Help the spine. How to sit correctly. Hernia of the lumbar spine: useful and harmful exercises How to sit with a lumbar intervertebral hernia

The ankle joint is one of the largest in the body. He bears an impressive load every day. It is this that allows the foot to move correctly when walking, ensures normal gait and full motor activity.

In cases of falls or serious mechanical impacts, the ankle is the first to suffer. A person may hit or twist their leg, causing the integrity of the bone, cartilage or connective tissue to be compromised.

The joint is fixed in the normal position of the ligament. When healthy, these connecting elements are highly elastic. Due to metabolic disorders and other health problems, the ligaments are torn and stretched.

Injury ankle joint– damage to an organ without compromising the integrity of the tissues of which it consists. Only a doctor can determine the consequences of an injury.

After any mechanical impact on the ankle, which leads to severe pain, swelling and limited mobility, you should urgently contact a trauma center.

How to treat an ankle sprain?

→ Home treatment → Emergency conditions→ Bruise

The ankle joint has certain anatomical features - the inner and outer ankles protrude to the sides, which causes them to be frequently injured. In this part of the limb there is practically no fat layer and subcutaneous tissue.

How to recognize an ankle bruise - the main symptoms:

for several days a person is bothered by pain, which intensifies when trying to stand on his leg; at rest, the intensity of the discomfort decreases, the discomfort may completely disappear;
when walking, not only the damaged joint, the talofibular ligament, but also the entire foot hurts, severe lameness appears;
ankle, foot swells, noticeable swelling appears;
upon rupture small vessels a hematoma occurs.

The ankle can be damaged by falling even from a small height, by an impact, or by a sudden or careless movement; injury can occur due to age-related atrophy of the anterior talofibular and calcaneofibular ligaments.

Due to increased loads, dislocations and other injuries to the capsular-ligamentous apparatus of the ankle are often diagnosed in overweight people. The ankle joint contusion was assigned a code according to ICD-10 - superficial injuries S 90.

Important! A severe injury is indicated by numbness and decreased mobility of the toes.

First aid

The extent and shape of the injury can only be determined to a qualified doctor. Before the ambulance arrives, you need to properly fix the limb and try to eliminate the pain.

How to help with a bruise:

Immobilize the injured limb, the leg should be in an elevated position - this will help avoid the appearance of severe swelling and bruises.
Treat the injury site with an anesthetic; do not use drugs with a warming effect.
Apply ice, first wrap it in a thin cloth, hold it for a quarter of an hour, then take a break for 10 minutes - after this procedure the swelling will not spread higher.
Secure the damaged joint with an elastic bandage; the bandage should be applied from the toes to the very top of the ankle joint.

If the pain is intense, you need to drink Analgin, Ketanov, Nimesil. Panadol, Efferalgan or Nurofen are recommended for children. About everyone medications taken should be reported to your doctor.

Treatment methods

If you bruise your ankle, you need to visit a doctor; during the examination, he will listen to the patient’s complaints and be able to determine the extent of the damage. Then an x-ray needs to be taken. To clarify the diagnosis and determine ligament rupture, an MRI is additionally prescribed.

Therapy includes joint immobilization, drug treatment, aids you can use alternative medicine recipes.

Immobilization of the injured ankle - effective method treatment, especially if a bandage is applied within 2 hours after a bruise or sprain. Polimedel film helps a lot, as it improves blood flow in tissues and reduces inflammation. It should be applied three times a day for half an hour.

If the pain is severe, or a ligament rupture occurs, the doctor performs an anesthetic blockade. The foot is placed in a physiological position, a plaster splint is applied from the upper third of the ankle joint to the toes.

After 10 days, to speed up the recovery process, the doctor may prescribe physiotherapy:

paraffin therapy – eliminates signs inflammatory process;
diadynamic currents – help get rid of pain;
magnetic therapy – removes swelling, restores blood circulation;
ultrasound – enhances therapeutic effect drugs that restore damaged vascular walls;
UHF – after the procedure, metabolic processes in tissues are accelerated, blood flow is normalized;
mud therapy – helps restore damaged soft tissues.

Important! After immobilization of the joint, bed rest is indicated; the bandage is usually removed after 7–10 days. At severe injuries, dislocations, cracks, fractures – 4–6 weeks.

To treat a bruise, products for external use are used; painkillers and injections are needed only in cases of pronounced pain.

What medications help with a bruised ankle:

non-steroidal anti-inflammatory drugs - Diclofenac, Nise, Fastum gel, eliminate pain and signs of the inflammatory process;
drugs with a resolving effect - Troxerutin, Badyaga, Heparin, help cope with swelling and hematomas;
ointments and gels with a warming effect - Capsicam, Finalgon, eliminate pain, improve blood circulation in tissues, accelerate the regeneration process, cannot be applied in the first days after injury;
combination drugs - Indovazin, Dolobene, Dicloran plus, allow you to get rid of all the consequences of a bruise at once;
homeopathic ointments – Traumeel S, acts slowly, but enhances therapeutic effect other drugs approved for the treatment of children.

If a child has injured the ankle, then for treatment you can use products based on arnica, badyagi, Troxevasin, Rescuer.

Important! Anti-inflammatory external agents should be used on the second day after injury, warming drugs - after 4-5 days.

ethnoscience

At home, you can treat a bruised ankle with folk remedies in the form of baths, compresses, and ointments.

How to quickly get rid of the consequences of a bruise:

Baths - dissolve 400 g of sea or regular salt in 7 liters of water, keep the damaged ankle in the solution for a quarter of an hour. The procedure can be performed daily, but only a week after the injury.
Grind 100 g of comfrey roots, pour in 50 ml of olive oil, strain after 2 weeks, discard the sediment. Melt 40 g of beeswax, add 20 drops of lavender essential oil, 150 ml of castor oil, pour in the prepared olive oil. Mix, place in dark glass containers, store in the refrigerator, use for massage sessions, lubricate the injured joint before bed.
Pour 250 ml of water 1 tbsp. l. wormwood, simmer the mixture over low heat for a quarter of an hour, cool. Soak a bandage in the solution, make a compress, and keep for 2–3 hours.
Dilute warm water red or blue clay until it becomes thick sour cream, make a compress on the joint, hold until completely dry.

READ ALSO: Boil under the arm: how to treat it with folk remedies

Important! The simplest and quick way to cope with pain and inflammation from a bruise - slightly beat off a fresh cabbage leaf, grease one side with honey, apply to the injured ankle, and secure with an elastic bandage. This compress can be left overnight.

Rehabilitation

The recovery time after an ankle injury depends on the severity of the injury. For mild to moderate injuries, all unpleasant symptoms disappear within 2–3 weeks; severe forms recovery will take 1–1.5 months.

For a speedy recovery, it is necessary to follow the doctor’s recommendations, attend massage sessions, and regularly engage in physical therapy at home.

A set of exercises for a bruised ankle:

Move your right and left toes in different directions. In this case, you need to feel the tension in the muscles of the foot and lower leg.
Calf raise.
Grasp the chair with your toes, pull it towards you, and gradually increase the weight.
Walk at a moderate pace for 1–2 hours daily.

Gymnastics should be done three times a day, each exercise should be repeated 10 times; for older people, the number of approaches can be reduced to 7. There should be no pain or other unpleasant sensations during exercise.

At timely diagnosis and proper treatment, bruises and sprains of the ankle heal without any complications, but sometimes negative consequences of the injury occur.

Why is an ankle bruise dangerous?

hemarthrosis – blood accumulates in the cavity of the damaged joint, it is necessary to make a puncture to remove the fluid;
synovitis is a severe inflammatory process, which is accompanied by severe swelling and redness of the skin;
periostitis - inflammation of the periosteum, often acquires chronic form;
pronounced violation blood circulation at the site of injury due to a sedentary lifestyle;
post-traumatic arthrosis – pain in a bruised ankle can occur several years after the injury;
with repeated bruising, the risk of bone deformation, complete or partial damage, and ligament rupture increases.

When the syndesmosis ruptures due to an old bruise, false joints appear, or the ankle is torn off, surgical intervention is required. The operations are carried out using external osteosynthesis or the joint is formed using metal structures that are inserted through incisions.

To avoid bruises, development severe complications After injuries, every person needs to monitor their weight, regularly but moderately load their muscles, eat right, and give up bad habits.

No one is immune from ankle injuries - this is one of the most mobile joints in the musculoskeletal system, and experiences motor and weight loads every day. Correctly provided first aid, massage, gymnastics, medication and folk treatment will help to quickly cope with the consequences of injury.

The ankle joint contains the fibula, tibia, and tibia. They are secured to each other in the working position using ligaments, divided into three types. The first includes ligaments that have internal layout between the tibia, the external and internal deltoid ligaments form the second type.

Ankle sprain
- Risk factors for ankle sprains
- Manifestation of sprain symptoms
Different degrees damage to tendons and ligaments
First aid
Treatment of ankle injury
- First degree sprain treatment
- Treatment of a second degree tear
- Third degree complex ligament rupture
Ankle treatment with traditional methods
Recovery period

The third type includes the posterior and anterior fibular talus and fibular calcaneal ligaments. The ligaments of the third group are most often stretched.

The ankle joint bears the weight of the body and, when moving, performs various rotational, translational and abductive movements when walking on an inclined plane or running, jumping. Thanks to the ligaments, all the difficulties of movement are solved; elastic joints stabilize the looseness of the joint and protect it from injury.

ICD-10 code for ankle contusion

Like any other disease, bruise of the osteoarticular system in the ankle area has a code according to ICD-10. Where is ICD international classification diseases, and the number 10 next to it means the current edition adopted during the tenth revision.

According to ICD-10, bruises and similar diseases correspond to class 19, which is called “Poisoning, injuries and other consequences arising from external causes.” Diseases and injuries affecting the foot and ankle joint are collected in one general block, designated S90-S99.

Specialized treatment

Specialized treatment An ankle injury is performed by a traumatologist. The doctor fixes the injured leg with a bandage or plaster cast. Local anesthetics are used to relieve swelling and pain.

Medicines that a doctor can prescribe for a bruised ankle:

Uymisbol (gel) is a herbal preparation based on cinquefoil, eliminates tissue swelling, reduces the severity of pain, and simultaneously has a chondroprotective and anti-inflammatory effect;
Wobenzym - enzyme preparation, available in tablet form, used for pain relief, swelling and inflammation;
Ibuprofen is an anesthetic that helps cope with severe pain and inflammation, often prescribed by doctors for bruises and other injuries that damage soft tissue;
Diclofenac is a strong analgesic, eliminates swelling, relieves pain and reduces the severity of inflammation, but it has many contraindications.

Effective gels and ointments for a bruised ankle:

Sinyak-OFF - gel to accelerate the resorption of hematomas;
Indovazin - gel to reduce tissue swelling, relieve inflammation and relieve pain;
Heparin ointment- used to treat bruises and contusions, as well as Heparin-Acrigel, Lavenum, Leeton, Trombless;
Troxevasin (ointment)- relieves swelling, has an anti-inflammatory effect, strengthens the walls of blood vessels;
Venolife gel – contains dexpanthenol, heparin, troxerutin.

Physiotherapy

If the ankle joint is severely damaged, physiotherapeutic procedures are indicated. Electrophoresis, magnetic therapy, UHF and paraffin baths are most often prescribed.

Methods of physical treatment are also indicated during the rehabilitation period.

A set of therapeutic exercises is indicated after removal plaster cast to develop the joint. In the first days, massage and light movements are indicated.

Exercises for the ankle joint:

Walking on your toes (after tissue healing).
Circular movements of the feet.
Rolling a water bottle with your feet (performed while sitting).
Grasping small objects on the floor with your fingers.

After the doctor has ruled out sprains and other serious injuries, you can begin to treat the bruise. On the day of injury, it is better to provide complete rest to your leg by placing a pillow or a cloth cushion under it. At severe bruise you need to use a cane if there is a need to move.

When painful sensations and the swelling has gone away, the patient is prescribed a massage and special restorative gymnastics, during which a person, sitting or lying down, bends and straightens his fingers, foot, and twists it.

After a week, the use of warm baths with the addition of sea salt is allowed, alcohol compresses, compresses of heated salt. In case of a severe injury, one cannot do without physiotherapeutic procedures - electrophoresis, paraffin baths, ultraviolet irradiation and others.

Specialized curative therapy bruise of the ankle joint is carried out in medical institutions. The position of the leg is recorded by the doctor. A bandage or plaster splint is used for the procedure. Non-steroidal anti-inflammatory drugs are prescribed for severe inflammation.

To exclude a fracture, dislocation, or other possible injuries, the patient undergoes x-ray examination. After this, he is prescribed drugs to eliminate acute manifestations bruise and improve tissue healing.

Having considered various options treatment, we can conclude that it is possible to get rid of the consequences of a bruised ankle joint in a very short time, if you resort to therapy in time.

Based on where exactly it hurts and how it hurts, you can roughly make a diagnosis or at least suggest it. It would seem nothing complicated: my neck hurts - cervical chondrosis or osteochondrosis, lower back - radiculitis or osteochondrosis, joint pain - arthritis, arthrosis.

But sometimes there are pains for which even a conditional diagnosis can be quite difficult and requires thorough examination and change large quantity analyses. These include pain behind the knee.

Description

Pain behind the knee is quite common and affects many people. different ages. Sometimes the pain continues for a long time, becoming more intense and making movement difficult.

Anatomical structure The popliteal fossa and its features make it difficult to identify the causes of pain. And pain under the knee can vary in intensity and nature:

Pulling.
Aching.
Sharp.
Pain when bending or straightening the knee.
Strong or tolerant.

The knee is bounded above and below by tendons and the femoral and ankle muscles, adipose tissue and epidermis, which cover the nerve, becoming a barrier to infection, hypothermia and mechanical damage. As a rule, it is the nerve that makes itself felt, disturbing with painful sensations.

Signs

Symptoms that you need to pay attention to and take action:

Pain of any nature (pulling, sharp, strong, aching, dull, when bending or straightening);
On palpation examination, swelling and bulging are observed;
Swelling and redness of the knee;

Increase in body temperature;
Fever under the knee;
Hematomas in the knee area (above or below it).

There can be many causes of pain under the knee and it is impossible to determine them on your own. Even an experienced doctor will not tell you anything definite with just one visual examination, without additional examinations.

However, the most common reasons why the leg hurts under the knee are the following:

Purulent-inflammatory process knee joint begins only if there has been damage to the joint area, accompanied by bleeding and tissue ruptures. Sometimes suppuration can be caused by inflamed lymph nodes. If the wound is not properly treated or the form of lymphadenitis is advanced, purulent-inflammatory processes of the knee joint begin, namely in the area of the popliteal fossa. Due to the fact that the lymph nodes are located deep under the skin and muscles, it is not so easy to determine exactly the reasons why pain occurred under the knee. Swelling and redness are usually absent; the only signs that can be detected are slight swelling and increased pain when straightening the knee and pressing on the popliteal fossa.
A meniscal cyst is accompanied by a nagging pain under the knee. Unlike Baker's cysts, meniscal cysts are invisible when initial examination and palpation. The causes of meniscus cysts are previous injuries and excessive physical activity.
Meniscus tears cause sharp pain when they tear posterior horn internal meniscus, it cannot rupture on its own. This happens most often after or during injuries. In case of careless rotation of the ankle joint. The pain may be accompanied by involuntary extension or flexion of the knee.

Diseases of the tendons, joint tissues, and tendon bursae also cause pain under the knee. Tendons and tendon bursae are structurally soft tissues, and they are very often damaged, causing pain behind the knee. The causes of this group are accompanied by the presence of seals under the knee, upon which pressure occurs. nagging pain, when pressed, they do not decrease in size and do not change their structure. The causes of the onset of diseases of the soft tissues of the joint are long-term abnormal physical activity.
Baker's cysts, which are accompanied by symptoms such as swelling in the middle of the popliteal fossa and pain in the knee area. With Baker's cysts, the amount of secretion increases synovial fluid, the excess of which begins to pour out of the joint, leading to bulging at the back. When the leg is bent, the protrusion disappears, and when the leg is extended, it appears. After pressing on the bulge, the protruding tubercle decreases as the liquid spreads under the skin and then gathers again.

Tumor and vascular diseases, which include arterial aneurysms, tumors of the tibial nerve, and vein thrombosis. Such phenomena are characterized by severe pain in the knee, hip, foot, increased tone muscles, tendon weakness. With an arterial aneurysm, a detachment of the artery walls occurs, one of which protrudes outward, accompanied by pain and pulsation; it is pulsation that is the main difference between an aneurysm and a Baker’s cyst when diagnosing the disease. During arterial dissection, bleeding occurs into the body cavity, causing unpleasant consequences in the form of suppuration and infection of the wound. With thrombosis of the popliteal vein, there are practically no signs, however, with complications, a nagging pain appears under the knee. In such cases, the symptoms are similar to signs of pinched sciatic nerve, therefore, to make an objective diagnosis, ultrasound of the vessels of the lower extremities is prescribed.

Important contraindications for hernia lumbar region spine include a ban on heavy physical exercise and axial loads on the back. This disease is accompanied by severe pain and untimely treatment can lead to disability and immobilization. You should pay close attention not only to prohibitions in exercise, but also to lifestyle, rest and nutrition, which also greatly influences recovery.

Why does it appear and what are the symptoms of hernia pathology?

The main provocateur of the problem is lifting a heavy load when a person is in a bent back position. - a disease in which a disc bulges between the vertebrae. Often the place of their localization is lumbar hernia, less often - cervical and chest area. Spinal hernia is typical for people between 30 and 50 years old. It does not appear immediately, but as a result of the accumulative process of “depreciation” of the spine over the years. Main reasons:

lack of fluid in the body;
errors when sitting, walking and standing;
improper exercise;
wearing uncomfortable shoes;
heredity;
sedentary work mode and lack of physical education;
poor diet and alcohol abuse.

The main symptom is pain at the site of the disease and virtually immobilized injured area. The patient finds it difficult to exercise and his lifestyle becomes less active due to the inability to fully perform habitual movements. The pain can be sharp and sharp, or aching. This is especially true when the body is in an awkward position.

What should you not do if you have an intervertebral hernia?

With this disease, it is strictly forbidden to lift heavy objects.

At lumbar hernia There are a number of restrictions that can reduce the risk of the situation worsening. Lifting heavy objects and any intense axial load on the spine should be completely avoided. Also, contraindications for hernia of the cervical spine and other areas include types physical activity when the body remains in an upright position for a long time. A person suffering from this disease should carefully consider changing the type of sport, food, and lifestyle. Not all work is permissible when there is a hernia of the thoracic spine or other parts.

What exercises should you not do?

Prohibited exercises for spinal hernia or their elements:

blows;
jumping;
pushes in the back;
twisting in the initial stages of treatment;
exercises with high load on the spine or with sudden movements.

It is contraindicated to overload the body. The consequences of improper physical exercises greatly affect the course of the disease. A hernia should be treated comprehensively. If prohibited movements are avoided, the quality of therapy will be higher. When exercise causes pain, you should stop immediately.
Contraindicated sports

People with this diagnosis should not jump.
If yoga and physiotherapy are considered the best treatment solution. But other sports are not allowed. Contraindications for intervertebral hernia The lumbar region includes bodybuilding training: power squats, lunges, deadlifts. It is worth completely abandoning team competitions where there is running and jumping, and also when the degree of injury is high. Any sport with a hernia requires preliminary muscle warming and wearing a special corset.

It is better not to joke with such a diagnosis as herniated intervertebral discs, since the spinal cord passes through the spinal canal, from which nerves depart that provide innervation to organs and systems. Naturally, when nerve endings are compressed, not only symptoms of pain may appear, but also disturbances in the functioning of certain organs. According to statistics, it is the lumbar region that is often affected, since it accounts for not only motor activity, but also the need to withstand body weight. The lower back is often susceptible to injury during sudden movements, due to muscle overstrain when lifting heavy objects, and, as is known, it is not so easy to relieve pain when the lumbar area hurts. Let's look at the causes and signs of a lumbar spinal hernia, as well as the principles of treatment, including pain relief, physical therapy, tips on how to sleep and how to sit correctly. Let's look at what a hernia is in terms of anatomy and physiology.

The lumbar spine consists of 5 large vertebrae connected to each other by intervertebral discs, which, in turn, create a shock-absorbing function. Discs are also necessary to evenly distribute the load across the lumbar region. The reliability of the disc is ensured by the fibrous ring, and inside this ring there is a core of semi-liquid consistency. With increasing loads, after a back injury or other circumstances, destruction of the fibrous ring is possible, that is, the appearance of cracks through which the core partially enters the spinal canal - protrudes. Thus, over time, a herniated disc forms, which, in turn, can compress nerve endings, blood vessels, and narrow the lumen of the spinal canal, which leads to negative consequences. The patient may be at risk of disability due to a hernia, disrupting the functions of the genitourinary system, gastrointestinal tract, causing paralysis of the lower extremities, so we will consider the causes and risk factors to protect ourselves from this pathology.

Causes

Intervertebral hernia is one of the rare pathologies that can be caused by both an overly active lifestyle and a sedentary lifestyle. Most often, a person is faced with the fact that he has signs of a hernia of the cervical spine and lumbar region. A herniated disc in the lumbar region can be caused by constant stress on the muscular apparatus, that is, people whose work involves lifting heavy objects and working with vibrations suffer. The second risk group is athletes, and weightlifters are especially susceptible. If at a young age intense training keeps the muscular system in good shape, then with the cessation of training, old injuries and damage to the musculoskeletal corset in the lumbar region begin to appear.

In women, childbirth is often the cause of a hernia, and it may not be the birth itself that is to blame, but weight gain during pregnancy, and after it, carrying the child in your arms. There are problematic births, when the fetus is large or has an incorrect presentation, then the risk of spinal injury increases.

Risk factors for developing a hernia in the spine:

getting a back injury, especially in an accident when the body experiences a shock or jerk;
a blow to the back with a blunt object or a fall from a height onto the back;
impaired metabolism due to alcohol abuse, junk food, diabetes, smoking;
lack of vitamins and minerals, a particularly pronounced condition with the aging of the body;
obesity, which increases the load on the lower back.

Most often, these reasons are combined, for example, people with diabetes mellitus prone to obesity and a sedentary lifestyle. It is worth noting that a hernia of the lumbar region may not be noticed immediately, since the disease is characterized by progression, a slow onset of development pathological process. A degenerative-dystrophic process is observed in the spine, accompanied by impaired nutrition of the discs, which is why it loses its strength. That is why the disease can be caused by various infections, such as tuberculosis, syphilis, which affect the body systemically.

And of course, do not forget about the factor predisposing to hernia – osteochondrosis. Most patients with a hernia have a history of this disease, since osteochondrosis affects the structure and nutrition of the spine.

Symptoms

Most often, a hernia in the lower back develops between the L4-L5 vertebrae, a little less often the sacral region is also involved in the process, that is, in L5-S1, which is why we can conclude that the lower lumbar region suffers and this is associated with increased loads on this area.

Consequently, the symptoms often involve in the process not only the lumbar area, but also the buttocks and lower extremities, which is why the disease is characterized by complications such as lumbago, pinching of the sciatic nerve, radiculopathy and others. Therefore, it is better for patients with a hernia not to joke with their health, so as not to trigger the disease, since complications of a hernia lead to the fact that the patient is often unable not only to run or swim, but also to walk normally.

The pathology is characterized by symptoms of pain, the strength of which increases with exercise. If there is compression of the nerve endings, then lumbago appears - sharp pain with every movement, which passes in a state of rest. Pain relief for lumbago with conventional drugs (analgesics, NSAIDs) is not always helpful, so, as a rule, patients seek medical help. In addition to pain, a person with this diagnosis suffers from stiffness in the lower back, sensitivity is impaired, and a burning and tingling sensation appears at the site of the hernia formation.

When inflammation develops due to compression of the spinal cord or nerve endings, additional symptoms. In addition to the fact that the pain sharply intensifies from turning or tilting the torso, the sensations of pain spread to the buttock area, go down the legs, right up to the toes. The patient may have problems with genitourinary system, manifested in decreased potency, retention, or, conversely, uncontrolled urination. The gastrointestinal tract may be affected. If the hernia is not treated, the patient is at risk of developing paresis and paralysis.

Conservative treatment

With the help of conservative treatment, it is unlikely that it will be possible to cure the hernia completely; in many respects, everything depends on the size of the hernia, but if you start treatment in the early stages, you can stop its growth, that is, stop its progression. Moreover, if you strengthen the muscle corset, you can avoid squeezing the nerve endings, which is why doctors often resort to non-surgical treatment.

Therapy has two directions at once, the first of which is aimed at eliminating the symptoms of pain. The following methods are used for this:

drug therapy - drugs from the NSAID group (Ibuprofen, Diclofenac, Meloxicam), muscle relaxants (Sirdalur, Mydocalm);
non-traditional methods - acupuncture (acupuncture), by the way, acupuncture can only be performed by a doctor;
spinal blockade using hormones - Diprospan, Kenalog in combination with Lidocaine.

A blockade for a herniated lumbar spine is prescribed when other methods of pain relief are ineffective, since the introduction of hormones poses a risk of developing side effects. The hernia is blocked once every 3 months, more often in advanced cases. Acupuncture for hernias is used to reduce pain symptoms.

The second direction of treatment is aimed at strengthening the muscles, which requires training to pump up the muscles. But do not forget that the training program should be selected individually. A popular technique is hyperextension for a hernia of the lumbar spine, that is, special exercises aimed at strengthening the lower back muscles. For this purpose, special simulators are used for hernia.

A lumbar bandage, which must be worn as directed by a doctor, helps reduce the load on the spine. Some doctors recommend using an exercise bike for exercise. By the way, it is not recommended to pump the abs during a hernia in the usual position from the floor, so you should not perform exercise therapy exercises that the doctor has not prescribed.

Swimming is effective for hernia, which is why swimming is recommended for prevention, especially for people with spinal curvature. Replace sea water the pool will be able to, and if you go to the pool with osteochondrosis, then the chance of developing a hernia decreases. If a woman is expecting childbirth, then she is also recommended to visit the pool, but she needs to work out with a trainer and after consulting a gynecologist, then the birth will be successful.

By the way, about issues of prevention. You can give a technique that helps strengthen, pump up all muscle groups and protect the spine from osteochondrosis, hernia - this is a fitball. Fitball is an excellent prevention of diseases of the musculoskeletal system, which consists of exercising with a special elastic ball.

Don’t forget about nutrition if you have a herniated disc. It is necessary to exclude alcohol, cigarettes, fatty and fried foods. It is recommended to add vitamins to your diet.

Physiotherapy for lumbar hernia is often indicated to relieve inflammation. The question arises: is it possible to use all ERT techniques; the answer is no. A doctor can select procedures, since electrical stimulation has a number of contraindications. Electrophoresis helps well with hernia of the lumbar spine.

Prevention of complications

Now he will talk about what is and is not possible with the disease, that is, contraindications for a hernia of the lumbar spine. Be sure to follow a diet for a hernia, it helps walking, since a sedentary lifestyle negatively affects the disease.

Massage and going to the pool are allowed, that is, swimming is not only possible, but also necessary. Among exercise therapy exercises, lifting weights is prohibited, that is, strength exercises, techniques that can severely stretch muscles and ligaments. Squats are only shown in the early stages. By the way, squats and abdominal pumping help with preventive purposes, and as you know, prevention is better than cure.

You cannot self-prescribe painkillers for a hernia, lift heavy objects, or sit on a chair for a long time. Many people are concerned about the question of how to live with such a diagnosis, but with early treatment and following the recommendations, you can even prevent disability.

Of course, in advanced cases, surgery is necessary and a long period of time will be required. rehabilitation period, which includes a swimming pool, ERT, exercise therapy.

2017-01-19

Intervertebral hernia of the lumbosacral region

The lumbar spine consists of 5 vertebrae, between which are intervertebral discs. The sacrum is represented by one bone, the sacrum. The last lumbar vertebra is also connected to the sacrum by a disc. Accordingly, hernias can occur at any of the listed levels, but most often the cartilage tissue between the 4th and 5th lumbar vertebrae, as well as between the 5th lumbar and 1st sacral vertebrae, is affected.

Lumbar hernia sacral region the spine occurs most often, since it is in this section spinal column account for maximum loads. A hernia is a protrusion of the inner part of the intervertebral disc (nucleus pulposus), which occurs as a result of degenerative changes in the cartilage tissue and rupture of the fibrous capsule of the disc. This is a complication of a disease such as osteochondrosis, although traumatic disc herniations can rarely occur.

A lumbosacral hernia is a dangerous disease, since the protrusion can put pressure on the spinal cord if the hernia forms at the level of the 1st-3rd lumbar vertebrae, or on a bundle of nerve fibers inside and outside the spinal canal if the protrusion appears at the level 4th lumbar-1st sacral vertebra (since at this level there is no spinal cord inside the canal).

Causes

There are several reasons for the formation of intervertebral hernias. As a rule, they appear as a result of a degenerative-dystrophic process such as osteochondrosis. For a long time this disease was considered normal age-related changes, but in the last few years the incidence of osteochondrosis has increased significantly among people young and even teenagers. This proves that it's not just about age. An important role is played by factors that contribute to disruption of metabolic processes and nutrition of the cartilage tissue of the discs, as well as constant overload of certain segments of the spine.

Risk factors for developing intervertebral hernia:

working conditions when the lumbar region is subject to constant loads, which cause microtraumas inside the cartilage tissue and disc degeneration, for example, working as a loader, gardener, staying in one position for a long time (office workers);
spinal injuries;
congenital and acquired diseases of the musculoskeletal system;
curvature of the spine;
excess body weight;
poor development of back muscles;
metabolic and endocrinological diseases.

Important to remember! The risk factors described do not mean that their owners will necessarily develop intervertebral hernia, but the more such negative influences, the greater the chance of getting sick. Therefore, people who are at risk should take preventive measures to prevent pathology.

Symptoms

Signs of an intervertebral hernia depend primarily on its size, level of occurrence and type (depending on location).

There are several types of disc protrusion relative to the circumference of the spine:

Posterolateral. These are the most dangerous and clinically significant types of formations, since the protrusion is directed into the spinal canal (medial), which can lead to compression of the spinal cord tissue. Also, the hernia can be turned towards the spinal roots (foraminal and paramedian) and cause their inflammation, irritation or compression with corresponding consequences.
Lateral or lateral. In this case, the hernial sac prolapses away from the spinal column. Such a hernia is not dangerous; it can cause symptoms only if it reaches a large size.
Ventral. Diagnosed when the protrusion is located in front of the spine. This type of hernia never causes pathological symptoms and is not of particular clinical interest; as a rule, it is diagnosed accidentally during examination for another reason.
Common. In this case, the protrusion occurs along the entire perimeter of the disc. It can be circular, when the disc is squeezed out evenly, or diffuse, when it prolapses unevenly. In both the first and second cases, the hernia poses a serious problem and health hazard, as it often causes compression of the structures of the nervous system.

Depending on their size, lumbosacral hernias can be classified as follows:

small (1-5 mm), which require mainly outpatient conservative treatment, exercise therapy, and possibly the use of spinal traction;
medium (6-8 mm), treats them on an outpatient basis, surgery is not indicated;
large (9-12 mm), which they try to treat conservatively, but surgery may be prescribed for symptoms of spinal cord compression or the development of cauda equina syndrome;
giant (more than 12 mm), surgical treatment; conservative therapy can only be used if there are contraindications to surgical correction.

As a rule, the disease develops gradually over several years. Symptoms of the pathology appear if the protrusion causes irritation, inflammation or compression of the nerve roots that exit the spinal canal, or the tissue of the spinal cord is compressed.

The main symptom that indicates a lumbosacral hernia is pain. Lower back pain can have several options:

Lumbodynia is chronic pain in the low or low back. medium intensity. They appear or worsen in case of overload of the spine or awkward movements.
Lumbago is an acute pain that occurs suddenly in the lumbar region in the form of a lumbago, its intensity is very high. Pain forces a person to freeze in the movement in which he is when the pain overtook him, and does not allow him to straighten up. Lasts several minutes, then gives way to lumbodynia.
Lumboischalgia. This pain syndrome is characterized, in addition to typical lumbodynia, by the spread of pain along the sciatic nerve (posterior surface of the buttock and thigh). It can be either one-sided or occur in both legs at once.

In parallel with the pain syndrome, patients feel stiffness in the lower back, limited range of motion, muscle tension in this area, crunching or clicking may occur when moving in the spine.

The following symptoms indicate damage to the spinal cord or nerve endings:

decreased muscle strength in the lower extremities;
foot paresis;
impaired sensitivity of the skin of the legs;
muscular atrophy of the lower extremities (you may notice muscle loss);
various disorders of the pelvic organs (retention or incontinence of urine, feces);
erectile dysfunction in men, loss of genital sensitivity in women;
when the spinal cord is compressed, paralysis of the legs (lower paraparesis) can occur.

If the hernia is located at the level of the 3rd lumbar-1st sacral vertebra, then the bundle of nerve fibers that extend from the spinal cord may be compressed, since at this level the spinal cord is no longer present. In this case, cauda equina syndrome develops. These nerves provide sensory and motor innervation lower limbs and pelvic organs. This function suffers when the cauda equina is compressed.

Diagnostics

In each case, a spinal hernia requires detailed diagnosis, because there are several dozen other diseases that can manifest similar symptoms. Also, clarifying the location, type of protrusion, and its size plays an important role in drawing up a treatment program.

Diagnostic methods:

neurological examination,
standard set of laboratory tests,
radiography of the spine,
MRI or CT scan of the lumbosacral spine.

Treatment

Treatment of lumbosacral hernia can be conservative or surgical. As a rule, at an early stage of the disease, success conservative therapy very high and reaches 90%, but only if all medical recommendations are followed. The following methods are used:

drug therapy (analgesics, non-steroidal anti-inflammatory drugs, muscle relaxants, decongestants, chondroprotectors, B vitamins, drugs to normalize microcirculation);
special complexes of therapeutic exercises (therapeutic exercises)
spinal blocks with local anesthetics, corticosteroid hormones to relieve acute pain;
spinal traction;
kinesiotherapy;
massage;
physiotherapeutic procedures;
Spa treatment.

If conservative therapy is ineffective for 6 months, there is constant severe pain, or there is a threat of spinal cord compression or the presence of such, surgical treatment of the hernia begins.

There are many techniques surgical intervention on the spine for a hernia, in particular, modern and minimally invasive ones. The choice of the necessary procedure is made by a specialist doctor, based on the individual situation of each patient.

It is important to note that, despite modern technologies and surgical techniques, surgery spinal hernia is always a big risk; in addition, in such cases, long-term rehabilitation is necessary, on which half the success depends. Therefore, it is better to try to get rid of the problem using conservative methods, which, in addition to the therapeutic effect, also have a preventive effect.

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Osteochondrosis and its manifestations in Lately have literally become unprecedentedly widespread, gradually acquiring epidemic proportions. Many people do not think about why this disease, which was previously experienced only by older people, now affects even young people, not to mention the middle age category.

Perhaps the most common manifestation of osteochondrosis is intervertebral hernia - an extremely unpleasant problem that can seriously worsen the quality of life of any person. And the leader among such manifestations, due to the structural features of the human body, is a hernia of the lumbosacral spine.

What causes this problem, what are its symptoms, how to prevent its occurrence and what treatment is necessary if you have already encountered a similar problem?

Causes of intervertebral hernia

Unfortunately, to this day it is unknown why a hernia develops intervertebral disc. The only precisely known fact is a direct connection with metabolic disorders in the spinal column. Thus, it turns out that an intervertebral hernia can equally occur with excessive physical stress and with insufficient stress on the spine. In both of these cases, there is a disruption in the process of blood circulation and metabolism in the muscles and cartilage tissues that surround the spine.

The situation is aggravated by the fact that the intervertebral disc itself does not have its own blood vessels, it receives nutrients from surrounding tissues through diffusion. This process is quite reliable, but it is very dependent on whether the required amount of movement and load is present, and with modern sedentary this is a real problem in life.

Another, no less important point is the presence of necessary vitamins and microelements in the tissues that surround the intervertebral disc. Even if the amount of stress is sufficient, it may happen that the body simply does not have one or more components that are necessary for normal functioning disk. This is enough serious problem, given the fact that food ordinary person Nowadays, what we eat is little compatible with the concept of “healthy” - for the most part products are not of very high quality, generously “flavored” with various chemical components, which increase shelf life, improve taste, etc. Moreover, such components themselves are also not at all harmless, but that’s another question.

This is not about joining the “adherents” healthy image life and start eating exclusively grass and salad, you just need to reconsider your diet a little and more often give preference to healthy foods rather than tasty ones. Even simply eating organic foods can largely solve this problem.

Risk factors

Considering all of the above, we can identify some very specific risk factors. This:

low mobility and weakened back muscles;
excessive static or dynamic loads on the spine;
damage or injury to the spinal column or intervertebral disc;
congenital defects in the development of the musculoskeletal system;
scoliosis;
osteochondrosis;
bad habits that cause innervation and disruption of blood supply to both the discs themselves and the surrounding ligaments and muscles.

In addition, it should be remembered that a herniated disc most often manifests itself in the lumbosacral region for the reason that this is where the center of body mass is located, and the spine itself bears the maximum load, so the slightest disruption intervertebral discs immediately leads to the appearance of protrusions, and then hernias.

How does the disease manifest itself?

With a problem such as a herniated sacral spine, symptoms may not appear immediately. The specificity of this department suggests that there is a certain “reserve” here, which is necessary to ensure the mobility of this part of the spine, therefore, in some cases, disc protrusion, and sometimes a full-fledged hernia, practically does not manifest itself in the early stages. However, there are some signs that you should pay attention to and consult a doctor without waiting for full-blown pain syndromes to develop.

Stiffness in the lower back that occurs during physical activity, difficulty in independent movements;
change in skin temperature of one of the legs;
violations of muscle tone in one of the legs, with progressive atrophy or malnutrition often observed;
the appearance of neurological symptoms (burning, numbness, lumbago and sciatica, which occur on the affected side);
compensating body postures that a person takes unconsciously.

Any of the symptoms described above is worthy of attention, even in cases where it has just begun to appear. Sciatica and lumbago, which are essentially pain syndromes, in the first stages of the disease have a paroxysmal nature and low intensity, but without necessary treatment the pain will intensify.

How is this disease treated?

Treatment of a lumbosacral hernia is usually carried out in such a way as to avoid surgery. This is the so-called “conservative” treatment. It should be noted that it is quite effective and helps patients in more than 90% of cases.

At the first stage of treatment, the patient is prescribed bed rest for several days, which is then replaced by a regimen of limited motor activity. In this case, symptomatic drug treatment is carried out. The basis of this method is the use of non-steroidal anti-inflammatory drugs, which successfully relieve inflammation and swelling, thereby reducing compression of nerve endings and reducing pain. U similar drugs there is only one serious drawback - they do not have the best effect on the functioning of the gastrointestinal tract, so usually the doctor tries to prescribe minimally effective doses.

For severe pain syndromes, painkillers are also used, but they, in fact, only mask the pain without eliminating its cause. This carries a certain risk, because the patient, misunderstanding the situation, begins to load the spine and further harms it.

If necessary, muscle relaxants (to relieve spasms of the back muscles) and chondroprotectors (to protect intervertebral joints damaged by osteochondrosis) can also be used.

The second stage of treatment includes physiotherapeutic procedures, massages and therapeutic exercises. Objectively speaking, this stage is much more important than the period of fighting pain, since it is during this period that the body adapts to changed conditions and develops a new motor stereotype. After all, as you know, a vertebral hernia does not disappear with the end of treatment, it remains, and a person has to learn to live with this problem.

For the lumbosacral region, this issue is most relevant, given heavy loads which he has to endure. In particular, it is very important that a person learns how to move correctly, lift weights, etc.

In case of spinal hernia, special attention should be paid to the sleeping area. There are certain sleep rules that will slow down the development of pathology and help avoid injury. The place to sleep should be moderately rigid and have an orthopedic base. It is necessary that the mattress follows the contour of the body, but is not too soft. During exacerbations, it is necessary to switch to a harder surface to ensure a traction effect.

How to sleep properly with a spinal hernia

Proper sleep with a herniated disc will significantly relieve pain. Initially, you should choose the optimal position from several possible ones and sleeping accessories: pillows, mattress, bed.

Note!

For good rest Doctors may prescribe pain relievers and muscle relaxants to take before bed. This is required to relieve pain and ensure comfortable treatment conditions.

Ways to improve sleep quality:

Go to bed only when you feel sleepy. At night the pain intensifies. If you are not tired, it will be difficult to fall asleep.
Avoid using electronics. Intense light radiation forces the brain to believe that the daylight hours have not ended. This makes it difficult to sleep. 30-60 minutes before bedtime, you should turn off all devices.
The sleeping area should be dark and cool. Night curtains can be used to block out daylight. The room should be ventilated before going to bed.
Avoid food, caffeine and alcohol 2-3 hours before bedtime.
Half-hour walks or light physical activity significantly improve the quality of sleep.

Stretching your back will prepare your body for sleep. Perform it before bed using a special roller. They lie on it with their back and gently move their body back and forth.

Use various techniques relaxation: meditation, self-hypnosis, deep breathing etc. They will take no more than 15 minutes, but will bring significant benefits. Calm music and herbal tea will also help you relax.
A cold compress with ice will reduce inflammation and pain. The duration of the procedure is 10 minutes. Prolonged contact with cold can damage fabrics.

What to sleep on

The ideal option is an adjustable bed. But you can also rest comfortably on a regular bed if you choose the right mattress and pillow.

A folded pillow under the knees will reduce stress on the lower spine

If you have difficulty choosing a position for a herniated spine, you can sleep in a reclining chair. Elevating the upper body reduces stress in the lower spine.

During periods of exacerbation, you can switch to a harder surface (for example, the floor). It will provide good support for the spine, keeping the skeleton straight. But you should not overuse it, as there is a high probability of developing complications.

Selecting a mattress

The mattress is chosen to be elastic, but most importantly – comfortable. They check it personally: just lie on it in the store for 5-10 minutes. We recommend choosing an orthopedic mattress taking into account the patient’s weight.

It is permissible to use a mattress with springs, but a polyurethane soft mattress pad 8 cm thick is placed on top.

Note!

You should not sleep on a hard surface all the time, as treatment will be useless. A hard sleeping place is acceptable up to 20 years; later the ligaments need softer surfaces. A hard mattress increases the load on the spine.

The mattress should be made of natural soft materials. More convenient two-layer samples: one side is hard for the acute stage, and the other is soft for the remission period.

Video

In the video, Elena Malysheva will tell you what should be taken into account when choosing a mattress for patients with spinal pathology.

Pillow selection

Orthopedic pillows have a special shape that allows the cervical spine to take a neutral position. It minimizes the load on other parts of the spine.

Pillows are not only placed under the head during sleep. They are used to limit leg movement and ensure the natural position of the lower back when lying down. A good option there will be a memory foam product that can conform to the contour of the body.

Don't choose a high pillow or ignore it. This leads to stretching of the capsules of the intervertebral discs and impedes blood circulation, pinching the vessels. It can also provoke inflammatory reaction or malfunction of brain cells.

The pillow will limit the movement of the legs and ensure the correct position of the spine

A simple elongated pillow is also suitable for sleeping. The back of the head should lie on it, and the ends should be straightened above the shoulders. If you need to lie on your side, roll up the pillow and place it under your neck.

Criterias of choice:

good rigidity, but soft and comfortable (the exact rigidity will be indicated by the doctor);
the presence of a recess for the shoulder;
a special hump to maintain the natural position of the neck;
height 14-60 cm depending on shoulder width;
the width is also selected according to the shoulders - they should not go beyond the edges;
for sleeping on the stomach, select a soft and thin pillow to prevent the head from throwing back.

Choosing a bed

An ideal option would be an adjustable bed to reduce the load on the spine. Often a hernia causes pain when a person lies down on a horizontal surface. An adjustable bed allows you to raise the head of the bed to ease the load and reduce pain. At first it may be difficult to get used to it, then it is acceptable to sleep for a couple of hours on the bed. But over time, the duration of sleep on it increases.

environmental material;
elastic slats;
comfortable height;
the width allows you to lie on your back and fold your arms behind your head - your elbows should not hang.

Adjustable bed

Sleeping position

If you have back pain, you should sleep on your back to ensure maximum relaxation of the spine. But it is worth remembering that stretched legs will increase pain. Doctors advise bending them slightly at the knees and securing the position with a roller. The head and neck can be slightly elevated using a small pillow, but the back and shoulders should be completely on the surface of the mattress.

If sleeping in one position is problematic, then alternating is acceptable.

Sleeping on your side is optimal. For comfort, you can use a special pillow or roll up a blanket from a blanket. At the same time, the pillow will allow you to straighten your back and neck.

If sleeping on your back is uncomfortable, you can try the fetal position. To do this, lie on your side, tuck your legs toward your stomach and place a pillow between them to limit movement. In this pose, the spine has a smooth curve, which relieves tension and pain.

Those who prefer sleeping on their stomach need to place a bolster or pillow under the pelvic and groin area to prevent a strong deflection of the spine and tension in the ligaments. But it is worth remembering that this pose straightens the natural curve of the spine.

On the stomach, it is difficult for the spine to assume a normal position

After waking up, sudden movements should be avoided. You need to start with a small exercise for your arms and legs in a lying position. Next, turn onto your stomach and place your feet on the floor. Rise smoothly without tilting top part bodies.

Note! Each person must individually choose comfortable position. What suits one may be uncomfortable for others. You should try different options to find the position that produces the least amount of pain.

How to sleep with a hernia of the lumbar spine

Two methods are used:

1 Lifting- sleep with your legs elevated. With this type of pathology, you should rest lying down. Raising your knees removes additional tension from your lower back. To do this, you can use a special bed or place two pillows under your feet. If there is severe pain in the legs, tuck a blanket while lying on your side. 2 Alignment using a pillow or cushion. They are squeezed between the thighs. Then they turn over on their side and fall asleep.

How to sleep with a herniated cervical spine

In case of a cervical hernia, it is necessary to ensure a straight position of the spine. Make sure that the neck line is parallel to the bed.

It is comfortable to sleep on your side, one leg should be straight and the other bent. In this case, one hand is placed on the pillow, and the other on the bed. Uncomfortable turns should be completely eliminated. In some cases, special orthopedic devices are used.

Orthopedic pillow for cervical hernia

If sleeping on your side is problematic, you can sleep on your back. The head should be on the pillow, and the cervical spine bent forward. Sacral and thoracic regions should be on a mattress, and a cushion should be placed under the lower back.

The quality of sleep with this type of hernia will determine right choice pillows and mattress.

Which side to sleep on if you have a hiatus hernia?

If you have a hiatal hernia, you should sleep on your right side. This is due to human physiology and is necessary to prevent the throwing of leftover food. It is also recommended to exclude meals a couple of hours before bedtime.

The fetal position is ideal for sleeping

If you have a herniated spine, you should sleep in the recommended positions and use orthopedic bedding. This will minimize the load on the spine, eliminate pain and speed up recovery. Correct positioning will reduce pressure on the nerve roots. To improve sleep quality, doctors may prescribe pain medications.

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Learning how to sleep properly when you have a herniated disc can help you relieve back pain. First of all, you need to find the optimal position for your body and be willing to try several possible positions. Once you've decided on the position that best suits you, you can make your sleep even more comfortable by choosing the right bed, mattress and pillows. Your doctor may also prescribe muscle relaxers and recommend a pain reliever to take before bed. Medicines will help provide you with good sleep, which is very important for relieving pain and creating conditions for healing a damaged intervertebral disc.

Steps

Choosing the right sleeping position

Sleep on your side to relieve pain. If you have a herniated disc, sleeping on your side may be the best option. Try sleeping in the fetal position with a body pillow to support you when you lie on your side. This will help relieve some of the pain associated with a frontal disc herniation.

Having a body pillow will help align your back and neck when you sleep on your side.

Avoid sleeping on your stomach if you have a herniated disc. Sleeping on your stomach is the worst option even for a person with a healthy back. At the same time, the natural curve of the spine is straightened, which puts additional stress on the back muscles. If you have been diagnosed with a herniated disc, you should under no circumstances sleep on your stomach.

Try sleeping on your back with a pillow under your knees. If you have a herniated disc, a good option is to sleep on your back with your knees slightly bent and supported by a hard pillow. This position allows you to relieve stress from the lower part of the spine and provide the most optimal conditions for healing the injury during sleep. Simply place a medium-sized pillow under your knees to support them.
- You can also elevate your feet by placing one or more pillows under your heels.
Try a few various poses for sleep. Each person with a herniated disc should have their own experience with sleep. A pose that works well for one person may not necessarily work for someone else. Try several different sleeping positions and choose the one that gives you the least amount of pain.
- Try to fall asleep in a new position. If you wake up in the middle of the night in a different position, try to return to a new sleeping position.
Place a pillow between your legs to ease the load on your spine. If you choose to sleep on your side, try sleeping with a pillow between your knees. This will be more comfortable and will remove some of the load from the spine.
- Try using a small memory foam pillow that will conform to the contours of your body.

Promoting quality night sleep

Go to bed only when you feel sleepy. If you have a herniated disc, your pain is likely to be worse at night. If you go to bed without feeling tired, falling asleep on its own will be difficult, and even more so with pain in the spine. Try to go to bed only when you are tired.

Don't use electronics before bed. Light from phones, computers and other devices can trick your body into thinking it's still day. This will make it more difficult for you to fall asleep. Try to turn off all electronic devices about half an hour before going to bed.

Keep your bedroom dark and cool. Achieving a good night's sleep will be easier if you keep your bedroom completely dark and at a cool temperature. Try to close night curtains to block light from entering the room through the window. Keep your bedroom at a cool but comfortable temperature.

Avoid late meals, alcohol and caffeine. Eating immediately before bed, drinking alcohol or caffeinated drinks may interfere with night sleep. Don't eat 2-3 hours before bedtime. Additionally, limit your caffeine intake after two or three in the afternoon. You should also limit evening alcohol consumption, as it can lead to restless sleep.

Exercise regularly. Maintaining physical activity in daytime may improve night's sleep. If you have a sedentary job, be sure to periodically get up and walk around the building or office. Also try to get at least 30 minutes of physical activity almost every day (walk, bike or swim).

Use special relaxation techniques . Relaxation techniques such as deep breathing, meditation, progressive muscle relaxation, and self-hypnosis will be helpful in relieving pain and promoting a quality night's sleep. Try to spend at least 15 minutes a day using your chosen relaxation technique. If you practice relaxation immediately before bed, it will be especially beneficial.
- To unwind before bed, you can also try taking a warm bath or shower, listening to soothing music, or drinking herbal tea.
Use a special fitness roller to do some back stretching before bed. Back stretching using a fitness roller is also useful for relaxation and preparation for sleep. Use a foam roller just before you go to bed to stretch your back muscles and promote good sleep.