Acute functional blockade of the spine

Acute functional blockade of the spine occurs when one of the arched processes is displaced.

What is an acute functional block of the spine?

With a careless movement, your back, like an electric discharge, pierces a sharp pain. This is an acute functional block of the spine. Pain, like a lightning stroke, affects a person at the very beginning of the movement, leaving it bent in three deaths, motionless and unable to straighten.

The slightest movement causes you the greatest pain. You can neither bend, nor straighten, nor move your foot. This is really a critical situation. Often, the knees just give way, and you settle on the floor, and to move you from the place, you may need an injection of pethidine (narcotic analgesic, close to lidol or promedol). This is a very frightening experience, it is difficult to forget for many years.

Such an attack can occur at any time: when you turn in the bed, get out of the car, move the chair, bend over the toothbrush, pick up the bale with linen, etc. One patient this happened when she fastened the zipper on the dress. A characteristic feature of all these cases is the complete surprise of the attack: after all, it would seem that you did not do anything special. Moreover, the lack of tension and the routine of what you were about to do seems to play a key role here.

For me, as for the therapist, acute functional blockade of the spine is one of the most discouraging conditions. During the crisis, patients are in an emergency situation; the very idea of movement is intolerable for them, and they are hysterically afraid of everything that can provoke a second attack. Long after the first attack they are afraid of its repetition, and some even think that their life will never be the same.

For many years, various assumptions about the causes of this phenomenon were expressed. Although with a severe blockade of the spine, the sensation is as if something has jumped out, it is quite clear that this is not a disk. However, there is no objective evidence that would accurately explain what happened. There are no abnormalities on the radiograph or any other types of scanning, neurological evaluation also does not indicate the presence of the disease. But before us is a suffering man, immobilized and helplessly lying on the floor, as if in a stopped frame from the film, and literally numb with pain.

The most popular explanation was the pinching of a meniscoid (a tiny cartilaginous claw on the edge of the arcuate joint) between two articular surfaces, which immediately caused a protective spasm of the muscles of the back. A similar, and more probable, explanation was the pinching of the sensitive tissue of the synovial membrane between the two articular surfaces.

I believe that the main reason for the "closure" of the articular joint is a short-term loss of coordination in the spine movements, because of which the arcuate joint is slightly displaced. The spine is caught unawares by the movement that has begun, and one of the arcuate joints protrudes slightly from the common line.

The shift is almost invisible, so it is simply impossible to distinguish the displacement of the joint on it. But the problem is not at all in this shift. Problem in the reaction: in an instant and powerful defensive response of the muscles blocking the spine, which is why you literally catch your breath.

If any other joint is dislocated, such a protective reaction will not occur. (Many of us have experienced what is an unreliable knee when the knee cap temporarily leaves the joint.) But the spine has a serious responsibility to maintain the entire musculoskeletal system and to protect the delicate web of nerve endings inside the spine, so it reacts very sharply to any threat to their integrity.

When the arcuate joints of the neck are blocked, they simply return to their normal position. Cervical vertebrae are easily accessible, so manipulation with them is much easier than with lumbar vertebrae, where the strongest protective spasm makes it difficult to affect the segments. If you are lucky and you quickly get to an osteopath, a chiropractor or a physiotherapist, a sharp hand pressure, at which a characteristic click will be heard, can unlock the joint and return the vertebrae to its original position.

There are miraculous healings that we often hear about. This method instantly opens the joint, so that the joint surfaces are connected correctly. If everything went well, the joint immediately begins to move freely, and you can safely go home, completely getting rid of the pain. The rest of the muscle spasm will take place the next day.

However, much more often you get to the doctor only when the muscles have already decreased so much that the joint can not be exposed by physical action. Any manipulation at this stage will only exacerbate the situation, further strengthening the protective muscular spasm.

What causes acute functional blockade of the spine?

• A natural weak zone at an early stage of slope.
• The restriction of the mobility of the vertebral segment predisposes to blockage of the articular joint.
• The weakness of the muscles contributes to the blockage of the arcuate joint.

A natural weak zone at an early stage of slope

The spine is extremely vulnerable when tilted, if not properly stressed. It seems to me that the arcuate joint is blocked when the spine is not ready to tilt at the moment of passing through the weak zone at the very beginning of the flexion.

Muscles of the back and abdomen simultaneously contract, creating around the body a kind of belt that protects the spine. They are an indispensable springing mechanism supporting the motor segments, until a powerful system of muscles and ligaments running along the spine commences. This mechanism gradually "releases" the spinal column, tilting it forward, like a mechanical tap. However, neither the powerful long back muscles nor the back ligaments function until the back is bent properly; and only then they create sufficient tension in order to secure the movement of the spine.

Until then, the spine passes through a "non-descending" incline where he feels insecure and where he has to be slightly rounded and rely on the abdominal press. Light stress and rounding play an unremarkable, but extremely important, role as multi-parted muscles and transverse abdominal muscles are prepared for action, which control the slope of the segments.

But the minimum delay of one of the "partners" for joint reduction can cause a failure in traffic. If the spine began to move before both systems were fully alert, it would be taken by surprise, and some of the arcuate joints slightly shifted. The threat to the spine causes a powerful defensive reaction of the muscles clamping the slipped joint so that it does not move further. It is this reaction that literally puts you on your knees.

This often happens in the process of recovery from a viral infection. It seems that the reason is in general weakness, when all the reflexes are dulled, and the abdominal muscles can not respond quickly and support the spine.

Blocking arched joints can occur in a day or two after serious physical stress, for example, repairing or digging up the garden. Most likely, in this case, it is the excessive activity of the long back muscles and their residual high tone that violate the natural harmony of these imperceptibly working muscle groups.

The story is always the same: the back was chained for a day or two, and it was more difficult than usual to keep the stomach tight. Then, when you least expect it, there is some trifling incident - too insignificant to take it seriously - that can lead you to a catastrophe.

[1], [2]

The restriction of the mobility of the vertebral segment predisposes to blockage of the articular joint

Limitation of mobility of the vertebral segment, in which the disc has lost its properties, predisposes to blockade of the spine.

One of the specific functions of the multi-parted muscle (as well as its assistant on the other side of the arch of the articular joint - the yellow ligament) is to prepare intervertebral discs at the lumbar level. When the spine starts moving, the disc should be as tight and bulky as possible so that the vertebrae do not move from side to side. If the disc has lost fluid and the pressure inside it has fallen, the muscles around the arcuate joint are much more difficult to prepare for work. Therefore, the blockage of the arcuate joint is more likely in the spine, in which the symptoms of restriction of mobility of the vertebral segment gradually develop.

When the thickness of the disc has decreased, and the ligaments holding the segment in place are weakened, the segment becomes more vulnerable. The arcuate joint, providing stability at the initial stage, is not able to prevent minor movements of the vertebra, and if there is no support for the consciously contracted abdominal muscles that can compensate for the failure of the joint function, the arcuate joint can slightly slip obliquely. When the stomach is relaxed, any accident can lead to disaster.

Muscle weakness promotes blockage of the articular joint

Chronic limitation of mobility of the vertebral segment weakens the muscles. When the segment can not move, the small muscles that move it will atrophy. This is especially true of the multi-parted muscles located directly above the articular joints and serving as their special protection.

When a segment slides, a partitioned muscle that controls the joint may not be able to cope with its task. This takes on special significance if there is already a violation in your back. For example, data have been obtained suggesting that with a mild inflammation of the articular joint, the divided muscle is "intentionally" under-treated to prevent the inflamed joint from excessive compression. Although this can shortly save you from unpleasant sensations in the inflamed joint, in the long term the arcuate joint remains without muscle control, which can compensate for the ineffectiveness of its work. Problem joint can be considered ready for blocking.

Not only the automatic suppression of the muscles, but also their weakness can also cause blockage of the arbor. Because of the banal laziness and unwillingness to support your body in the form, the fine coordination of the abdominal and back muscles is broken, so that they are unable to synchronously interact, creating a support for the spine. At some point they begin to act uncoordinated, which is why it is more difficult for deep muscles to get involved in work at the right time. If they can not slightly round their back at an early stage of tilt, and two important groups of deep muscles do not create the optimal pull line, the main element in the center of the moving segment - the disc - will not be properly prepared and the segment can slip. First of all, weak muscles are to blame during this movement, a multi-part muscle is activated on the left side of the abdominal press, and unfortunately, many of us suffer. Because of the weakness of the muscles, the "hydraulic sack", which should spring the spine, becomes completely flabby. When there is almost no support for the spine from the side of the abdominal cavity, the structures that connect the segments are weakened and the vertebrae strike each other when tilted. This especially affects women in the last months of pregnancy and after childbirth. When the abdominal muscles and ligaments are stretched and weakened, the entire muscular system is poorly prepared for the operation of the spine. This can happen to any of us when exhausted, unsatisfactory physical form, newly acquired obesity. Blocking of the joint also often occurs during the recovery period after the illness, possibly due to general weakness. Usually, food poisoning and influenza are mentioned as risk factors.

Relatively weak ability of the partitioned muscle to prevent the turn of the vertebra around its axis also contributes to the blockage of the articular joint. Almost in all our slopes there is an element of rotation (we are not robots that move only strictly up-down or left-right), and a partitioned muscle trying to limit the torque looks compared to a massive body like David before Goliath. Rotation of the segment is possible only by a few degrees, and only a partitioned muscle (working on one side) directly controls its vertebra. It limits the rotation at the very beginning of the turn, holding it by the sprout and not allowing it to move forward or to the side. (Another deep muscle of the back, iliac-rib, also restricts the rotation of the vertebra, but only when you bend deeper.) All the remaining muscles that prevent spinal rotation are located on the surface of the trunk and are not attached directly to the spine.

What happens to the back?

Acute phase

The electric discharge of pain overtakes you at the earliest stage of the movement - you can even say, before it started. A fraction of a second before this, there is an ominous feeling that your back is going to do something unnatural. In itself, the action, it would seem, is quite insignificant: you reached for a cup of coffee, and suddenly the whole world freezes. It's not just that everything happened so suddenly, it's just impossible to believe that such an elementary movement completely took you out of action.

The pain pierces you sharply and completely deprives your strength. You grab for the furniture, trying to lean on, then your hands go down, and you slip helplessly to the floor. Here you have, at least, nothing hurts, but you remind a whale thrown ashore - no one can move you from your place. If this happens, when you were alone at home, it may take hours before you can get to the phone and call for help.

During this period, an unpleasant sensation of cramping alternates with painful bouts of pain in any movement. If you need to move your leg, you have to move it by centimeter. When you try to lift your leg or move in any direction, the pain will swell again, and you literally catch your breath.

[3], [4], [5], [6], [7]

What causes back pain?

Attacks of pain in the acute phase come from the muscles that squeezed the entire spine to hold one joint. They react instantly as soon as they feel that the joint is trying to move. Strange as it may seem, but it is the protective reaction of your body that causes such pain. Muscle spasm does not allow the joint to move further, and also prevents it from breaking apart, and then it connects in the right position. Muscles persist, and they are the main cause of the whole problem.

Strong squeezing of the still not working joint causes the same alarm signals, as in the case of trauma. The back will not let you go as easily as, for example, a sprained ankle, perhaps because of the complexity of its structure, and also because of the disproportionate size of the tiny joint and the powerful muscles that protect it. Until these muscles find that they can relax, they will continue to guard the joint, not allowing it to move.

Special mechanoreceptors in the joint capsule are reported to the brain that the joint is strongly compressed. They do this at a time when the joint is immobilized. And repeat the signal every time with the slightest contraction of muscles. A few hours later there is a new pain - this time from the stimulation of the chemoreceptors of the joint capsule. They record the accumulation of toxins in the tissues, both from the initial damage to the capsule, and from the slowing of the metabolic processes in it. As the concentration of toxins rises, the protective spasm increases, and because of this the pressure on the joint increases, and hence the pain becomes stronger.

In itself, muscle spasm can also cause constant pain of the same nature. When blood is pierced through the abbreviated fibers, metabolic products are not excreted. Their concentration increases, they irritate free nerve endings in the tissues of the joint, which is interpreted by the body as pain. In addition, convulsively stressed muscles can not pass enough oxygen through themselves, which causes characteristic aching pain, with tingling attacks after a long stay without movement.

Pain causes spasm, and spasm generates pain. If you do not start moving and do not activate the joint, this cycle will be repeated with all the new strength. Accordingly, in the treatment it is important to quickly relax the muscle spasm and begin to move. However, immediately after an attack, any movement seems completely impossible to you. At this time, your body is a continuous source of pain, and your back is solid, like a stone.

Now it is best for you to intramuscularly enter a petition (a strong anesthetic) and a muscle relaxant. The first thing to do is move you from floor to bed; The sooner you call the doctor, the better. For the purposes of subsequent rehabilitation, it is best to go through this stage faster.

If at the first attack you or your doctor made a mistake, you can never recover after it (both physically and emotionally). Many people with chronic disorders think that it all started with such an incident, from which they really did not cure. In 20-30 years they remember every detail and claim that their back after that never came back to normal.

Subacute phase

The crisis sharp period must pass in a few days. Rest in bed and properly selected medications relieve muscle spasm, and the movement becomes easier. Your own position plays an important role here. Fear and inner tension only slow down the process of recovery. Keep calm and consciously make your back move - the only way you can cure and develop a joint.

As the muscles relax, it becomes easier for you to get out of bed, although turning is still painful. The protective reaction gradually loses its force, and the "shell" gradually weakens. If you move slowly and smoothly, acute attacks of pain will not happen. You can already sit down, unless, of course, you make sharp movements, do not cough or sneeze; but to do something more complicated, for example getting out of bed, is still very difficult.

Extensive pain is gradually localized to a small sensitive site, and it is easier to determine its source. At this stage, your back is weak, but ready to start moving.

The chronic phase

When the disease enters a chronic phase, your sensations are almost the same as with arthropathy of the articular joint. After a protective muscular spasm, the joint is often incapacitated. It is necessary to restore its mobility as soon as possible, otherwise the problem will become chronic and will accompany you all your life.

When the damaged articular joint begins to gradually move, the muscle spasm around it remains, and your condition worsens. The joint capsule is compressed due to inclusions of scar tissue, but, paradoxically, remains weakened. Microscopic scars cover the entire joint and tightly tighten it, because of what it still remains clamped; but at the same time, the initial rupture of the joint capsule and the weakness of the local muscles weaken it and make it more vulnerable to repeated traumas.

In extreme cases, the arcuate joint can become unstable. This condition is one of the most intricate puzzles for physiotherapists. How to strengthen the joint capsule, when, perhaps, only because of its rigidity, the joint still holds?

Such a problem arises with the instability of any synovial joint, and it is very difficult to cope with it. Therefore, it is better to tackle it earlier - after the first blockage of the arcuate joint, so that you do not have to deal with this difficult stage.

Our goal is to force the joint to move to avoid scarring. Even if the problem is chronic, the joint still needs to be developed. This can be done with exercises for deep back muscles, for example, lifting the body from the edge of the table or, in an easier version, tilting with the touch of the toes.

If the deep muscles of the segment are not restored, the back will be damaged with each rotational movement. You cant to help the old woman bring the bag, and feel the familiar pinch-you over-strained the weak arcuate joint. The next day you twisted and there was a familiar transverse bend with the hip forward. The back is more tense on the one hand, you are constantly kneading it with your fingers to get relief.
Usually at this moment people turn to the doctor, because the weak joint is pinched more and more often, and it is more difficult to restore it. If earlier it was enough to spend a couple of days in bed, then now it takes ten; only one attack passed, and now a new one. It feels like they are changing each other.

What can you do to self-medicate with an acute functional block of the spine?

In the treatment of acute blockade of the spine, first of all you need to overcome your fear so that you, at least, can move and turn in bed. After the crisis has passed, it is important to engage in the development of the joint, and then pull the problem joint with a ribbon of muscles to secure it.

To remove muscle spasm is best of all by muscle relaxants and anesthetics, usually injected. As soon as the drugs work, the back should start moving to loosen the muscles and release the joint. As soon as possible (and as often as possible), you should practice the exercises - lifting your legs and pulling your knees to your chest. Usually, in less than a day you will be able to move freely in bed with your feet and sit down.

The shorter the phase, the sooner the process of recovery will begin. Relaxation of muscle spasm and restoration of normal mobility of the injured joint can be achieved by leaning forward from the prone position. By forcing the muscles of the abdomen to work properly, you thereby remove the spasm of the long back muscles and promote the normal slip and rotation of the blocked vertebra. As soon as the joint starts to move, excess fluid is removed from it, and the pain immediately weakens. Treatment at this stage in many ways resembles treatment in the chronic phase of arthropathy of the articular joint, although the emphasis here is on restoring muscle control over the damaged joint.

The last stage of treatment is devoted almost exclusively to strengthening different muscles that affect the joint and improve their coordination. The strength of deep muscles compensates for the expansion of the capsule and will ensure that the joint is not subjected to new tests. At the same time stretching the long back muscles, especially at deep slopes, suppresses their desire for excessive activity, because of which the deep muscles automatically become weaker. Slopes (in particular, with the touch of the toes) contribute to relaxation of the back.

Typical treatment for acute functional blockade of the spine

Purpose: to weaken muscular spasm, to relieve pressure from the clamped arcuate joint.

• Pulling your knees to your chest (60 seconds)
• Relaxation (with knees bent at the knees) (30 seconds)
• Pulling your knees to your chest
• Relaxation
• Pulling your knees to your chest
• Relaxation
• Pulling your knees to your chest
• Relaxation
• Raise your knees to the chin (5 times)
• Relaxation
• Raise your knees to your chin
• Relaxation

Take medications: intramuscular pethidine, muscle relaxants and non-steroidal anti-inflammatory drugs prescribed to you by a doctor. Observe bed rest. Repeat the exercises every half hour, if from drugs you tend to sleep, then less often. Alternately, pull up one or the other knee to your chest. Lifting both legs, you risk disturbing your back and causing another bout of pain.

Duration. If you immediately start treatment, you can go to the subacute phase for the next morning.

Typical treatment in the subacute phase of functional blockade of the spine

Purpose: to remove muscular spasm, to strengthen the abdominal muscles, to begin to develop a clamped arcuate joint.

• Pulling your knees to your chest (60 seconds)
• Tilting forward from the prone position)
• Relaxation (30 seconds)
• Pulling your knees to your chest
• Tilting forward from the prone position
• Relaxation
• Shake up your knees towards your chest
• Tilting forward from the prone position
• Relaxation
• Tilting forward from the prone position (10 times)
• Relaxation
• Tilting forward from the prone position
• Relaxation

After completing a set of exercises, rest on the floor, putting your feet on the pillows. Repeat the complex three times a day, but do not rush. Remember that the first inclines forward from the prone position will be more painful; make sure that the shoulders are straightened during the exercise. If you go up with a straight back, you can only aggravate the situation. The pain can subside after the first inclines from the prone position. If you do them too painfully, you should go to the exercises for the acute phase. Programs for the subacute phase adhere to as long as the slopes are painless and you will not have pain attacks with careless movements. This is usually achieved in 2-3 days.

Typical treatment for chronic blockade of the spine

Purpose: to relax the back, restore the mobility of the articular joint, strengthen the multi-parted muscle and abdominal muscles.

• Pulling your knees to your chest (60 seconds)
• Rifts on the vertebrae (15 seconds)
• Cobra posture (10 seconds)
• Pose of the child (10 seconds)
• Exercise with the block for the back (60 seconds)
• Pulling your knees to your chest (60 seconds)
• Tilting forward from the prone position (15 times)
• Cobra posture
• Pose of the child
• Exercise with a block for the back
• Pulling your knees to your chest
• Tilting forward from the prone position
• Squatting (30 seconds)
• Tilting with the touch of the toes (3 times)
• Diagonal inclinations with the touch of the toes (4 times to the sore side, 1 time to the healthy one)
• Squatting
• Tilting with the touch of the toes
• Diagonal inclinations with the touch of the toes

Your back at this stage still hurts with careless movements, but overall, your well-being is much better. You will experience discomfort from a long stay in one position or aching pain if you spend a lot of time on your feet. In that case, you should lie down and shake your knees towards your chest until the pain subsides. The next regime can be passed when the back almost does not hurt.

A typical treatment with a close to a chronic blockade of the spine

The goal: to restore the mobility of the problematic articular joint, to strengthen the periarticular muscles, to improve the coordination of the muscles of the back.

• Exercise with a tennis ball (15 seconds)
• Cobra posture (10 seconds)
• Pose of the child (10 seconds)
• Exercise with the block for the back (60 seconds)
• Pulling your knees to your chest (30 seconds)
• Tilting forward from the prone position (15 times)
• Cobra posture
• Pose of the child
• Exercise with a block for the back
• Pulling your knees to your chest
• Tilting forward from the prone position
• Diagonal twisting in the supine position
• Diagonal inclinations with the touch of the toes (4 times a patient to the side, 1 time to a healthy one)
• Squatting
• Diagonal inclinations with the touch of the toes
• Squatting
• Slopes of the body from the edge of the table (12-15 times)
• Lifting the knees to the chest Rolling on the back (15-30 seconds)
• Slopes forward from the prone position (2 times to the sore side, 1 time to the healthy side)
• Squatting (30 seconds)

The whole complex of exercises does not need to be done constantly. When the pain subsides, continue twice a week to perform exercises with a tennis ball, a block for the back and diagonal inclines with the touch of the toes. Nevertheless, during the day you need to squat more often (especially when the back is tired). Sensitivity and weakness of the injured joint will remain for a long time, so you simply have to continue to perform the exercises supporting it. Remember that when you tilt with the touch of your toes, moving to the sick side will always be more limited than in the healthy one.

[8], [9], [10], [11], [12]