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Artrosis de columna

La columna vertebral es la región del cuerpo donde más frecuentemente se desarrolla la artrosis. Esto es debido a las malas prácticas que ejercemos sobre ella a lo largo de la vida: malas posturas, sobrecargas y cizallamientos al coger pesos, etc.

La columna vertebral sostiene el tronco, nos mantiene erguidos y alberga en su interior la médula espinal.

Las vértebras se disponen una sobre otra formando una especie de torre de piezas encajadas con tres puntos de apoyo:

Artrosis de columna

Artrosis de columna

los cuerpos vertebrales: forman el apoyo principal. Se sitúan en el centro y entre ellos tenemos los discos intervertebrales. Éstos están formados por un anillo de tejido fibroso y una especie de gelatina o núcleo pulposo en su interior. Actúan como almohadillas entre las vértebras para amortiguar los impactos y distribuir la carga.

las articulaciones interhapofisarias: se sitúan a los lados y un poco por detrás de los cuerpos intervertebrales. Tienen forma de láminas o tejas y permiten los movimientos de rotación y lateralidad de la columna.

Entre los cuerpos intervertebrales y las articulaciones interapofisarias se forman unos orificios por donde emergen las raíces nerviosas que se unen para formar los troncos nerviosos.

La columna no es recta: tiene unas curvaturas fisiológicas que ayudan a mantener el equilibrio del cuerpo. En la región lumbar se mete hacia dentro (lordosis), en la región dorsal se curva hacia fuera (cifosis) y en la región cervical vuelve a meterse hacia dentro.

 

La artrosis en la columna cursa con síntomas diversos, dependiendo de la región en que aparezca, aunque suele producirse en todas sus partes.

En primer lugar, la columna se va deformando con los años. Los discos intervertebrales van perdiendo grosor e hidratación y el anillo fibroso se vuelve más quebradizo, lo que puede provocar que el núcleo interior se salga y dé lugar a una protrusión o a una hernia. Los cuerpos intervertebrales se van acuñando, acentuando las curvaturas fisiológicas y disminuyendo la estatura de la persona.

En segundo lugar, el desgaste de las superficies óseas, ya sea de los cuerpos intervertebrales o de las articulaciones interapofisarias genera picos que se llaman osteofitos. Tanto si es debido a éstos como a la presencia de una protrusión o hernia puede producirse un pinzamiento nervioso por disminución de espacio en el orificio situado entre las vértebras.

Aparecerá un dolor mecánico en los movimientos en que participa activamente la columna como son al sentarse y al levantarse o al coger pesos en el caso de la región lumbar, o al mover el cuello en el caso de la cervical. Se pueden sentir crujidos como si hubiera arenilla dentro de las articulaciones.

También aparece rigidez matutina. Al levantarse por la mañana la persona es incapaz de realizar los movimientos.

 

Nuestro mejor aliado contra la artrosis de columna es la prevención.

Debemos cuidar nuestras posturas:

en la oficina nos sentaremos lo más correctamente posible, al fondo de la silla y con la espalda bien pegada al respaldo;

si tenemos que permanecer largo rato de pie colocaremos un pie en una superficie ligeramente elevada y lo iremos intercambiando con el otro. Así aliviaremos la carga de nuestra columna lumbar;

para dormir nos colocaremos de lado, con las piernas ligeramente dobladas, en una posición confortable en la que la columna descanse recta. Colocaremos una almohada que rellene bien el espacio entre el cuello y el hombro para que la cervical también descanse en paralelo al resto de la columna;

para coger pesos del suelo nos agacharemos doblando las rodillas. Cogeremos el peso lo más cerca posible del tronco y nos incorporaremos utilizando la fuerza de los cuádriceps;

si tenemos que transportar peso lo mejor es que utilicemos una mochila con un buen refuerzo en la espalda. Ajustaremos los tirantes de forma que no quede ni muy alta ni muy baja y de la misma medida los dos para que el peso se distribuya igual en ambos lados.

 

El tratamiento de fisioterapia está encaminado a disminuir los síntomas y a retrasar el avance de la enfermedad.

Consiste en aplicación de calor suave, relajación de la musculatura, movilizaciones rítmicas acompañadas de tracción y aplicación de electro analgesia.

También se le enseñan ejercicios sencillos para flexibilizar la columna y mejorar el tono muscular.

 

Érika Gabaldón

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