Vertebral displacement (spondylolisthesis)

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Vertebral displacement (spondylolisthesis) is a displacement of a vertebral body relative to another with a deviation of the spinal axis. This disorder occurs quite often in middle-aged and elderly people. When displaced, irritation of the nerve roots occurs, which causes back pain and stiffness. Spondylolisthesis varies according to the vectors of vertebral displacement. When the displacement is directed backwards, it is retrolisthesis; if the vertebra moves forward, it is vetrolisthesis. There are also more complex deformation changes in the spinal column. Late diagnosis and delayed treatment of the disease leads to serious consequences.

In colloquial speech you can hear: “displacement of vertebral discs”, “displacement of spinal discs”, “a disc has slipped out in the spine”, “a disc has popped out in the spine or back”, “displacement of intervertebral discs” and other options. All of them are not correct. Only the vertebrae can move.

Why does vertebral displacement occur?

Factors that provoke displacement can be: spinal injuries, heavy physical activity, unsuccessful and sudden turns of the body. In all these situations, the pressure on the intervertebral discs increases significantly. As a result, the spinal canal narrows and the nerve endings are compressed. Most often, displacement occurs in the lumbar spine.

In adolescents, vertebral displacement is possible due to weakness of the back muscles. This is due to the rapid growth of bone tissue and weakness of muscle development in the lumbar region, as well as a lack of general physical development. In old age, the disease is a consequence of age-related degenerative changes (osteochondrosis).

Common reasons:

physical exercise
congenital disorders of the spine
static voltage
spinal injuries
complications of osteochondrosis
curvature of the spine
arthrosis
muscle weakness
malignant neoplasms

How does a manual therapy session work?

The process of conducting a session may differ slightly depending on various factors, but in general the sequence of manipulations is performed according to the general scheme.

First, the doctor must warn the patient about the features of the procedure and possible pain, after which the latter lies down on the couch and the chiropractor examines the problem areas with his hands. The patient should relax, breathe evenly and calmly.

It is advisable to bring x-rays or the results of other examinations to an appointment with a specialist, but an experienced doctor can use his hands to determine the condition of the spine, ligaments and muscles and identify places where there are tension or inflammation. This is the diagnostic stage of therapy.

The actual treatment procedures begin with a light massage, which is necessary for relaxation. Gradually, the intensity of the effect increases, becomes stronger, the doctor realigns the vertebrae, pressing on them, and turns the patient’s neck. At this stage, unpleasant sensations are likely; a characteristic crunching sound is often heard, which is considered normal. After this, in most cases, relief occurs, the pain subsides or decreases.

The duration of treatment and the number of sessions are determined individually, as well as their frequency. In most cases, twice a week is enough. Sometimes procedures can be performed daily, but only if the patient can easily tolerate the impact on the spine.

Manual therapy is often accompanied by pain, which gradually decreases over the course of the course. Usually the pain is short-lived, but if it is so severe that it is difficult to bear, the patient should inform the doctor.

Physiotherapy is often prescribed along with a course of manual therapy, since the combined use of these methods increases the effectiveness of treatment and gives excellent results.

After completing the session, the body needs rest. The patient should follow the doctor's recommendations, possibly reduce physical activity, avoid tilting the head, sudden movements and turns in the cervical spine. In some cases, the spine is fixed with a special corset.

One to two hours after the procedure, discomfort often occurs. This is due to the fact that the body is recovering, and the muscles and ligaments are in the correct position. In order to relieve pain, it is permissible to take a painkiller.

The price of manual therapy of the cervical spine depends on the qualifications of the specialist. A course of procedures will help with neck and back problems.

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Myostimulation of body muscles

Degrees of displacement

1st degree - displacement area less than 25%

2nd degree - displacement up to 50%

3rd degree - from 50 to 75%

4th degree - over 75%

5th degree - complete displacement without contact of surfaces and with prolapse of the vertebra

1. Pain appears in the lumbar region, usually worsening when bending over and sitting for long periods of time.

2. The nature of the pain intensifies with active movements and becomes permanent. There is a more pronounced displacement of the fifth vertebra.

3. The body shortens and sinks into the pelvis. Movement in the lumbar region is limited.

4. The chest and stomach are pulled forward, the gait changes.

Complications after manual therapy

It is important to conduct a thorough examination before the first session so that the doctor knows about all the patient’s diseases that can cause:

Hypermobility of the spine as a result of abnormally mobile ligaments.
Bleeding.
Spinal fracture.
Ligament rupture.

Sometimes complications can occur in patients who have no contraindications. If during a session a person experiences very severe pain, unbearable discomfort, and after the procedure the discomfort does not subside and it is impossible to get up, then this should definitely be discussed with a doctor or refuse his services. These symptoms indicate a risk of complications.

The likelihood of side effects among patients is assessed through surveys. According to the results of the study after the session, 15% felt dizzy, 5% experienced spinal hypermobility, 22% experienced increased pain, and 7% experienced progressive disease.

The decision to choose manual therapy for treatment is made by the patient himself, having weighed all the pros and cons, having become familiar with the possible risks and side effects.

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Stages and symptoms of spondylolisthesis:

1. In the initial period, the disease often occurs without symptoms and can only be detected on an x-ray. Pain syndrome occurs periodically - with a sudden change in body position or physical activity.

2. In the second stage, the pain is longer lasting and occurs immediately after physical activity.

3. During the third stage, the malaise is pronounced. There is noticeable stiffness when moving, severe pain, numbness, and possible disorders of the genitourinary system. The intervertebral discs become thinner, the spine begins to sag, and pinching of the nerve roots may occur.

4. At the fourth stage, the disease makes irreversible changes to the structure of the spine. Severe muscle weakness appears, gait changes, there is no possibility of independent movement over long distances, numbness appears in the lower extremities, severe chronic pain in the lower back, and convulsions occur. If left untreated, the disease progresses rapidly and a person may become disabled.

The exact diagnosis is determined by the doctor based on MRI or x-ray data taken in two projections and the patient’s complaints.

Spondylolisthesis responds well to complex conservative treatment at the initial stage. It necessarily includes exercises to strengthen muscles and create a muscular corset for the spine, as well as drug therapy to restore the elasticity of cartilage tissue.

What is manual therapy and how does it differ from massage?

Manual therapy affects the human body - muscles, joints, bone and ligamentous tissues and internal organs. This technique is minimally invasive, and its effects are based on a variety of manual techniques.

Manual therapy of the cervical spine is suitable for men and women of any age, as well as for children. The history of this technique goes back several centuries. In this field, over the past 150 years, new techniques have been developed that can be used individually and in combination with each other.

Manual therapy helps patients with various symptoms and diagnoses, such as osteochondrosis, arthritis, VSD, headaches, protrusions, poor posture, hernias, gastrointestinal diseases and others.

Not all people understand the difference between this technology and massage. But in reality, there are fundamental differences between them both in the qualifications of the specialist and in the power of influence.

Massage affects only soft tissues (muscles and skin), which eliminates muscle spasms, increases their tone, improves blood circulation and blood supply to tissues.

The difference between a massage therapist and a chiropractor is their qualifications. For the first one, medical education is not mandatory; he undergoes training in special courses.

A chiropractor always has a medical diploma, so he can work on both bones and joints, which a massage therapist absolutely cannot do.

The method under consideration includes non-drug methods for diagnosing and treating radiculitis, osteochondrosis, herniated discs and other spinal diseases. To practice manual therapy, a certified neurologist or orthopedist is trained in this technology through professional retraining courses.

At the doctor's appointment, the patient's medical history is collected. An ultrasound, x-ray or scan is required. The chiropractor also conducts an examination and palpation examination. Based on the results and individual characteristics of the patient, the doctor selects the appropriate treatment technique. Most often, manual therapy methods are aimed at the spine. This is due to its key importance for human health.

Complex conservative treatment:

prescribing painkillers, muscle relaxants and antispasmodics to relieve tension in the back muscles and relieve pain.

local blockades of the spine in places of displacement of the vertebrae with injections of hormonal drugs.
therapeutic massage (not prescribed during periods of acute pain)
acupuncture
use of chondroprotectors
physiotherapy (electrophoresis, paraffin, salt or radon baths)
physiotherapy

After eliminating the displacement of the vertebrae, the doctor may recommend wearing a specialized corset or belt to fix the spine. This will significantly reduce muscle tension and pain.

Rehabilitation period

During the rehabilitation period, you need to wear a corset.
Correction of the cervical vertebra puts it in place, but after it a period of rehabilitation will be required to consolidate the result and prevent recurrence of the injury. Rehabilitation after editing includes:

complete abandonment of an active lifestyle, sports, and other physical activities;
sleep on a hard mattress and orthopedic pillow;
wearing a corset;
bed rest for 5 days;
rest after a session in the clinic;
a diet with sufficient vitamins and minerals.

During the first time after reduction, it is necessary to carefully monitor how you feel. If unpleasant sensations occur in the spine, neck, or head, you must immediately notify your doctor.

Physical therapy to help!

The selection of a set of necessary physical exercises for a patient with spondylolisthesis is carried out only by a specialist!

More often, static exercises and complexes aimed at stretching tendons and muscles are recommended.

It is forbidden:

Perform exercises when pain worsens
Exercise in a vertical position.
Increase the tilt of the body by more than 20 degrees (in this case, repeated displacement is possible).

If conservative treatment methods do not lead to the expected result, the doctor may recommend surgery. To avoid surgery, if there is any suspicion of vertebral displacement, it is necessary to urgently be examined by a specialist!

How to put cervical vertebrae in place at home

A small displacement can be corrected with the help of a thick roller.
A small child or newborn should never put the cervical vertebrae in place on their own at home. This manipulation should only be done by a specialist with experience, having the diagnostic results in hand.

There is no need to self-medicate if the atlas is damaged, this is fraught with complications and aggravation of the problem. However, anyone can correct slight displacement with the help of massage and a set of exercises.

To alleviate the condition with slight displacement, it is useful to perform the following steps:

lie on your back on a hard surface with a cushion or rolled up terry towel under your cervical region for several minutes, making sure that your head is slightly thrown back;
in a sitting position, slowly turn your head from side to side until it stops, remaining in each position for 10-15 seconds;
repeat the exercise, tilting and lowering your head, trying to reach your chin to your chest;
Self-massage of muscle tissue in the cervical region is useful, but provided that it is done carefully.

All other exercises, massage movements, techniques can only be performed under the supervision of a specialist. When performing exercises on your own, it is important to avoid forceful techniques or sudden movements.

Massage when the cervical vertebrae are displaced should be performed without affecting the spine, using hands only on the soft tissues of the back to achieve muscle relaxation.

Exercises for editing Atlanta - Makeeva gymnastics

To adjust Atlanta independently, turn/tilt the head while stretching the neck and fixing it in a turned/inclined position. Fixation or delay is performed at the moment of maximum stretching. And a straight, elongated neck allows you to exclude all cervical vertebrae from rotation and concentrate bending loads on the area of the connection between the Atlas and the skull.

The feeling of pain when performing exercises for editing Atlanta indicates the presence of pathology

Exercises:

Neck stretching, in which you need to stretch your head up, shoulders down, move your head back as much as possible, keeping your chin parallel to the floor.
Tilts of the chin down, in which the neck remains vertical and the crown continues to stretch upward.
Tilts of the head, in which the nose remains motionless, and the head turns with the right or left ear up, rotating around the tip of the nose.
Raises the chin to the sides from the lower position, when the chin is pressed to the neck.

When performing these exercises, you may feel pain in the upper neck. Soreness indicates a pathological process, the presence of subluxation and inflammation of the cervical vertebra.

Each exercise is performed 8 times with fixation in the extreme rotated position for 10-15 seconds.

Reduction of cervical vertebrae using the method of Dr. Makeev uses similar exercises to the method of doctor Shishonin, who developed a complex of gymnastics for cervical osteochondrosis.

Etiology

Signs of vertebral displacement are observed for various reasons. As already mentioned, one of them is a disease such as spondylolysis, nonunion or defect of the vertebral arch, which leads to a fracture of the vertebral pedicle. As for other factors, they are presented as follows:

spinal injuries;
spinal surgery;
spinal stretch;
osteochondrosis;
sharp contraction of the spinal muscles;
congenital pathology in the form of bone weakness;
pathological changes in the intervertebral joints that appear with age.

In the case of children, displacement of the vertebrae can be observed due to birth trauma or sudden movement.

In addition, displacement can occur as a result of:

traffic accident;
falling on your back;
intense loads;
lifting weights.

How to straighten the Atlas yourself: neck stretching

In order to put Atlas in place, use inverted hangs upside down.

What is important is fate:

A crossbar is required for hanging. There are two ways to stay on the bar. The first is with legs bent at the knees. The second - with fixation of the feet with special loops that are hung on the crossbar.
Hanging time is from 20 to 60 seconds.
To enhance stretching, bend your arms at the elbows and place your palms on the back of your head. In this position, the weight of the person’s arms is added to the weight of the head.
While hanging, you can lightly tap the back of your head and back of your neck with the edge of your palm. Light tremors of the muscles contribute to their complete relaxation.
The frequency of exercises is 2-4 times a day, at least in the morning and evening.
While hanging, you need to completely relax your neck muscles. The head should hang freely.

A person’s head accounts for 7% of his weight, and this is up to 6-7 kg for an adult. Which is quite enough to stretch the Atlas joint and the base of the skull.

The displaced vertebra is held in the wrong position by spasmed muscles. Complete relaxation of the muscles leads to the fact that the vertebrae occupies the correct place. Based on this theory, the popular Atlanta editing technique, known as Atlasprofilaks or Atlasprofilaks, works. In this expensive procedure, the neck muscles are relaxed using a vibrating massage device. As a result of their complete relaxation, the vertebra painlessly takes its correct place.