Taking advantage of the benefits of civilization, we move less and less, as a result of which we do not give the necessary load to the motor apparatus and it degrades. Disorders of the musculoskeletal system include scoliosis (curvature of the spine with a turn of the vertebrae), kyphosis (bending of the spinal column to the back), protrusions, intervertebral hernias, osteochondrosis, etc. Any of them causes discomfort and pain. Particular attention should be paid to herniated intervertebral discs, which entail serious complications: neuralgia, radiculitis, cephalgia, sciatica, visceral disorders, dysfunction of internal organs, paresthesia, hemodynamic disorders.
The intervertebral discs are the “spacers” between the vertebrae that give flexibility and strength to the spine. Each disc consists of a hard shell (annulus fibrosus) and a semi-liquid consistency (nucleus pulposus). Under certain inadequate loads and negative metabolic changes, the annulus fibrosus ruptures. Fluid from the nucleus flows out and pinches the nerve endings of the spinal cord. When compressed, the disc bulges out in different directions, and protrusion occurs, which with time can turn into a herniated disc.
Why do hernias occur?
Today there are four theories of the occurrence of intervertebral hernias.
Mechanical theory: an effect on the spine that does not correspond to the physiological functions of a person. When we lift and carry weights, mechanical changes occur in the cartilage tissue. Excessive stress injures small joints, as well as the annulus fibrosus. Sooner or later, this ring wears out, microcracks appear in it. The mechanical reasons for the occurrence of intervertebral hernias also include injuries and microtraumas, poorly formed posture. But this theory did not go further than the hypothesis, since many people are injured, but they do not have hernias.
Metabolic theory: the musculoskeletal system, like any matter, consists of molecules and atoms, metabolic processes constantly take place in its cells. In case of metabolic disorders – changes throughout the body in the form of a lack of some elements and an excess of others. Osteoblasts and osteoclasts are the building blocks for bone tissue. The dominance of some of these cells over others leads to the fragility of bones. When metabolism is disturbed, adipose tissue grows into the connective tendon. In this case, a large amount of lactic acid (lactate) collects in the muscle tissue and it weakens. Since the spine functions at the expense of the muscular apparatus, in this case, it is not able to support weight and loads. According to the metabolic theory, the cell is dehydrated from the inside, and fluid collects in the intercellular spaces, and edema occurs.
Similar processes occur in the spinal disc: it works because, under load, it absorbs moisture from the surrounding tissues. There are hyaluronidase enzymes, thanks to which the cartilage tissue allows the glandular body to pass through, and the disc instantly becomes larger and resists. In the case of metabolic disorder, fluid is constantly pumped out of this disc – it dries up and cracks. This also leads to diseases of the spine, including hernia.
Infectious theory: the scientists made histology of the tissue of the disc fragment removed during the operation. The study showed that it is infiltrated with all kinds of viruses, including herpes infections. This allowed us to conclude that in any inflammatory process, viruses end up in the tissues of the spine. When herpes is active, it reaches the ligamentous apparatus along the nerve trunks, causing inflammation, and with it changes in tissues. This theory also has a right to exist. For example, such serious infectious diseases as brucellosis and tuberculosis destroy the cartilage tissue of small joints.
Genetic theory: a predisposition to early changes in the spine also occurs. It has been noticed that in some children the stoop appears at a very early age. Such changes, multiplied by ecology, gadgets, and physical inactivity, are enough to worsen the violation. Most specialists dealing with spinal problems are inclined to believe that a herniated disc is a polyetiological disease that includes all four of the above factors.
View from the East
We know from Ayurveda that tissues are built through metabolic processes. The digestive system and Agni (enzymatic function) are responsible for metabolism. Suppose our digestion is perfect – the stomach, liver, pancreas, small and large intestines work without problems. In the process of assimilating food, tissues are formed:
1 – race (plasma) or blood,
2 – muscles are built from blood,
3 – from muscle tissue – fatty, lipid (hormonal),
4 – from fatty – bone,
5 – from bone – nervous,
6 – from nervous – reproductive. The reproductive tissue gives rise to Ojas – life force. Ojas starts Agni (fire, enzymes, heart, digestive tract) again, and this cycle repeats over and over.
Based on this, if a person has a hernia, it means that bone and nerve tissue is affected. Both are at the end of the metabolic chain. And this gives reason to assume: some nutrients do not reach them or are consumed excessively. The association with plumbing suggests itself: if water does not flow, then something is clogged. We remember that adipose tissue precedes bone tissue. In this case, we pay attention to fatty layers, glucose, cholesterol, uric and lactic acid levels. Laboratory research is indispensable here. Only by analyzing their indicators, it can be concluded that it is exactly what blocks the flow of necessary substances into the bone tissue and prescribe a comprehensive treatment aimed at nourishing tissues and restoring the correct metabolic chain (post-digestive process).
The concept of human constitutional characteristics also deserves attention. Each type – Vata, Pitta, Kapha – is characterized by certain pathologies of the musculoskeletal system.
Vata-type people have a lean build. They are characterized by violations of peripheral blood supply, dryness of tissues and cartilage, which contributes to the formation of intervertebral hernias in the lumbar region.
Representatives of the Pitt-type have a sports figure, moderately developed muscles. The emergence of intervertebral hernias is accompanied by an inflammatory process, fever, edema. In this case, means with a cooling effect are used in the treatment.
The Kapha type is people with a large physique, prone to overweight. Most often, their hernias are formed in the cervicothoracic region and are accompanied by edema, pulling pain, and frequent headaches.
Treatment or surgery?
20 years ago, when they started doing MRI, as soon as a patient was diagnosed with a hernia, he was immediately sent for surgery. But over time, we were faced with the fact that after surgery relapses occur or adhesions occur. In parallel with this, the number of patients who managed to cope with the problem without surgery increased. Situations like this made doctors wonder whether it is always appropriate to operate. If there is no strong compression of the root and the threat of muscle tissue atrophy, there are no violations of somatic functions, while reflexes are preserved, conservative treatment is recommended. The absolute indicator for the operation is a sequestered hernia with persistent compression of the root (only 5% of the total number of such hernias).
To debunk another medical myth: A severely bulging hernia can be treated with an IV or a pill. There is a technique when a sciatica infusion is given to a patient with acute pain. But it is used to relieve swelling. Steroid injections are given to relieve pain and swelling. While the pain is relieved, the spine adapts to a stable curvature. That is, a person is in an antalgic (forced) position, but does not experience pain. It is hardly possible to call this a full-fledged treatment. To cure a hernia, it is necessary to influence all links of pathogenesis, taking into account the constitutional characteristics of the patient.
We start with a mechanical theory: during the examination, we analyze the state of the spine, what is its static balance, the length of the legs, how the body weight is distributed, we examine the muscular frame for spasms, infringements. Muscle spasms often occur as a defensive response to inflammation. There can be many reasons, and they must be eliminated.
How to do it? With the help of massages, compresses, injections of relaxing, analgesic, and improving tropism (the process of cellular nutrition), there are many options. Depending on the violation, the patient has been prescribed a complex of therapies.
Reflexology, in this case, acupuncture has proven itself well. The impact occurs by stimulating biologically active points using thin needles. The endorphins released during the procedure affect the nerve endings and relieve pain. Depending on the depth and angle of immersion of the needle, certain mechanisms are triggered to normalize the work of internal organs. This method of therapy also affects the movement of energy along the meridians, which allows you to eliminate its blocks and harmonize the work of the body as a whole.
Massage is an obligatory component of the treatment of herniated discs. Massage movements in this case are soft, without force, to exclude damage to the disc by bone segments. In the period of exacerbation and the presence of acute pain, such a procedure is excluded.
As you know, pain perception occurs in the brain. “I trained in one of the Ayurvedic institutes in India,” Dr. Skopintsev DI, chief physician of the CALENDULA, Ayurvedic and medical clinic shares his experience. – Once a man came to an appointment with acute pain. He was hunched over on his side, unable to straighten his legs. He was given a marma massage, but the pain did not subside. I suggested doing Shirodhara relaxation therapy. Prepared the dharapati (Ayurvedic massage table) so that the patient could lie on his back. We spent 2 hours with Shirodhara until he relaxed. The slow flow of warm oil along the forehead area allowed to relieve the tension of the cerebral cortex, and with it the pain. Then I did a blockade (an injection at the site of the swelling). Only after the patient straightened his legs, my Indian colleagues and I found the trigger zone and prescribed treatment.
Therapeutic blockade Today, acute pain is relieved by injection. Correctly performed manipulation is akin to a successfully performed operation. It is necessary to pick between two vertebrae – over the hernia and without touching the nerve. If the drug is injected accurately, and the hernia is not sequestered (sequestration is a condition in which the integrity of the intervertebral disc is violated, the substance of the disc nucleus is poured out and completely separated from the disc), the pain subsides on the same day. The next day, the person straightens, it becomes possible to mechanically influence the problem segment of the musculoskeletal system. For this procedure, Novocaine, Lidocainum, Marcain, etc. are used.
Metameric therapy The development of the embryo is segmental. First, the dorsal tube of the spine appears, and tissues and organs grow from it. Each segment of the spine has its metameres – areas of the skin (dermatomer), muscles (myomer), vessels (vasomer), tendons, ligaments and periosteum (skeleton), internal organs (visceromere). Through the impact on them, you can influence the segments of the spine. This can be achieved by introducing into the receptor zones of drugs that are tropic to these tissues in minimal doses. The injected substance has a direct effect on specific tissue, causing it to react correctly. The most commonly used Cerebrolisini (protein-free hydrolyzate of the brain substance) – drug corrects pain sensitivity well. Actovigan is also prescribed, depending on the localization of motor disorders, in one session 10–20 points are injected along the main metamers.
Manual therapy Gentle manual impacts on certain areas of the back and legs allow you to relieve tension, stimulate the functions of relaxed muscles, eliminate pain, swelling, and inflammation, stimulate blood supply and metabolic processes, as well as adaptive mechanisms.
Therapeutic gymnastics One of the main causes of disorders in the work of the musculoskeletal system is a weak muscle frame. Therefore, the priority is to strengthen the extensors (extensor muscles). Depending on the location of the hernia, the doctor prescribes an individual set of exercises. Gymnastics classes begin in the acute period, gradually increasing the depth and intensity of the exercises.
Yoga classes are also effective (but twisting is contraindicated in this case), Pilates (helps to restore the mobility of the vertebrae, remove clamps and pinching), swimming (water removes the main load from the spine and evenly distributes it throughout the body, reduces pain), hanging on a horizontal bar (occurs an increase in the intervertebral space, which reduces the pressure of the protrusion on the nerve and muscle tissues, but this exercise is contraindicated for overweight people), kinesiotherapy (performing exercises on a special simulator; certain movements reduce protrusion, the spine keeps its natural shape). All exercises must be performed with an instructor.
Leg presses, lifting the load upward, exercises on straight legs (overloading the intervertebral discs), strength training, running (the intervertebral discs cannot cope with the shock absorption function, which causes their deformation), twisting (movements in the lumbar region lead to pinching of the protrusion) are Herniated disc: from diagnosis to cureprohibited …
Herbal medicines Since the treatment should be complex, medicines cannot be dispensed with. The only question is – which ones? First of all, sedatives are prescribed to calm and relieve pain in the nerve endings, including in the paravertebral muscles of the back. Thanks to this, the pressure on the intervertebral disc is reduced and all associated syndromes are relieved. Diuretic drugs are also needed to remove excess fluid from the intercellular spaces and the body as a whole, that is, to relieve edema. In this case, Ayurvedic herbal remedies gently affect the body without causing side effects. Herbal remedies strengthen the nervous system, including the paravertebral muscles of the back.
Ayurveda has a wide arsenal of drugs that can repair damaged tissues. A drug based on the Jatamansi plant has a sedative effect. Pain relief is provided by scorpion extract, inflammations are relieved by cream, or Annona muricata, Gentiana.
Another advantage of herbal medicine is that herbal substances can restore destroyed bone and cartilage tissue. You can influence osteoblasts and osteoclasts with the help of guggul (Commiphora wightii), mummy, Boswellia serrata, etc.
Panchakarma realizes the need to cleanse the body, it is worth mentioning in which cases it is impossible to cure a hernia.
With chronic flatulence, when the abdomen constantly swells. The artery and vein, which drain blood from the pelvis, also drain it from the lumbar spine. Bloating is always a stagnation of blood in the pelvis, and therefore in the spine. In this case, treatment should be aimed at eliminating such phenomena.
With metabolic syndrome. Abdominal pressure (a large belly filled with adipose tissue and tight as a drum), dyslipidemia (metabolic disorders of fats with their subsequent infiltration into the tissue), atherosclerotic changes in blood vessels, hyperglycemia, protein metabolism disorders (gout and hyperuricemia) – all of these disorders associated with metabolic syndrome. If it is present, a hernia can be treated only symptomatically – relieving pain, alleviating the condition.
“Most often we are visited by patients with hernias and protrusions in the cervical spine,” says the head physician of the CALENDULA clinic, Dr. Dmitry Skopintsev. – As a rule, these people experience discomfort: pain radiating to the arm, stiffness in the neck, pain in the back of the head, sleep disturbances. They come to the clinic after a course of sciatica infusions and steroid injections, against which there were pains in the stomach, hyperacidity, edema. Treatment of metabolic syndrome with cleansing procedures allows you to eliminate back pain in the early stages. Of course, an integrated approach is important, – continues Doctor Skopintsev. – Our method of treatment of intervertebral hernias includes plasma therapy, collagen injections for joints, electric wave therapy, which allows you to remove osteophytes on the spine. This is the only way to influence all the links in the pathogenesis of an intervertebral hernia and thereby achieve a stable remission, which ultimately will allow the patient to lead a full life. The course to achieve the result should be 21-28 days. And sometimes longer.”