Otto Bock Dyneva User manual

1 Ottobock | Your back in focus
Your back in focus
Degenerative disc disease
Spinal stenosis
Information for patients

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What is
degenerative disc
disease?
Degenerative disc disease occurs as a result of wear
and tear to the cartilage that acts as a “cushion”
between the vertebrae. Over time, it becomes
thinner and more brittle. If there is a narrowing of
the space between the vertebrae, this is referred to
as spondylosis. In a herniated disc, the disc bulges
(protrusion) or tears and the inner core pushes out
(prolapse). And if a disc presses on a nerve or the
spinal cord, it can cause a feeling of numbness or
weakness, as well as being painful.
Facet joint
Spinal cord
Disc

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Causes
A certain degree of wear and tear of the discs
is normal. The following factors can make these
conditions worse:
• Genetic predisposition
• Being overweight
• A sedentary lifestyle
• Activities at work: prolonged sitting, liing or
moving heavy objects, bending, twisting, repetitive
movements and constant vibrations can all result
in damage to the spine.
Symptoms
Disc degeneration does not necessarily cause
pain. The following symptoms may occur as a result
of damage:
• Pain due to irritation of the weakened discs
during movement. If the intervertebral disc bulges
outwards, this can make the situation worse.
• Pain following physical activity or sitting for
extended periods.
• Painful stabbing, throbbing or burning sensations
that radiate into the legs.
• Sti back
• Numbness or tingling in the limbs
 Prolapse Protrusion

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What is spinal stenosis?
Spinal stenosis refers to a narrowing of the spinal
canal, which leads to pressure on the spinal cord
and nerves. These changes can cause pain and
other symptoms. Stenosis can aect a small or large
section of the spinal column. Degenerative changes
occur in the spine as a result of the ageing process.
The ligaments that support the spinal column
become harder and thicker. The bones and joints
can become deformed and compress the spinal
nerves even further.

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Most people do not experience any symptoms
of age-related stenosis until they reach the age of
50 or so. However, individuals with hereditary
spinal disease or a spinal injury may experience
symptoms earlier.

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Symptoms
Sometimes spinal stenosis does not cause any symptoms
at all; sometimes symptoms occur only gradually and then
get worse over time. You may experience the following:
• Neck or back pain
• Numbness or weakness, cramps or a painful burning
sensation in the arms or legs
• Pain that radiates into the legs (known as sciatica),
potentially making it painful to walk longer distances
without resting
• In severe cases, problems can occur in the arms and legs
or in the bowel and bladder
Causes
• Osteoarthritis
• Hereditary spinal diseases
• Disc degeneration or rupture
(herniated disc)
• Abnormal lateral curvature of the spine (scoliosis)
• Other causes, such as tumours and injuries, diseases
(e.g. Paget’s disease, which causes bones to become
weakened and deformed), calcication of the spine, etc.

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Treatment options
What are the treatment options?
As the disease progresses, a variety of treatment
options aim to alleviate symptoms rst and fore-
most and – as far as possible – address the causes
as well. These range from manual therapy (physi-
otherapy), progressing to painkillers, to longer-
term solutions such as wearing an orthosis.
Usually, this will relieve pain to start with, but none
of these treatment options can reverse the bone
defects in the long term. However, innovative
developments such as the Dyneva can promote
stretching and strengthening of the stressed back
muscles, resulting in increased activity.
Treatment options in more severe cases
When standard methods fail to relieve pain, or if
additional symptoms occur – such as numbness in
the legs, or bowel or bladder problems – your
doctor will oen recommend surgery.
However, if the symptoms are less severe or you are
reluctant to resort to surgery, specialised orthoses
can provided targeted support in day-to-day life.

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Activation
Dyneva
Art. no. 50R300N
Dynamic effect on the back
muscles during movement
The Dyneva has a dynamic effect on
the back muscles during movement.
It stretches and strengthens them,
thus relieving the facet joints. Pain
during movement is reduced, and
users can walk longer distances and
increase their activity levels.
Dyneva light
Art. no. 50R301N
Dynamic effect on back muscles
during movement
The Dyneva light works in the same
way as the Dyneva. The slimmer
abdominal section is an alternative
option for some body shapes.

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Notes on the Dyneva
You should gradually increase the length of time
you wear the Dyneva to allow your muscles to
become accustomed to the new movement. The
brace only works when you’re moving, which is
why it is not recommended for use during activities
while sitting. Suitable activities include walking,
riding a bike, going shopping, etc.
Aer some time, the brace may no longer be
required for certain indications. However, it
can be worn again at any time if the situation
deteriorates again.

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Stabilisation
Smartspine LSO high
Art. no. 50R232
Relieves the lumbar spine
This brace provides a high degree
of stabilisation while relieving
pressure on the lumbar spine in
cases where pain is acute. As well
as providing pain relief, the unique
pulley system offers the highest
possible level of compression with
minimal effort.
Lumbo Tristep
Art. no. 50R30N
Stabilises while mobilising
The brace supports the healing
process thanks to the option of
removing the stabilising elements
in three stages. The patient’s
movement and mobility increase
with every stage. Flexible support
elements with new strap pockets
and variable strap components
ensure an excellent fit – and this
is also enhanced by the recently
added lateral wedges.

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Lumbo Direxa Stable
Art. no. 50R54
High level of stabilisation
Thanks to its highly effective
stabilising properties, the Lumbo
Direxa Stable relieves pressure on
the lumbar spine without becoming
bulky.
Your specialist dealer will be happy to help you
choose the right brace

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Your doctor will prescribe a treatment
plan to suit your particular back problem.
You can also strengthen your back by
supplementing this treatment with the
following exercises, which you can do at
home aer consulting with your doctor.
Exercises you can
do at home
Remember to breathe regularly and evenly during each
exercise. Avoid holding your breath. Stop immediately if
any movement causes pain. Some of the exercises are
designed to strengthen your abdominal muscles, as strong
abdominal muscles are always a prerequisite to a strong
back. Just 5–10 minutes of exercise every day can have a
positive eect on your musculoskeletal system. Enjoy the
workout – it won’t be long before you notice the results!
Exercise 1: Bending exercise
Lie on your back and draw both
knees up towards your abdomen.
With your hands holding your
thighs behind the knees, pull your
knees as far as possible towards
your chin.
Hold this position for around 15
seconds and then return to your
starting position. Take a short
break, then repeat this exercise
three times.
Principles of training:
• Do these exercises only after consulting your doctor or
physical therapist.
• Integrate the exercises into your daily routine.
• Observe the recommended time limits.
• None of the exercises should cause pain or other
problems.
• If anything is unclear, ask your doctor or physiotherapist.

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Exercises you can
do at home
Exercise 3: Strengthening your
abdominal muscles
Lie on your back and place your legs on
a chair or stool with your knees at a right
angle. Rest your arms on the floor to the
sides of your body. Breathe in, drawing
in your navel and pressing your lower
back to the floor. Now breathe out and
lift your head and rib cage so that your
shoulder blades are off the floor and your
arms are lifted. Breathe in and hold this
position for a few seconds. Then, while
breathing out, roll your upper body
down, vertebra by vertebra.
Exercise 4: Relaxing and stretch-
ing your back muscles
Sit on a stool with
your knees slightly apart. Now draw
your navel in, curving your back and
slowly bending forward until your
forehead touches your knees. Now
bring your arms forwards, placing
them lightly on your feet, and feel the
stretch. Breathe in and out deeply six
times. Finally, roll your upper body
up, vertebra by vertebra, until you are
sitting upright.
Exercise 2: Bending exercise
Lie on your back and place your legs
on a chair or stool with your knees at
a right angle. Make sure your knees
are not touching. Lift your head and
shoulders slightly off the floor and
press both hands against your thighs
for around five seconds. Don’t
forget to keep breathing regularly
and evenly despite the effort this
requires. Briefly lower your head
and shoulders to the floor. Repeat
this exercise 10 times.

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Exercise 7: Strengthening your
straight abdominal muscles
For this exercise, lie on your back
again. Bend your knees and place
both feet flat on the floor. Gently
raise your head and shoulders.
Now press your hands against
your thighs and maintain this
position for 15 seconds. Try
to press your navel into the
floor. Repeat this exercise three
times.
Exercise 6: Strengthening your
muscles
Lie on your back and put your feet
flat on the floor, shoulder-width
apart, bending your knees as you
do so. Now slowly raise your hips
so your back is lifted away from the
floor. Tighten your abdominal and
gluteal muscles so that your back
is straight. Hold this position for
15 seconds. Repeat the exercise
three times.
Exercise 5: Relaxing and stretch-
ing your back muscles
Kneel down and sit on your heels
with your knees slightly apart. Now
draw your navel in, lean and bend
forwards slowly until your forehead
touches the mat. Now bring your
arms forwards and feel the stretch.
Breathe in and out deeply six times.
Finally, roll your upper body up,
vertebra by vertebra, until you are in
an upright sitting position.

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Exercise 10: Flexing your spine
and stretching the back muscles
Get down on all fours. Put your head
on your chest and arch your back
like a cat. Hold this position for 5 to
10 seconds. Raise your head again
and hold it as an extension of the
spine. Now press your spine down
so that you have a hollow back.
Once again, hold this position for 5
to 10 seconds. Repeat this
exercise three times.
Exercise 9: Strengthening your
back and gluteal muscles
Get down on all fours. Extend your
left leg out behind you, flexing your
toes as you do so. Now raise and
extend your right arm forward. Hold
your arm, head, and leg parallel to
the floor with your back straight.
Hold this position for 10 seconds
and then repeat the exercise with
your right leg and left arm. Extend
your right leg behind you and lift your
left arm. Repeat the exercise three
times.
Exercise 8: Strengthening your
transverse abdominal muscles
Lying on your back, raise your knees
and put your feet flat on the floor. Lift
your head and shoulders. Touch your
right knee with your left hand. Hold
this position for 10 seconds. Now
relax and touch your left knee with
your right hand. Again, hold this
position for 10 seconds. Repeat the
exercise three times.

© Ottobock · 646D892=EN-02-1808 · Technical changes reserved.
Please contact us if you have any
further questions or would like more information.
Ottobock SE & Co. KGaA
Max-Näder-Straße 15 · 37115 Duderstadt/Germany
T [phone] · F [phone]
[email protected] · www.ottobock.com