Reviews hernia in the cervical spine treatment

Share your experience: is it worth it to perform an operation to remove a hernia of the cervical spine? How to treat a cervical hernia without surgery at home? What drugs or folk remedies are the most effective? What are the symptoms of a cervical hernia? Advise the best recipes and methods that helped you get rid of a hernia. They are interested in real reviews of the cured and the advice of doctors.
Read the reviews below.

The seven vertebrae of the cervical region are designated C1, C2, C3, C4, C5, C6, C7

Shishkevich Vladimir, orthopedic and traumatologistShishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.

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What is dangerous hernia in the cervical spine, symptoms and recommendations:

Forum: Cervical Hernia – How to treat? reviews: 17

My husband (37 years old) was diagnosed with a hernia of the cervical spine. Was upset. Myself on maternity leave. There is a link to a recipe from Kalanchoe, I can not find on the internet an electronic version of the journal “Healthy”. I ask, if it does not complicate, please send a recipe with Kalanchoe! Thank you if you hear me.

If possible, send a prescription with Kalanchoe for the treatment of vertebral hernia: cervical joint. I can not find the electronic version of the “Bulletin of healthy lifestyle” Please. The husband is being treated for 4 weeks in the hospital. Massages . I want my husband to recover, and that there would be no surgery. Thanks.

June 22, 2011 was diagnosed with intervertebral hernia of the cervical 5-6 vertebrae. I am 36 years old. Doctors insist on surgery. And I’m afraid to be operated on. It’s never too late to go under the knife, I want to be cured by folk remedies. I read your recipes. I will try.

Thanks to everyone who shares their success. All health. I also have intervertebral hernias in the cervical and lumbar spine. Approximately 2 to 4 mm. A month after the hospital, it got worse than it was. I want to try folk remedies. But I do not know what to choose from this variety. Good luck to everyone.

Hello . After the flu, all the sores came out, including a cervical hernia. The hernia is large, the doctors say it’s only an operation, but I don’t want to go under the knife yet, I’m looking for alternative treatments. Who knows what from Grandmothers and Grandfathers write, we will be grateful to you. Vladimir, Omsk.

A hernia of the cervical spine, did an MRI – posterior left-side medial-paramedal hernia of the C6 / C7 disk of 0,5 cm. 8 weeks exacerbation, the left arm does not rise, the fingers go numb, was treated medically: diclofinac, capsicum, chondroxide, asterisk, xefocam, combilepen, midcalm, traumel, combilipen, sirdalul, cotodalon, nise, pentalgin, patch, blockade with flasterone, massage and warming up to exacerbation. With a hand a little better, rises to the elbow, partially numb fingers. Queued for surgery, is it really impossible to cure a hernia by the non-surgical method? Pain in breathing, made ZKG – heaviness on the heart. What to do, I just don’t know, I can’t work – two children, operation “expensive pleasure”, help or advise something.

Hello! I read comments and understand everyone, I myself suffered for a long time with pains, could neither sit, nor lie, nor stand, nor sneeze, nor stretch. What mattresses just did not try !! What pillows did not buy !! And there were hernias (maybe they still have) in the spinal region two and in the cervical two. In Latvia they sent for an emergency operation, I was terrified !! And they don’t give guarantees with the operation, and they frighten without the operation !! You can stay so paralyzed! Returned to Germany, turned to a familiar neuropathologist, showed a video from computed tomography. He said that in such cases they don’t do surgery, surgery is the most extreme case, and you need to start with medical gymnastics. How difficult and painful it was to start everything, but slowly, carefully, BEFORE PAIN (without overcoming the pain), clearly feel your body. If it hurts, doing lower, smaller, easier, depending on what exercise you are doing. Very soon, I switched to yoga, found on the Internet, in YouTube, an excellent coach. The whole Internet shook with masses of advice, very soon switched to exercise with physical activity. All the time you need to TRY your strength, do not overdo it, of course, now sport is my life, because only the muscles hold our skeleton. If the muscles are relaxed, then the skeleton gradually sags. Moreover, the work of all organs is disrupted by this. Correctly noticed here that in the aggravation of NO heat. There is a nerve clamp, try to lower the finger clamped in the doorway into hot water, the effect is the same. In the sitting position, the greatest load on the spine occurs, and this does not equal the weight of your body, but, about 300 kg, on the patient, yourself and think how we, without noticing, harm ourselves. I would also like to add that two and a half years have passed since the survey. Now I am doing yoga, physical exercises on muscles, heart. I’m jumping on a rope and twisting a holo-hoop !! I can twist 1000 or more times, in total it takes me from 40 minutes to an hour to do exercises, I also do calanetics. I complicate the load all the time. Of course, the weight with the sport goes away, the figure changes, a lot of money went only for examinations, and not a penny was restored.
I found an excellent invention on the Internet, it looks like a swimming circle, but there are balls. Since I do not live in Russia and could not get it, I copied movements that can be reproduced without a circle. They are very similar to holo-hoop rotations, only to all parts of the spine. It’s just that the balls help to orient in the correct rotation, but since I was spinning a holo-hoop tirelessly in childhood, my muscles remembered those movements. It didn’t work out right away, but neatly, slowly, everything returned. I wish everyone, both sick and healthy, not to forget how we played in childhood. How many movements! And our life is in motion! Too lazy to think, but getting up to charge, it passes! Without medicine, your body will grow stronger in general. Be healthy!!

I have hernias, cervical and lower back, tell me the real treatment from the field of traditional medicine. Really, who writes that they have been cured by folk remedies, write! People, please share your tips, WE NEED THEM, THANKS for not just reading.

Hello! I am glad for those who are lucky and they feel good.
I have 2 hernias in the cervical region of 4 mm and a cyst of 6 mm. She suffered a stroke 2 years ago. As it turned out, s-deformation of both carotid arteries. I read that they do laser-endoscopic surgery in Kiev, but they offer me under general anesthesia. I’m afraid

Respond who operated on the cervical using Cage. I have hernias s5-s6, s6-s7, offer to be operated on.

Good day to all! I did an MRI, found 2 hernias of the cervical 3 mm and lumbar 6 mm! Pain is present, while tolerant. What advise: do the operation or start with massages, etc.?

Hello, I am 36 years old. 2 years ago, a hernia of the cervical spine was discovered. It’s just horror, how many pains, unbearable, between all this I still gave birth, all suffering pains. Frequent dizziness has begun, the neck, even that look looks like it will fall off. I do not know what to do!! Tell me, where to start the treatment of hernia, vertebrae c6, c7?

Hello! I need an operation to replace the intervertebral disc in the cervical spine. Has anyone heard of the ADR technique?

Hello! My mother is the owner of three hernias in the cervical spine at once – 7 mm, 3 mm, 4 mm. She is tormented very much, nothing helps, neurosis, oxygen starvation, she constantly drinks some medications, makes droppers to somehow soothe pain, vomiting periodically, dizziness . In general, it’s very difficult to observe all this. Age 50 years. Who faced this? I think the only way is surgery. But scary, there is no money for the laser, we will not dare to use the usual one. Still, the neck . Advise a good doctor. We are residents of Almaty.

A hernia in the cervical 4 mm and 2, protrusion in the lumbar. Such treatment helped – swimming, yoga, massages, as well as sedatives.

I have a hernia of the cervical spine, c5 and c6, C6 and c7, dizziness, high blood pressure, nausea, pain, are sent for surgery, implant placement, who did these operations, please write how they went with you.

I had a 10 mm sequestered hernia in the lumbar region, as well as 0,5 and 0,3 mm. In the thoracic region, osteophytes (spikes) that pressed on the heart and lungs. In the cervical hernia 0.3 mm. in the hospital, the hormones hydrocortisone and diuretics began to be dropped to relieve swelling and pain. There was a very strong attack, I could not go to bed, slept while sitting, there was paresis of the left limb. I didn’t do the operation. Did the hormone diprospan to relieve swelling and severe pain. Also, in the area of ​​the coccyx, a cyst 0.9×1.5 cm and a hemangioma 0.8 cm were found. Astragalus woolly flowered began to drink at first infusions, and then tinctures (causes exacerbation and rash), contains natural hormone. Saw 2 months. It got better. Did MRI hernia decreased by 4mm. Exacerbations began in the thoracic part of the saw for 1 month. Diuretics (veroshpiron and furosemide) relief was temporary. Found horsetail (removes salts, heavy metals, fungus, lead)
in 2–3 days, he relieved the exacerbation and after this recurrence of pain there was no. I forgot to say drank sabelnik tincture, it removes salt. Pour a packet of roots with a bottle of vodka and infuse for 1 weeks, but be sure to start with infusions (3 tbsp. Brew 2-1 tbsp. Boiled water) drink 1.5-1 months. I feel fine now. Everything was taken from the site Monastic herbalist and, upon request, folk remedies in Orthodoxy. Now I drink tincture of burdock, it also alleviates pain and removes salts.

Reviews hernia in the cervical spine treatment

Good afternoon! I’ll tell you a little about myself: sedentary work of 8 years, at the same time episodically engaged in a barbell with fairly decent weights, mainly squats and bench presses. In his youth, there was 1 category in powerlifting, he tried to keep fit. In November last year, after practicing the barbell, the bench press with extremely heavy weight, felt some instability in the spine and a sharp pain in the neck, a few days after that there were difficulties with turning the head at work, burning. After that, everything went away for a month. Then, with a long sitting position, I felt that my neck muscles began to tire, did not attach any importance to this, everything went away at home. With the bench press, I press with the bridge – a slight crunch and malaise were felt in my neck. But the sting as usual. Then the neck muscles at work, when sitting for a long time in one position began to hurt and seemed to burn, difficulties arose in holding the head, slight dizziness and weak occipital pains arose. He began to monitor his posture and everything seemed to be gone again. After another month, he got the flu and the symptoms returned. The pains were not strong, they were removed with an ibuprofen tablet, but since the work was sedentary, at the computer, without the ability to change the pose, they became a constant weak background. In principle, I was almost used to it, but two weeks ago I decided to do an MRI.

The results were as follows:

Physiological cervical lordrosis in a supine position is straightened. The spinal canal is primary and secondary narrowed. The sagittal size of the bone spinal canal at the c7 level of the vertebra is 12 mm (normal from 14 mm). Subarachnoid spaces are passable. 7 cervical vertebrae are visualized. Their form, the ratio is not changed. The structure of the bodies is not changed. The spinal cord, the roots of the spinal nerves are not enlarged in size, of a homogeneous structure and Mr signal. Paravertebral soft tissue without features.

Degenerative-dystrophic changes are detected.

– decrease in the intensity of the mr signal on t2 vi from intervertebral discs at the study level

– reduction of the height of the disk s6-s7

– ventral marginal osteophytes of bodies s5, s6, s7 vertebrae.

-subchondral sclerosis of supporting locking plates

– uneven width of the articular fissures, subchondral sclerosis of the facet and articular processes of the c5, c6, c7 vertebrae.

– at the level of the c3-c4 segment, dorsal protrusion of the intervertebral disc up to 2,6 mm is determined, deforming the anterior surface of the dural sac extending into the intervertebral foramen on both sides.

– at the level of segments c4-c5, c5-c6, dorsal diffuse hernias of the intervertebral discs up to 3,2 mm are determined, deforming the anterior surface of the dural sac extending into the intervertebral foramen on both sides.

– at the level of segments c6-c7, a dorsal diffuse hernia of intervertebral discs up to 3,6 mm is determined, deforming the anterior surface of the dural sac, spreading into the intervertebral foramen on both sides.

conclusion: osteochondrosis of the cervical spine with protrusion c3-c4. Hernia s4-s5, s5-s6, s6-s7. Primarily narrowed spinal canal.

With these indicators came to an appointment with a city neurologist. The diagnosis struck her greatly, but she did not reveal neurology in me. Practically, in addition to pain in the neck from a long sitting posture and sometimes a crunch when I extend the neck, I do not feel any other deviations. She asked if I could leave my current job. Prescribed with xefocom, medical, neurobion, carbamazepam. In May we agreed on a day hospital with droppers. Now I have taken a week-long sick-list, I’m sitting at home for 2 days, I’m injecting prescribed medications, there are no special changes yet, there are slight pains in a sitting position, their character does not change. Helps a change of pose or stand up and walk. After injections for two hours, everything becomes just perfect.

1. Should I change the current sedentary work without the ability to change the pose and with periodic sharp movements of the head and neck. Work in a closed room, in the stuffiness. Or if you closely monitor posture and posture, make smooth movements, five-minute breaks – can you continue to work at this place?

2. Can I continue to work on the site and the garden? we have a private house, which is not yet fully completed and the garden. can I do some heavy work, for example concrete, associated with carrying gravel, concrete in buckets, manual mixing in a neck corset? to what extent is the load permissible? did an MRI of the lumbar last year – no abnormalities were detected, i.e. problems only with the neck. Can I work without just loading her?

3. what are my predictions in the future, will an operation be needed or can hernias decrease and resolve? there were much more severe problems in the lower back, about 15 years ago, when I was actively engaged in squatting with a barbell – the leg was taken away, terrible pains in the lower back and tailbone, I could not sit, I walked with a limp, but somewhere in a year or two everything went away, last year did an MRI of the lumbosacral region – everything is perfect. Although I was engaged in the barbell all this time (Mr did because hemorrhoids arose and somehow his symptoms reminded me of the story of 15 years ago with a lower back. As a result, I decided the question with a pair of ichthyol candles) Maybe with the neck it will turn out just the same will resolve? or at least fibrous rings grow together and hernias become small protrusions?

4. if it comes to surgery, do you have to do it immediately on all disks? in what cases do you need to have an operation?

I’m writing all this seemingly cheerfully, but cats scratch my soul – two children, a family, lots of plans, I don’t want to become disabled in the prime of my life ((Could there be such a solution that I put off all the hard housework for a year and do only walking and a pool – and the body will recover. Or all the same, a cardinal change in lifestyle is required with a change of work and a review of all plans related to the house.

All about joints

It is important to correctly identify the symptoms and treatment of a hernia of the cervical spine and, most importantly, on time. There are many types of hernias of the cervical spine, which can also occur in the lumbosacral spine. But the leader in the number of cases is still considered to be a hernia, which occurs in the cervical spine. Approximately 1/6 of all inhabitants of the planet faced this ailment.

Previously, more than 90% of patients were elderly, but now the situation has changed drastically due to poor ecology, poor diet, and lack of mobility.

The neck and the spine associated with it are quite flexible and stable, but with excessive load there is strong pressure on the intervertebral lining of the vertebrae. This pressure causes damage to the fibrous ring, which is the foundation of the gasket, inside which the core is also in a liquid state. A hernia of the spinal disc is considered very dangerous, since damage can cause the nucleus to go beyond it.

More about hernia

Complications of a hernia of the cervical spine

Some neglect the disease of the cervical spine and do not even show initiative in treatment, which is fraught with a number of negative consequences.

The fact is that the neck is the connecting link between the brain, spine and the whole body. Through it, the brain, arteries, channels, nerve fibers are fed. In a normal state, the brain receives and gives everything to the body in sufficient quantities, but with a hernia of the cervical spine, pinching of important channels of the spine may occur, which can subsequently paralyze a person or even cause a stroke.

Therefore, if you suspect a hernia of the cervical spine, you should visit a specialist.

What provokes a hernia of the cervical spine?

Among the causes of a hernia of the cervical spine can be identified a number of main:

  • Damage to joints, spinal injuries during vigorous activity. If you started training without a warm-up and do not know the safety precautions of a particular exercise, you can easily provoke the appearance of a hernia.
  • Osteochondrosis also ranks first among the causes. It can occur due to a constant sedentary lifestyle, which puts excessive pressure on the cervical vertebrae, which provokes the disease.
  • Spondylosis This disease of the cervical region is characterized by growths in the vertebrae.
  • Slouch. It is important to work out the correct posture.
  • Passive lifestyle.
  • Traumatic movements for the neck, which are performed sharply and in a strong rhythm.

The main symptoms of a hernia

During the initial stage, a person feels such a symptom as slight discomfort, which can be attributed to overwork, fatigue, overload, or does not feel any discomfort at all.

During the further development of the disease, the patient may experience the following symptoms of a hernia of the cervical spine:

  • Intense pain that constricts movement as a symptom. It can pass from the neck to the shoulder joint, hands, elbow joint.
  • Passive, longer pain that passes from the cervical region to the shoulders, hands, elbow joint, and even the tips of the fingers.
  • Symptoms such as frequent headaches and cramps are not uncommon.
  • Increased irritability as a symptom of a hernia of the cervical spine, which can be caused by pinching of nerve fibers.
  • Such a symptom as a feeling of numbness in the area of ​​the hand or numbness of the fingers.
  • Chill on the skin or goosebumps.
  • Unstable blood pressure as a symptom.
  • Symptom in the form of intense cough.
  • Pain when trying to make neck movements.

As the disease of the spine develops, the intensity increases, and the time interval decreases. It is important to fully consider the treatment and symptoms of a hernia of the cervical spine, so continue.

Hernia treatment folk remedies gymnastics

It is worth noting that the treatment of cervical spine disease with alternative methods is possible only at first, when there is no complete rupture of the discs, and as a result of a change in the entire cervical spine, gymnastics can be done. If you already have a severe illness, then most likely you cannot do without surgery.

  1. With a hernia of the spine, like gymnastics, horse fat helps a lot. During use, it must be in a sol />
    To achieve maximum effect, it is best to do this before going to bed like gymnastics and leave until the morning.
  2. Garlic compress dressings. Pre-clean 200-250 gr. fresh garlic, grind it with garlic press, add a glass of alcohol to the resulting mixture. Tincture must be kept for 10 days in a cool and dark place. It is considered one of the effective means.
  3. Gruel from Kalanchoe leaves. For the preparation of medicinal gruel, which can later be used as compresses, it is necessary to tear 100-200 grams of leaves and grind using a meat grinder.
    During use, so that the compress does not subside, it can be additionally fixed with a plaster.

Drug treatment of hernia

There are several groups of drugs that are prescribed for the treatment of cervical hernia:

  1. Anti-inflammatory drugs. Due to their properties, they help stop all inflammatory processes during treatment of the spine, also act as analgesics, which helps to reduce discomfort during the course of the disease. This category includes: meloxicam, diclofenac, and ibuprofen.
  2. Analgesics. Do not give the treatment itself, but only only temporarily muffle pain, doctors do not recommend getting carried away with such drugs. These include: analgin, spasmolgon, ketorol.
  3. Muscle relaxants. They help relieve tension during treatment, calm the muscles, it is recommended to use during treatment only in combination and only by prescription. The most famous are Sirdalud and Midokalm.
  4. Other cervical medicine. With a hernia, vomiting spasms, nausea and headaches can occur, which are also desirable to treat.

Hernia surgery

When the disease is severely launched, removal of a hernia of the spine by surgery is recommended.

Medicine does not stand still, therefore, in addition to traditional operations, gymnastics, a laser operation also takes place.

Laser treatment of the spine has more advantages compared to conventional surgery.

Firstly, when a laser has a hernia, the risk of damage to the disc is minimized, unlike other methods.

Secondly, recovery occurs 1/3 of the time faster than after a normal operation.

Thirdly, the laser helps the cartilage to regenerate and grow.

Reviews for hernia treatment

“The surgeon said that surgery can only make things worse. Therefore, I am treated with traditional methods. I’m used to it

“I suffered a lot from the intervertebral hernia of the cervical spine. My head ached constantly, I couldn’t walk normally. The hernia was too large, two vertebrae held literally on the strings. I tried almost all the methods and massages and gymnastics and medicines, but because of neglect, nothing helped. I had to decide on an operation. She did it in Israel, it was very difficult, and she was afraid a lot, but fortunately everything went well. Now I live and enjoy life ”

“They discovered the disease, as it were, at the very conception, by chance during honey. commission. I started taking a course of treatment prescribed by a doctor in combination with folk remedies and now I don’t even remember about this ailment ”

Thus, the article examined the symptoms and treatment of a hernia of the cervical spine, folk remedies, medical and surgical treatment, and people’s reviews.

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Reviews hernia in the cervical spine treatment

Welcome to the A.N. clinic Baklanova! We offer reliable and safe technologies in the treatment of the spine.

Treatment of a patient with a diagnosis of “spinal muscular atrophy of the Kugelberg-Velander”

Elina Abdrashitova, 15 years old – spinal-muscular amyotrophy of Verdnig-Hoffmann

History of a patient diagnosed with SMA, 20 years old

February 17, 2017

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Surgery for a hernia of the cervical spine

Our Center is successfully engaged in the removal of hernias of the cervical spine. We will answer all your questions by phone: +7 (499) 746-99-50. You can also ask a question by filling out the request form below.

A cervical hernia is a rupture of the fibrous ring (“disk sheath”) and the exit of the pulpous nucleus (internal contents of the disk) into the spinal canal with compression of the nerves of the spinal cord.

A hernia of the cervical spine presses on the nerve of the spinal cord, causing a violation of blood supply in it. Lack of blood circulation leads to inflammation in the nerve and the development of pain.

Symptoms of a hernia of the cervical spine

The patient is disturbed by pains in the hand that can “give” to the fingers. Also, the pain spreads in the shoulder and shoulder blade, aggravated by turns and tilts of the head. If the compression of the nerve is strong, then numbness in the fingers may occur, tingling in the hand, muscles may twitch or spasm occurs. It is very rare if a running process arises weakness and atrophy (decrease) of the muscles of the biceps, triceps, hand.

The patient sometimes finds symptoms immediately after sleep, a traumatic cause may be absent.

Some patients feel relief from an elevated arm position, which is associated with a decrease in pressure on the nerve.

Causes of a hernia of the cervical spine:

  • A hernia can form due to injury or spontaneously.
  • Due to the lifting of weights on the neck, a hernia cannot form since the cervical spine does not carry a load when lifting
  • Smoking, alcoholism, a genetic predisposition, occupational hazards accelerate the aging process and degenerative changes in the cervical disc.

Diagnosis of a hernia of the cervical spine

Where to start a patient with a hernia of the cervical spine?

It is necessary to do an MRI of the cervical spine — a safe (no radiation) painless examination, using a magnetic field, an image of the spine and spinal cord is obtained. With MRI, nerves and intervertebral discs are very clearly visible.

Computed tomography is a safe, non-invasive, painless examination using computer beams.
The method is suitable for patients who for some reason can not do an MRI.
Within a few minutes we get sections of the spine where you can see the presence of a hernia of the cervical spine, displacement of the vertebrae, fractures of the spine.

X-ray study

A method that allows you to see the instability of the cervical spine, as well as gross pathology (fractures, vertebral displacements).
On the x-ray, one can also see bone growths, changes in the facet joints.

Electromyography of the upper limbs (hands)

Thin needles or electrodes are installed on the muscles, the results of the response are recorded by a special machine. A hernia compresses the nerve and it cannot transmit impulses at normal speed. This study will show how seriously the hernia presses on the nerve and whether the patient needs surgical treatment.

Cervical hernia treatment

Usually the doctor prescribes:

  1. painkillers
  2. non-steroidal anti-inflammatory drugs
  3. B vitamins
  4. muscle relaxants:
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) – relieve inflammation, pain, swelling.
  • Painkillers – treats pain.
  • muscle relaxants – relieves muscle spasm
  • Vitamins – improve the proficiency of a clamped nerve, “nourish” the nerve.

Paravertebral blockade is also carried out – steroid preparations are introduced into the hernia zone, which remove inflammation from the “clamped” nerve within a week.

Surgical treatment of cervical hernia

In case of progression of symptoms and treatment failure, surgery is required.

When planning an operation, it is worth considering such factors as a person’s age, duration of the disease, other medical problems, previous surgery on the neck.

Access with a hernia of the cervical spine is anterior (on the front of the neck).

Anterior Cervical Discectomy:

The surgeon makes a small incision on the front of the neck. Muscles, blood vessels and nerve fibers are pushed to the side to gain access to the spine and disk. Using special tools, the disc is removed along with a hernia that presses on the spinal nerve. A disc prosthesis is inserted into the cavity formed

There are 2 different types of intervertebral disc prostheses:

Static prosthesis and dynamic.

What prosthesis to put is decided by the operating doctor discussing this issue with the patient!

An example of surgical treatment of a hernia of the cervical spine in our center

A 31 year old patient was operated in our center with a diagnosis of Cervical osteochondrosis. Hernia m / n disk C5-C6 on the left. Pain in the left hand.
Surgical treatment was performed: Removal of a hernia of m / n disk C5-C6 to the left from parapharyngeal access. Discectomy C5-C6. Installation of the Pikovskiy interbody cage (static prosthesis) m / n disk C5-C6.
In the postoperative period, pains in the left arm disappeared. The patient was discharged with regression of neurological symptoms.

Morozov Georgiy

Georgy Morozov, rheumatologist. For more than 20 years, he has been involved in the diagnosis, treatment and prevention of joint diseases.