Il colpo della strega
Il mal di schiena che tutti conoscono comeil colpo della strega,cioè quel dolore che si manifesta nella parte bassa della schiena e che a volte si estende anche alle gambe, è un male che va curato conriposo, antidolorifici, antinfiammatori e farmaci che rilassanola muscolatura, spesso in tali casi contratta dolorosamente.
Tuttavia, se questi episodi di mal di schiena si ripetono di frequente, si consiglia di sottoporsi a una serie di esami strumentali, dalla radiografia alla risonanza magnetica, attraverso i quali si può stabilire la causa del problema, in modo da evitare fastidiose ricadute.
Quando rivolgersi allo specialista?
Quando si manifestanopiù episodi nell’arco dell’annoo quando permane per lungo tempo un senso di fastidio, di debolezza e la sensazione di non essere ben saldi sulle gambe. Ilsingolo attacco acutonon è infatti indicativo di un problema alla colonna vertebrale: ripetuti attacchi, invece, rappresentano un segnale da non sottovalutare.
Cosa deve fare un paziente affetto dal colpo della strega?
Il trattamento è a base di farmaci antidolorifici e se si avverte
una dolorosa contrattura muscolare, farmaci rilassanti, cioè che rilassano la muscolatura. Inoltre, si consigliaun riposo attivo,che consiste nell‘evitare lavori pesanti,come portare isacchi della spesa e guidare solo se indispensabile perché gli scossoni dell’auto in movimento possono aggravare il disturbo. Importante invece camminare per mantenere un buon tono muscolare.
In quanto tempo passa il colpo della strega?
Di solito inuna settimana o in una decina di giorni,se invece
non passa e si ripresenta nel giro di poco tempo si consiglia al paziente di approfondire la situazione sottoponendosi agli accertamenti necessari.
Quali accertamenti bisogna fare?
Innanzitutto, unesame clinicoda parte dello specialista di
tutta la colonna vertebrale e degli arti inferiori per valutare
la forza muscolare, l’equilibrio, i riflessi. Poi, in base alle indicazioni derivate dall’ esame clinico si prescrivono alcuni
esami strumentali: dalla sempliceradiografia alla risonanza magneticaestesa dalla schiena al bacino, per capire se ci sono lesioni o altri problemi che determinano la sofferenza accusata dal paziente.
Quali sono le cause del mal di schiena?
Le più comuni, per i disturbi della colonna vertebrale, sono:
-la prima èl’ernia al disco del disco,cioè la fuoriuscita del cosiddettonucleo polposodallasua sede naturaleche, in alcuni casi, comprime un nervo provocandone l’infiammazione.
Se così avviene, al mal di schiena e alla contrattura muscolare si associa a un dolore agli arti inferiori:la sciatica.
-La seconda causa è lo scivolamento di una vertebra sull’altra,
che, in termini medici, si chiama spondilolistesi degenerativa.
Come si cura l’ernia del disco l’ernia del disco?
Fortunatamente, ha la tendenza aregredire in modo spontaneo:
in un’alta percentuale di casi, infatti, la parte di nucleo polposo fuoriuscita dalla sua sede naturale non è più nutrita, cosicchè le sue dimensioni diminuiscono e in genere questo libera il nervo, eliminando lo stato infiammatorio.
Tuttavia, il processo è lungo e occorre attenderealmeno un meseperché il nucleo polposo si ritiri.
Che cosa si consiglia di fare al paziente in
quelle quattro settimane di attesa?
Si consiglia di assumere i farmaci prescritti e di seguire le regole diriposo attivodescritte prima.
E se il dolore non passa?
Se non si riscontra alcun miglioramento, bisognarimuovere
l’ernia del disco. Fra l’altro, ora questo intervento si esegue con
soli due giorni di degenza ospedaliera, grazie a tecniche mininvasive. E dopo tre settimane al massimo di
convalescenza il paziente può riprendere pure i lavori
più pesanti.
Come trattare invece la spondilolistesi?
In questo caso c’è bisogno di un trattamento rieducativo
effettuato consultando anche ilfisiatra.Lo scopo del trattamento
è diirrobustire i muscoliche sostengono la colonna vertebrale attraverso esercizi personalizzati per diminuire il carico sulle vertebre già sofferenti. Inoltre, il fisiatra consiglierà al paziente
le posizioni giuste da mantenere quando si sta seduti, come si solleva un peso e così via, caso per caso, secondo le vertebre interessate.
Questi trattamenti sono sufficienti per risolvere il problema?
La maggior parte delle volte bastano questi esercizi per ottenere una buona stabilizzazione della vertebra interessata. In alcuni casi, però,occorre ricorrere alla chirurgia.
Quando ricorrere alla chirurgia?
Se lo scivolamento è accentuato e coinvolge strutture nervose.
Ci sono molte tecniche chirurgiche a disposizione per trattare il problema e la scelta tra esse dipende delle condizioni cliniche
del paziente. In genere, si tende a liberare le strutture nervose compresse è a stabilizzare le vertebre interessate. Questi interventi hannotempi di convalescenza più lunghi,non inferiori al mese, e risultano piuttosto invasivi. Pertanto, al prolungarsi del mal di schiena, si raccomanda di seguire gli esami necessari in modo da riuscire a intervenire il più presto possibile.
Il dolore nella zona lombare può anche essere causato da problemi urologici?
Il mal di schiena può ancheessere sintomodi
un’infezione renale cronica,scambiata per un
problema vertebrale.
La gravidanza si può considerare un fattore di
rischio per il mal di schiena?
A volte,le modificazioni delle ossa del bacino,conseguenza
della gravidanza, portano a piccoli ma significativi squilibri nella colonna vertebrale, che determinano una predisposizione verso il mal di schiena.
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