How to treat a compression fracture of the spine. Recovery period after a spinal fracture Massage for a fracture of the cervical vertebrae

In case of spinal trauma, fractures of the vertebral bodies, arches, spinous and transverse processes are observed. Compression fractures of the vertebral bodies are common. Vertebral fractures are often accompanied by damage to the intervertebral cartilaginous discs. A rupture of the fibrous ring of the disc occurs, where the nucleus pulposus can penetrate, and a so-called disc herniation can form. This hernia compresses the roots of the spinal nerves, causing the corresponding symptoms. Severe fractures of the spine with compression or rupture of the spinal cord are accompanied by deep paresis or paralysis of the muscles of the limbs and torso, and dysfunction of the pelvic organs. When the spine is fractured, its function suffers, which is manifested in a decrease in its flexibility, mobility and loss of spring properties; when trying to move and upon palpation, severe pain occurs at the fracture site. A hematoma forms at the fracture site and movement disturbances are observed. The main objective of treatment of compression fractures of vertebral bodies is to prevent further deformation of the damaged vertebral bodies and spinal cord from compression, correct the shape of the damaged vertebral body, unload the spine and preserve its functional ability. The treatment method for compression fractures of the vertebral bodies is determined by the location, nature and extent of damage, as well as the age and general condition of the patient. With slight compression, the spine is unloaded in young and middle-aged people. For this, the patient is placed on a bed with a wooden board. Traction, therapeutic exercises and massage are used. For fractures of the cervical and upper thoracic vertebrae, traction is performed using a Glisson loop. In case of a fracture in the lumbar or lower thoracic spine, traction is carried out using axillary straps. A Glisson loop or armpit straps are secured to the head end of the bed, which is raised to form an inclined plane. The patient is on strict bed rest. He is not allowed to stand up, sit, or turn on his side. Treatment of patients with vertebral body fractures is carried out according to periods. First period (first 15 days after injury). During this period, massage of the limbs begins from the fifth to seventh day after the fracture. The massage aims to improve blood and lymph circulation and stimulate regenerative processes. General massage is used on the limbs. On the upper limbs it consists of grasping continuous stroking, alternating rubbing, stroking, spiral rubbing with four fingers, stroking, longitudinal kneading, stroking, double circular kneading and stroking. It is enough to massage each hand for 5-7 minutes daily. On the lower extremities the following is used: grasping continuous stroking from the base of the toes to the inguinal fold, alternating rubbing, stroking, spiral rubbing with four fingers, stroking, longitudinal continuous kneading, stroking, transverse simple continuous kneading and ending with grasping continuous stroking. Seven to ten minutes daily is enough to massage each leg. When massaging the upper and lower extremities, manual vibration is not used. From the very first days, in order to prevent bedsores, the places where they may form are massaged according to the method described above. The abdomen is massaged only if you are prone to constipation using the above method. Second period (from the fifteenth to the twenty-first day). The purpose of this period: further strengthening of the muscles of the limbs, shoulder and pelvic girdle, abdominal muscles and back muscles. At the end of this period, the patient is allowed to turn from his back to his stomach, provided that the straight position of the spine is maintained. During this period, the limbs continue to be massaged, but the depth of the massage effect increases compared to the first period and more emphasis is placed on kneading. After turning on the stomach, for the first two to three days a light back massage is performed, consisting of plane superficial stroking, alternating rubbing, deep stroking in three rounds, sawing, grasping stroking in two rounds, spiral rubbing with four fingers, and flat surface stroking. At the same time, the fracture area is spared. In the following days, gradually increase the force of pressure when performing massage techniques, including semicircular kneading, transverse continuous kneading, and rolling. Third period (from the twenty-first to the twenty-eighth day). The purpose of the massage is the same. During this period, they continue to gradually increase the load during the massage. As the patient becomes more active, the need for massage of the limbs and abdomen gradually disappears. Therefore, the massage therapist can spend more time massaging the back and especially the soft tissues along the spine along the paravertebral lines. Here they begin to use smoothing with the thumbs, spiral rubbing with two thumbs, smoothing, shifting, smoothing, intermittent pressure, smoothing, mechanical vibration with a spherical vibratode. Fourth period (from the twenty-eighth to the thirty-fifth day). During this period, the patient is prepared to stand up. All massage techniques are used on the back with the exception of manual intermittent vibration. The patient should get to his feet from a lying position on his stomach, without bending his back, leaning on his straightened arms. He is allowed to sit three months after the injury to avoid secondary radiculitis. When treating patients with fractures of the cervical vertebrae, neck massage is used, where special attention is paid to massage of the trapezius and sternocleidomastoid muscles. When adapting to the forced position of the patient, they use the techniques of planar and tong-like stroking, spiral rubbing with four fingers and tong-like kneading. It is more convenient to perform the techniques with one hand, in reverse. The massage therapist's free hand fixes the patient's head at this time. Neck massage not only improves muscle tone, but also enhances blood and lymph circulation, tissue nutrition, stimulates regenerative processes, reduces and eliminates pain. In cases of paresis and weakness of the muscles of the upper extremities, massage the upper extremities according to the massage technique for flaccid paralysis. The most flaccid muscles are massaged selectively, using mainly forceps-like kneading and mechanical vibration with an ebonite hemispherical vibratode. When applying a plaster semi-corset with a collar, after removing it, massage the neck and shoulder girdle. On the front surface of the neck, with the patient in the initial sitting position, general stroking is applied with both hands from the chin to the angle of the lower jaw, then along the sternocleidomastoid muscle to the manubrium of the sternum and above the collarbones to the sides to the shoulder joints. In the same direction, spiral rubbing is performed with four fingers simultaneously with both hands and separate stroking alternately with the left and right hands. Continuing to stand behind the patient, the massage therapist massages the sternocleidomastoid muscles on both sides simultaneously. His hands move from top to bottom along the sternocleidomastoid muscles from the top of the mastoid process to the sternum and collarbone in an anterior motion. At this time, his fingers are facing the end phalanges towards the sternum. On the sternocleidomastoid muscle, planar stroking is used with the pads of the second, third and fourth fingers. This is followed by spiral rubbing with three fingers, pincer-shaped stroking with the pads of the thumb and forefinger, pincer-shaped kneading with the same fingers and planar stroking. Then they move on to massage the back of the neck and shoulder girdle, where they apply:

1. Embracing stroking.
2. Alternate rubbing.
3. Plane stroking from the base of the occipital bone to the shoulder joints in reverse.
4. Sawing.
5. Plane stroking in reverse.
6. Spiral rubbing with four fingers in reverse.
7. Plane stroking in reverse.
8. Spiral rubbing of the soft tissues with the thumb along the paravertebral lines between the spinous and transverse processes of the cervical vertebrae.
9. Stroking.
10. Forceps kneading.
11. Embracing stroking.

Massage of the front and back surfaces of the neck and shoulders lasts 15 minutes daily. The massage course consists of fifteen procedures. The massage begins the next day after the corset is removed. In case of a fracture of the transverse and spinous processes, the spine is unloaded on a bed with a shield for two to three weeks. Massage is prescribed from the second or third day after the injury; the back and soft tissues along the spine are massaged. Massage improves the functional state of muscles, relieves pain and reflex muscle tension, accelerates the regeneration process. Massage procedures are performed daily for 15-20 minutes throughout inpatient treatment, and, if necessary, continue on an outpatient basis. Treatment of patients with spinal fractures complicated by damage to the spinal cord In the case of mild compression of the spinal cord and its roots, an unstable disturbance of sensitivity and a decrease in the functional ability of the muscles are observed. In this case, selective massage of muscles and muscle groups is used. Severe damage to the spinal cord leads to the development of flaccid or spastic paresis or paralysis. For paresis and paralysis, the appropriate massage technique is used.

There are fractures with a violation of the stability of the spine (the vertebrae are divided into parts) and compression fractures (the spongy tissue of the vertebral bodies and intervertebral discs are destroyed from compression). Compression fractures of the vertebral bodies are more common in the lower cervical, lower thoracic and upper lumbar regions, where the movable part becomes less movable. Particularly severe are injuries involving damage to the spinal cord (traction, osteosynthesis, plaster corset). Treatment methods are determined by the duration, location, nature of the damage, treatment method, and the presence of complications.

Objectives of exercise therapy and massage

The main task is to create a strong muscle corset (strengthen the muscles and ligaments of the spine), prevent trophic and motor disorders, and in case of damage to the nervous system, eliminate paresis and paralysis and develop compensation for lost functions.

Features of exercise therapy

Compression fractures of the cervical spine More often they are treated by traction of the parietal tuberosities. Exercise therapy is prescribed after an acute period of injury. In PI, lying down at a slow pace with a small amplitude of movements, elementary general developmental exercises are used (for the distal parts of the limbs and leg movements are performed in easier conditions with the legs moving along the plane of the bed) and breathing exercises (diaphragmatic breathing). After 2-3 weeks, traction is replaced with a cervical corset, the motor mode is expanded, classes are carried out in the IP lying, sitting, standing. Include exercises for all muscle groups, including isometric exercises for the muscles of the neck and shoulder girdle (from 2-3 seconds to 5-7 seconds). After removing the bandage, smooth bending and turning of the head is performed to restore movements in the cervical region, and a massage of the collar area is prescribed.

Compression fractures of the lower thoracic and upper lumbar spine

Most fractures are treated with traction (2 months of bed rest). The patient lies on a hard bed (a pillow with sand is placed under the lower back to straighten the compressed vertebra), the head end is raised, the upper part of the body is fixed by the armpits with straps at the head of the head. Exercise therapy is prescribed from the 3-5th day in the absence of pain in the fracture area.

Stage I (2 weeks). Perform static and dynamic breathing exercises with full arm movements, without raising your legs from the bed, so as not to strain the iliopsoas muscle (this can cause pain in the area of ​​the fracture). To decompress the vertebrae, they include exercises in bending the spine with support on the arms bent at the elbows and the legs bent at the knees. Duration of classes – 10-15 minutes 2-3 times a day at a slow pace.

Stage II (1 month). Allow a turn on the stomach with a tense back (without bending the torso). Exercises are performed in the IP lying on your back and on your stomach (to strengthen the back muscles). From the 2nd month of treatment, they include bending, turning the body, raising the legs, exercises for training the vestibular apparatus (head movements in combination with movements of the upper and lower extremities). You cannot bend your torso forward. The duration of classes is 20-25 minutes several times a day.

Stage III (2 weeks). In order to prepare the spine for vertical loads, perform exercises while standing on your knees and kneeling with your back bent, excluding the torso tilting forward. The duration of the lesson is 30-45 minutes several times a day.

Stage IV. The patient is allowed to get up from a kneeling position 2-3 times a day. After adaptation to the vertical position, dosed walking is prescribed. During this period, the main attention is paid to training the muscles of the lower extremities. The exercises can also be performed in a standing position. Avoid leaning forward. Sitting and bending the body forward are allowed 3-3.5 months after the injury with good adaptation to walking. After discharge from the hospital, physical therapy classes continue. The greatest effect is observed when exercising in water.

Massage

During the period of immobilization, to prevent bedsores, the area of ​​the sacrum, buttocks, and back is stroked and rubbed with camphor alcohol, placing rubber circles under them.

Massage is prescribed in the subacute period (after 5-6 weeks). First, massage the chest (all techniques gently), then the back (stroking and rubbing), the stomach (all techniques) and limbs. In the spastic form of paralysis (paresis), planar and circular stroking, superficial grasping stroking, longitudinal kneading and felting are used for muscles with high tone, and for antagonist muscles - stroking, rubbing, transverse kneading, and tapping. For peripheral paralysis, kneading, twitching, moving muscles, rubbing tendons and joints are used. The massage procedure lasts 10-20 minutes daily or every other day, 10-12 procedures.

The vertebrae, like the entire skeletal system of the human body, ideally have sufficient stability to withstand numerous external loads. But in a number of cases, such as, for example, mechanical modification of the structure, the spinal frame cannot always withstand the load. As a result, the specialist is forced to diagnose a spinal fracture. In middle-aged people, fractures occur most often due to an overly active lifestyle, due to excessive exposure to external factors. The endurance threshold of the vertebrae is exaggerated, and a fracture is evident. Often, such a disappointing diagnosis is caused by car or other accidents where there is a sharp blow. In addition, such injuries are often sustained by persons engaged in physically hazardous activities. A vertebral fracture can also be caused by a blow or a fall from a high point.

There are a number of reasons why a compression fracture of the spine is possible. One of them is physical weakness. In this case, only slight pressure on the spine is enough for a fracture to form in the vertebra. A spine with a healthy structure, like most human bones, can withstand significant pressure and has the natural ability to even “absorb” the entire force of an impact. But there are times when the vertebrae cannot withstand and break precisely from sudden loads.

One of the main methods of recovery is massage for a compression fracture of the spine. For a compression fracture in the thoracic or lumbar spine, massage is prescribed to strengthen and restore the muscles along the surface of the back. Massage is also prescribed to prevent bedsores, thrombosis and improve digestive processes in the victim’s body.

It consists of the sacrum, coccyx, and the vertebrae themselves, which are connected to each other using intervertebral discs. The spine makes the human torso flexible and ensures unhindered movement of the body in all directions. In addition, the spine is the basis for the formation of the thoracic, abdominal and pelvic regions of the body. Thanks to it, the human body has the ability to bend and unbend (frontal line), tilt left and right (sagittal line), and also twist in different directions (vertical line).

The cervical and lumbar regions are characterized by the highest mobility function. Each spinal segment belongs to a true or false group. The true group includes the vertebrae of the cervical, lumbar and thoracic regions, and the false group includes the sacrum and coccyx. A true group of vertebrae is characterized by their connection with the help of cartilage, the so-called intervertebral discs. This natural anatomy of the spinal skeleton gives natural flexibility and range of motion.

The spinal cord is localized in a special canal of the spinal column, which is formed by the body and arch of the vertebra. The end part of its arch is directly attached to the sides of the vertebral body, at the ends of which there are special “slots”. They form intervertebral spaces, inside which the entire length of the spinal cord, with all its nerves and vessels, passes. There are seven processes on the vertebral arch, one of which is unpaired, and the rest are pairs of superior, inferior and perpendicular spinous processes.

The vertebrae located in the thoracic region differ from those in the lower back in that they are connected to the ribs, and the size of their bodies is smaller. The body of the lumbar vertebrae, on the contrary, is wider and has an oval shape. The branches of the lumbar vertebrae are located in a straight line with a vector directed backwards, while the thoracic branches are located somewhere in the middle between the horizontal and vertical angle of departure from the base.

Causes of spinal fractures

The backbone of the human body by nature has a high degree of resistance and often resists considerable external pressure. But when the impact of external factors exceeds the impact resistance of its body, a fracture occurs. When the height of the vertebral body becomes smaller, this is the first sign of injury from increased compression. Experts note that this type of fracture occurs most often.

Often the root cause of fractures, including vertebral fractures, is reduced bone density. This pathology leads to a disease called osteoporosis. Based on this disease, fractures of various types often occur, which sometimes go unnoticed. And treatment measures not taken in time lead to curvature of the spinal trunk. The natural conclusion of this process is systematic back pain and the appearance of a “senile hump”. With osteoporosis, it is enough to unsuccessfully apply only a little force, and the bone tissue will be injured. Thus, in people whose age has crossed the line of eighty years, compression fractures can occur as a result of a simple fall while walking or even if the person simply stumbled.

A high percentage of spinal compression injuries occur when the spine is metastatically affected. They arise due to the appearance of aggressive malignant tumors, which begin the process of “capturing” the patient’s numerous internal organs. The spinal ridge is also no exception. When the vertebrae are affected by metastases, they are massively destroyed - as a result, the victim is given a diagnosis of a “fracture.” A characteristic feature in this case is the presence of minimal pressure from the external environment. To confirm the nature of the fracture formation, it is necessary to carry out diagnostics using the radioisotope method. Often the location of vertebral fractures is at the level of the thoracic region, in its lower part, which corresponds to the eleventh and twelfth vertebrae.

Thanks to many years of studying the anatomical features of the spinal ridge, experts have come to understand the factors causing injury. At the same time, they learned how to significantly heal compression fractures of the spine. When the height of the anterior part of the vertebra decreases, it penetrates into the spinal canal, resulting in strong pressure on the spinal cord. This, of course, entails a number of complications, and it is extremely difficult to get rid of them. However, it should be noted that injuries that damage the spinal cord occur less frequently than “standard” compression fractures.

When exposed to external factors when a fracture occurs, affected people usually feel severe back pain. Despite the “dorsal” localization of the pain syndrome, sometimes patients may experience pain in the extremities, both upper and lower. A symptom of nerve damage (which can also occur with a compression fracture) is weakness in the limbs, as well as a feeling of numbness. With minor vertebral injuries, the pain is quite moderate.

There is a classification of vertebral fractures according to the mechanism of injury.

Table No. 1. Classification of vertebral fractures.

The most common type of injury is a compression fracture. There are several degrees of this pathology depending on the severity of the damage.

Table No. 2. Classification of compression fractures.

Diagnostics

In anticipation of a full diagnosis, specialists make a tentative diagnosis, and subsequently develop a step-by-step plan for examining the patient. Palpation occurs in those areas where the patient experiences pain. The condition of the muscles and sensitivity of the limbs is assessed. The examination also includes checking tendon reflexes, tension of nerve endings and other highly specialized tests. This allows for an analysis of the patient's condition.

In order to confirm the diagnosis or obtain its refutation, it is mandatory to carry out. This examination helps specialists see the nature of the injury. It is performed using an X-ray machine, and the results of the study are displayed on a special film. The image clearly shows the bone structures.

In many cases, for a more in-depth examination, the patient is prescribed another diagnostic study - CT. This diagnosis reveals not only the transformation and changes in the bones of the spine, but also determines injuries to other organs. The result of a CT scan is a final image that combines a number of x-ray images from different angles.

In cases where the integrity of the spinal cord is suspected, it becomes advisable to carry out. This is the latest type of examination, which allows you to thoroughly examine any structure in the patient’s body, be it ligaments, muscle tissue, spinal cord or nerve fibers. The operation of such a device is based on electrical and magnetic pulses, which act together and produce a detailed analytical result of the study. With their help, measures to diagnose the structure of soft tissues in the human body are carried out absolutely painlessly. The main advantage of magnetic resonance imaging is its proven safety. And qualitative research significantly helps many specialists.

is a serious injury that can happen to anyone.

The human musculoskeletal system can often be subjected to heavy loads, some of which can result in injury. The most severe and serious injuries are those that lead to a fracture of the spine. Breaking this skeleton garment is not so easy, and this will require significant energy, which can be provided by:

• Road traffic accident.
• Work injury.
• Rope injury (fall from a height), especially to the head, legs or buttocks.
• Jumping into a body of water in an unfamiliar place.
• Whiplash injury. For example, when a car suddenly stops, the torso is fixed with a seat belt, the head inertly moves forward, the neck bends sharply, and the cervical vertebrae break. It is not the head that may move, but the entire body, and then the thoracic or lumbar vertebrae may break.
• The cause could also be a direct blow.

In order to better understand the topic, it is worth considering the anatomical structure of the spinal column.

• It consists of individual bones, which are called vertebrae. The spinal cord runs through them, which can also often be injured. The body has 7 cervical, 12 thoracic, 5 lumbar, 5 sacral (they fuse into a single monolith - the sacrum), as well as up to 5 coccygeal vertebrae.
• Each vertebra has a body, arches and processes, only the first and second vertebrae differ in their structure. The first does not have a body or processes, but only two arches that are connected to each other, and the skull is attached to it. The second has a body, processes and a tooth (the body of the first vertebra), on which the head rotates.
• The vertebrae are connected to each other by joints and intervertebral discs

Together they form curves called lordosis (forward bend) and kyphosis (backward bend).

When a fracture occurs, not one, but several vertebrae can be damaged, and fractures can also occur in different parts.

The spinal cord is often damaged. There may also be dislocations of the vertebrae, ruptures of the discs, ligaments that hold them in place, and damage to the roots. The cause of compression can be a hematoma (collection of blood) that forms after an injury.

Thus, in practice, two main groups of fractures are distinguished - with or without a complication (damage to the spinal cord).

The most common fracture is a compression fracture of the spine. It occurs from sudden compression of the vertebral body, especially in older people, and can be accompanied by spinal cord injuries.

Classification of vertebral fractures.

All spinal fractures are divided into vertebral fractures without damage to the spinal cord and with damage to it - spinal cord injury. Also, spinal fractures can be combined with damage to the intervertebral discs and nerve roots.

There are isolated spinal fractures, in which one vertebra is damaged, and multiple fractures, in which two or more vertebrae are fractured. With multiple fractures, damage to adjacent vertebrae or vertebrae located at different levels of the spine is possible.

There are stable and unstable spinal fractures. With unstable fractures, simultaneous damage to the anterior and posterior parts of the vertebra is observed, as a result of which displacement of the spine becomes possible. With a stable fracture, either the posterior or anterior parts of the vertebra are affected, so the spinal column maintains its stability.

According to domestic traumatology, compression fractures are more often observed, in which the height of the vertebral body decreases as a result of compression. Comminuted vertebral fractures are less common. Fractures of the vertebrae also occur with damage to the bodies, arches and processes - articular, transverse and spinous.

Symptoms of a spinal fracture.

Any spinal fracture and its symptoms directly depend on its location. It is known that the human spinal column includes the following sections:

• Cervical – 7 vertebrae;
• Thoracic – 12 vertebrae;
• Lumbar – 5 vertebrae;
• Sacral - 5 vertebrae fused into a single bone;
• Coccygeal - a rudiment of the tail, from 3 to 5 vertebrae.

The vast majority of fractures occur in the lower thoracic (11-12 thoracic vertebrae) and upper lumbar (1 lumbar vertebra) regions. The main signs of an uncomplicated spinal fracture, like many types of injuries, will be standard and include:

• Sharp pain that gets worse with movement;
• Visible deformation of the spinal column;
• Swelling of soft tissues;
• Skin damage - wounds, abrasions;
• Bleeding (rarely observed).

But this is not the main severity of spinal injuries. In this case, vertebral fractures are often combined with spinal cord damage. After all, it is known that the spinal cord runs through the entire cervical and thoracic spine, and ends at the level of the 1st lumbar vertebra, and below there are numerous fibers of the spinal nerves - the so-called cauda equina.

It is important to remember and understand that a spinal fracture itself is very serious and can bring with it many unpleasant and sometimes terrible consequences in the human body. It is no secret that our spine is connected with all vital organs and the functions they perform. Unfortunately, the consequences can even be disastrous, since the spine is primarily responsible for the musculoskeletal system.

If a person had a spinal fracture for one reason or another, then it is possible that he will be limited in his movements, and will also remain with an immobile part of the body, possibly for the rest of his life. This is the worst option, since a spinal fracture itself is a very serious and serious injury. If a person has such a misfortune, and he received a fracture of the spine, he needs to be patient and have good willpower. It is possible that such a patient will have to be immobile for a long time, because treatment of the spine itself can be a very long and problematic process. Of course, there are injuries that may be incompatible with life, but in such circumstances, doctors will first of all have the task of saving a person’s life.

What should you do first before identifying a fracture?

Often a bruise can be accompanied by the same symptoms as a fracture, so any spinal injury is regarded as a spinal fracture until the truth is finally established. That's why First, the person should be immobilized. Of course, a stretcher is ideal for this, but you can use a door, branches or boards, anything that is nearby and on which you can carry a person lying down, only the object must be rigid. Next, the victim is fixed by the head, torso and legs. You should not move the victim from one place to another unless absolutely necessary, nor should he move on his own. The neck should be secured with a collar. It can be factory-made or made independently from a piece of cardboard or fabric. The head should be turned to the side to prevent the tongue and vomit from entering the respiratory tract.

Remember that: If there is visible damage, it is STRICTLY PROHIBITED to straighten it!

Possible complications.

The consequences of spinal fractures can be different. They depend on the severity. Possible consequences could be:

• compression of the roots;
• spinal cord compression;
• the appearance of a hump;
• compression myopathy;
• segmental instability;
• development ;
• chronic pain syndrome;
• breathing problems;
• development of spondylosis;
• callus formation;
• formation of hernias;
• vertebral nonfusion;
• lateral curvature of the spine.

With the development of paralysis and paresis, the formation of thrombosis or congestive pneumonia is possible.

Treatment of a spinal fracture.

In the absence of complications, they begin with conservative treatment. It involves the use of painkillers, which are very good to use with, wearing a collar or corset, strict bed rest, limiting physical activity, using antibiotics, vitamins and minerals. Painkillers used include Ketorolac, Ibuprofen, and Nimesulide.

Spinal traction is used less and less today. If the thoracic region is damaged, the patient must wear a corset. Bed rest is required for one or several months. The patient must sleep on special orthopedic mattresses. After this period, the victim must wear special orthopedic devices (corset or collar).

Conservative treatment may include (phonophoresis, magnetic therapy). If the coccyx is fractured, enemas may be prescribed. Antibacterial agents should only be used in cases of infection. To eliminate pain, anesthetics are often used or performed. Rehabilitation after a spinal fracture is of no small importance. It involves gymnastic exercises (physical therapy).

This is the final stage of therapy. It must be remembered that conservative treatment is only justified for uncomplicated fractures without vertebral displacement.

Be careful, remember that the spine is the foundation of your entire body. Do not expose your life to danger, avoid unjustified risky actions (unless of course this is your professional duty). Be healthy!

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Any spinal fracture requires not only complex hospital treatment, and in some cases surgical intervention, but also a long process of rehabilitation of the victim, which includes a number of stages to restore the normal functioning of all body systems.

Rehabilitation after a spinal fracture plays a very important role in the treatment of injury.

You can learn about first aid for a spinal fracture.

Basic methods of rehabilitation and its necessity

The main methods of rehabilitation include:

• Exercise therapy for the spine. Therapeutic gymnastics is a specially designed set of exercises used from the first days of the rehabilitation period until the patient’s complete recovery.
• Massage. An experienced massage therapist will complement exercise therapy and consolidate the effect of therapeutic exercises.
• Physiotherapy. Depending on the complexity of the injury, the doctor prescribes certain medical procedures, including electrophoresis, UHF, UV irradiation and other methods of patient rehabilitation.
• Corset. At a certain stage of rehabilitation, the patient requires additional support and protection of the spine from possible overloads.
• Alternative techniques. The last stage of rehabilitation may include balneological procedures, swimming, yoga or Pilates, etc.

The rehabilitation period is very important because it allows the human body to fully recover after a fracture and treatment, allowing the patient to return to his usual lifestyle, naturally, with certain restrictions.

Exercise therapy after a spinal fracture

For spinal fractures, physical therapy begins a week after the start of conservative treatment, unless the patient has a complicated form of injury with displacement of the vertebrae and rupture of associated structures (for example, the spinal cord). In the latter case, preliminary stabilization of the person’s condition is necessary, usually taking from 2 to 4 weeks. Exercises after a spinal injury should be performed extremely carefully and not deviate from the course prescribed by the doctor.

Each stage of rehabilitation after a spinal fracture has its own deadlines; the doctor will prescribe an exact schedule of exercises!

First stage

Approximate time frame: from 7 to 12 days of the rehabilitation period. All activities are aimed at improving the functioning of the respiratory system, gastrointestinal tract, heart, blood vessels, increasing overall vitality and normalizing muscle function.

Mostly breathing and general developmental exercises are used in the form of individual short lessons of up to 15 minutes. The patient's position is supine, the limbs are not actively used.

• Deep inhalations and exhalations with breath holding at the peaks. 5-7 times, 2 approaches;
• Lifting the pelvis with support on the shoulder blades and feet. 7-12 times, measured, 2 approaches;
• Other simple exercises without stress on the back, large muscles and limbs.

Second phase

Approximate time frame: from 12 to 30 days of the rehabilitation period. Exercise therapy is aimed at normalizing the functioning of internal organs, stimulating regeneration, and general strengthening of muscles with the development of a basis for expanding the motor regime. The average duration of classes increases to 20 minutes, the patient can roll over onto his stomach and partially use his limbs.

• Arching in the thoracic region. 7-10 times, 3 approaches;
• Tertiary abdominal swing (load on the upper section). 5-10 times, 2 approaches;
• Lateral swings of arms and legs. 5-7 times, 4 approaches;
• Flexion of the feet. 15-20 times, 2 approaches;
• Active breathing exercises. 7-8 minutes;
• Alternately raising the legs to an angle of 45 degrees with a separation from the plane of the bed. 3-5 times, 2 approaches;
• Other exercises as recommended.

Third stage

The approximate timing of the third stage of therapeutic exercises for a spinal fracture is from 30 to 60 days of rehabilitation. Progressive loading with the help of exercise therapy after a spinal injury, including exercises with weights and resistance, partial use of axial load on the back. It is performed standing on your knees or all fours with unloading of the spine. Lesson time – up to half an hour.

• Active movements of the legs while lifting off the bed. 10-15 times, 3 approaches;
• Tilts to the sides, back. 5-8 times, 4 approaches;
• Moving on knees or all fours, first forward, then backward. 4-5 steps in both directions, 2 approaches;
• The entire set of exercises from periods 1 and 2, performed on a horizontally lowered bed as an addition.

Fourth stage

The final stage of rehabilitation includes the period from getting the patient off the couch until he is completely discharged from the hospital. Exercise therapy switches to full axial load, aimed at restoring walking skills, posture, and normalizing spinal mobility. Getting out of bed is possible in a corset, without using a sitting position.

Class time increases to 45-50 minutes. Exercises from all previous stages are used, as well as activities in a vertical position:

• Rolling from heel to toe. 20 times, 2 approaches;
• Ankle movements. 15 times, 2 approaches;
• Half squats with a straight back. 7-10 times, 2 approaches;
• Abduction and adduction of legs. 5-8 times, 3 approaches;
• Additional exercises with a gymnastic wall and sports procedural objects.

The exact set of exercises for a spinal fracture will be prescribed by your doctor, do not self-medicate!

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Lifestyle and sleep patterns after spinal injury

Rehabilitation exercises for the spine should be accompanied by a correct lifestyle and sleep pattern. During the rehabilitation process and after it, it is necessary to maintain normal circadian rhythms of sleep and wakefulness: sleep for at least 8 hours, in the afternoon it is also advisable to rest for 2 hours, be in a horizontal position on an orthopedic mattress, and dense cushions are placed under the neck and lower back.

During the first months, you need to minimize the sitting position of the body. An alternative is to kneel with a pillow under your knees.

A measured lifestyle excludes any sudden and shock loads, overexertion(both physical and mental). Sports activities – within the framework of exercise therapy and cardio exercise. Professional sports are contraindicated for at least 1-2 years, sometimes much longer. If possible, come to balneological resorts once a year and visit the physiotherapy room at the clinic for preventive purposes.

Nutrition and vitamins for recovery

During the rehabilitation period, the body needs vitamin and mineral support. Doctors recommend using complex medications, separately taking Calcium D3 and substances that potentiate its absorption by the body. The most important vitamins for recovery are vitamins B, C and D, as well as microelements: zinc, phosphorus.

You might be interested... The basis of nutrition during the recovery period is protein (50% animal and 50% plant origin). The nutrition plan is fractional, 5-6 meals per day. You need to eat enough meat, fish and eggs, as well as jelly-like products that help restore cartilage: jelly, jellied pork or chicken, jelly.

It is recommended to include a full range of dairy products in the diet, from cheese and fermented baked milk to sour cream, yogurt and low-fat cottage cheese. Additionally - beans, lentils, almonds, other legumes, seeds and nuts, as well as seafood, vegetables, herbs, fruits and berries in increased portions.

Massage after a spinal fracture

For spinal injuries, a complex symmetrical massage is used, which includes classical, reflex and acupressure components. Its main goal is to complement rehabilitation exercise therapy, normalize metabolic processes and blood circulation. It is carried out from 2-3 days after the victim’s admission until his discharge from the hospital.

Massage techniques in case of a spinal fracture are passive, with stimulation of the work of individual centers and a general decrease in reflex excitability. The load is dosed, the procedures are carried out first on a treatment couch (stages 1 and 2 of rehabilitation), then in the office of a chiropractor (the patient is in a plaster semi-corset). Basic milestones include:

Sessions at the 1st stage of rehabilitation do not exceed 15 minutes. From stages 2 and 3, the functionality of symmetrical massage expands significantly (treatment of the pelvis, collar area, paravertebral areas, etc. begins), the duration of the session increases to half an hour.

Physiotherapy after fractures

Physiotherapy is used at all stages of patient rehabilitation. Classic methods:

• Electrophoresis. Begins to use 2 days after admission. It is carried out with saturation of the treated area with calcium salts, nicotinic acid, aminophylline;
• Paraffin-ozokerite applications. They are used at the 1st stage of rehabilitation as a passive effect on the muscles and deep layers of the epithelium;
• UHF. Designed to reduce pain and normalize blood flow;
• Inductotherapy. Necessary to reduce tissue inflammation;
• Ural Federal District. Destroys pathogenic microflora, prevents the development of secondary bacterial infections;

Additional techniques are also possible: myostimulation, cryotherapy, diadynamic therapy, balneological procedures, etc., as recommended by the doctor.

Corset for the spine

A corset is an important element of protecting and supporting the spine during the rehabilitation process and the subsequent stage of transition to a normal lifestyle.

In a hospital setting, after completing stage 1 of rehabilitation, the victim is given a rigid plaster corset. After discharge, the patient must purchase this device independently.

Modern medicine recommends the use of metal-plastic corsets outside the hospital– they are lighter than plaster, can be adjusted to individual body structure and are multifunctional, since they take into account all the anatomical features of the patients.

Until the fracture has completely healed and a callus has formed, it is necessary to use only rigid versions of corsets. After 4-5 months, the doctor recommends changing it to an elastic one with a semi-free fixation, allowing you to bend freely: such products take on most of the loads and at the same time reliably hold the vertebrae.

Removing it yourself at any time is strictly prohibited; this can only be done after agreement with the attending physician (orthopedist and traumatologist).

Good corsets are made from high-quality materials - reliable, flexible and at the same time breathable so that the body can “breathe” under it. Be sure to pay attention to the degree of fixation: the more stiffening ribs the system has, the more variable the product itself becomes (it can be used for a long period of time, adjusting it to your needs after prior consultation with your doctor).

Wearing procedure:

• A thin cotton T-shirt is worn under the corset;
• The degree of fixation is adjusted so that a person can breathe freely, blood circulation is not impaired, and at the same time the spine is securely fixed. The first calibration of the device is best done in the presence of a doctor;
• By agreement with the orthopedist and traumatologist, the corset can be removed at night (if all the necessary conditions for sleep are met, there is an orthopedic mattress, bolsters for the lower back and neck, etc.).