spine. To choose the right shoes, make sure that the sole is textured, thick, elastic and cushioned.

You don’t need any special equipment for practicing, just a chair and a mat (in case you are sliding on the floor). The main thing to remember is that exercise should not cause discomfort. Otherwise, you are doing something wrong and may make your situation worse.

Warm up before you start. Without warming up, you can injure unprepared muscles; this is as important a part of the lesson as the exercises themselves.

1. For people with protrusion not in the cervical region, you can tilt your head to the sides and back and forth five times;
2. Next, carefully rotate your wrists, elbows, and shoulders five times;
3. Stand on your toes and lower yourself several times in a row;
4. Stand on your toes and lower yourself several times in a row;

To improve the quality of your workout, you can take a hot shower before starting the class, which will better warm up your muscles.

Contraindications

Please note that in some cases, gymnastics for protrusion of the lumbar spine can provoke the opposite effect and cause harm to the body. Contraindications to performing the exercises are as follows:

• elevated body temperature (more than 37);
• feverish condition;
• mental disorders;
• infectious diseases;
• high blood pressure.

Prevention

The main task of prevention in this case is to develop and maintain healthy muscle tone and their strength value. In the future, this will reduce the risk of complications and further development of osteochondrosis, protrusions, intervertebral hernia, as well as permanently consolidate the results of treatment. The list of preventive measures includes the following measures:

• From early childhood it is necessary to develop correct, healthy posture, and also maintain it in later life;
• Eliminate non-physiological loads on the spinal region from your life;
• Getting rid of bad habits and abstaining from them;
• Proper nutrition, taking into account the characteristics of the body;
• Regularity of sports exercises with a selected load and alternation with unloading.

And although this list is aimed at preventing protrusions, compliance with it will also help improve the quality of life in general. An organism that receives the required amount of nutrients, training and stress copes better with diseases and is less subject to degeneration and deformation. In a situation with bulging intervertebral discs, it is true that it is easier to prevent them than to cure them.

Sports activities useful for protrusions

For protrusions, sports are recommended that strengthen the back muscles, stimulate blood flow, reduce the load on damaged cartilage and eliminate muscle spasms. Water helps relax the back muscles and intervertebral cartilage, strengthening the muscle corset. A fitball is used as a simulator - a special ball available in sports stores.

Sometimes the question arises: is it possible to run with protrusion? The answer to this lies in moderation and clothing: sneakers with soft orthopedic soles reduce the load on the spine. In general, protrusions are a disease in which the following sports will be useful:

• water aerobics;
• Pilates;
• yoga;
• swimming;
• a set of exercises aimed at developing the muscles of the buttocks, flexion activity of the legs, as well as straightening the back;
• exercises on the horizontal bar and push-ups, but not in the stage of exacerbation of protrusion;
• easy running.

It must be remembered that all types of sports activities are allowed conditionally, the final recommendation is up to the physiotherapist. As a rule, classes are conducted under his leadership.

The first protrusion workouts should not last longer than a few minutes. Each sport decides the issue of restrictions individually. Thus, water sports are contraindicated immediately after eating; the water should be warm. Postures with back twisting are excluded from yoga classes. Strong deflections, loads on the shoulders, and rocking movements are also not recommended. Therefore, for example, in fitness there are a number of restrictions on protrusion, but in general it is recommended. Whether a corset is needed for protrusion training is determined by the nature of the device and the manufacturer’s recommendations. Corsets with rigid fixation are usually worn after classes.