Clínica Espaço Ativo

11/09/2023

Entre em contato através do link em nosso perfil e agende sua consulta! Siga a para ficar por dentro de todas as novidades e dicas 🍉🥗😁

03/08/2023

Foi ou é nosso paciente e se identificou com nossos tratamentos, pedimos que entre no link e marque a clinica nos comentários

Obrigado pela parceria de sempre!

04/07/2023

A Clínica Espaço ativo agora conta com mais uma área da fisioterapia: Dermatofuncional e Estética com a .

- Drenagem linfática
- Limpeza de pele
- Modeladora
- Massagem relaxante
- Detox corporal e facial
- Spa facial
- Dermaplaning
E planos de tratamento personalizados!

🦋🦋🦋

28/06/2023

28/06/2023

No dia 23/06 tivemos a festa junina do pilates da clínica espaço ativo, e para animar nossos pacientes tivemos um grande bingo onde contamos com parceiros que disponibilizaram alguns brindes. Nossa festa foi um sucesso e só temos a agradecer.

oliveira oficial

06/06/2023

É da área sa saúde e gostaria de um espaço para atender seus pacientes? Temos uma sala disponível no nosso Espaço! Entre em contato para mais informações!

16/05/2023

Oportunidade!!!

29/03/2023

Aviso importante!

21/03/2023

07/10/2022

Illustration of nociception and pain perception
🤕👇 👇 👇

👉 Pain is defined by the International Association for the Study of Pain (IASP) as an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual orpotential tissue damage. https://www.iasp-pain.org/publications/iasp-news/iasp-announces-revised-definition-of-pain/

👉 This subjective experience relies on the integration of diverse nervous signals, or the lack thereof, emanating from the peripheral nervous system (PNS), and processed in the central nervous system (CNS) (Fig.). Pain is a hypercomplex and multiple phenomenon, which involves not only one or several physiological mechanisms but also emotional, social, cognitive and cultural components, which are intimate. https://www.sciencedirect.com/science/article/abs/pii/S0169409X22002496

02/09/2022

Mechanisms of resorption in lumbar disc herniation

👇👇👇

👉 Clinically, the phenomenon of spontaneous shrinkage or disappearance of a herniated lumbar IVD without surgical intervention is called reabsorption.

👉 The spontaneous resorption rate of lumbar disc herniation (LDH) is over 60% according to a meta-analysis by Zhong et al. (2017) and Chiu et al. (2015) https://pubmed.ncbi.nlm.nih.gov/28072796/, https://pubmed.ncbi.nlm.nih.gov/25009200/ with extrusion and sequestration being more prone to regression than other types. https://pubmed.ncbi.nlm.nih.gov/24630494/

But how does this actually happen? 🤓

👉 Resorption of the intervertebral disc tissue can be explained by 3 theories, but the exact mechanism is not conclusively understood:

1. Reduction in disc material size due to gradual dehydration and shrinkage, which could explain the decrease in the signal of the disc on MRI. https://pubmed.ncbi.nlm.nih.gov/11901758/
https://pubmed.ncbi.nlm.nih.gov/11750011/

2- The tension on the posterior longitudinal ligament causes the herniated disc fragment to be retracted back into the intervertebral disc space. This can be a mechanism when the annulus fibrosus (AF) is not damaged, but not with extruded and migrated fragments.
https://pubmed.ncbi.nlm.nih.gov/24316264/
https://pubmed.ncbi.nlm.nih.gov/3875236/

3. The third theory, the most well studied and with the best clinical evidence, is gradual resorption of the disc material by enzymatic degradation and phagocytosis induced by an inflammatory response and neovascularisation: s. figure

📍When protruding IVD tissue squeezes out of the epidural space, it disrupts immune privilege, triggering an autoimmune response, then lymphocytes activate macrophages.

📍Related factors secreted by IVD cells and macrophages further drive the recruitment of macrophages to the intervertebral disc in paracrine and autocrine forms. Macrophages undergo differentiation from M1 to M2 types.

📍M1-type macrophages secrete pro-inflammatory factors to initiate angiogenesis, promote the expression of matrix metalloenzymes and apoptosis of herniated IVD nucleus pulposus cells.

📍M2-type macrophages secrete anti-inflammatory factors to relieve pain response, promote new blood vessel formation, and are responsible for tissue remodeling and repair, and absorb the protruding debris to reduce the total volume of the intervertebral disc, and reduce the mechanical compression of the nerve.

📍Throughout the process, infiltration and activation of macrophages mediate inflammatory responses, matrix metalloenzyme activation, and neovascularization.

https://pubmed.ncbi.nlm.nih.gov/16688039/
https://pubmed.ncbi.nlm.nih.gov/19333096/
https://pubmed.ncbi.nlm.nih.gov/15626982
https://pubmed.ncbi.nlm.nih.gov/35999644/