Physiotherapy

Definition

There are 7 vertebrae in our neck and 5 in our lower back. There are cartilage structures between these bones called discs. Discs contribute to the spine motion and facilitate balanced distribution of the loads falling on the spine. Neck and lower back hernia are the disorders emerging due to degeneration and overflow of these discs acting as shock absorbers.

Findings

Pain and limitation of movement are the primary findings of lower back and neck hernia. The source of the pain is the compression caused by the overflowing disc on the adjacent tissues being spinal cord and nerve roots primarily. Certain chemicals released in tissues with defective blood flow due to such compression cause the pain. And the resulting pain causes limitation of movement by triggering muscle spasm reflexively. Pains caused by the compression that the nerve roots are subjected to may spread to arms or legs as well as findings such as numbness and burning sensations may manifest. In case the compression on the nerves and spinal cord is severe, muscle weakness, urinary and fecal disorders may accompany the findings.

Causes

The most important cause of lower back-neck hernia is mechanical factors. Such factors emerging due to improper usage of the spine causes degeneration and overflow of the cartilages called discs. The passive lifestyle developed due to advancing technology, long-term working in sitting position, positions keeping the spine in an improper position for a long duration (computer usage, watching TV, working in industrial production, etc.), improper load handling are the most common causes of the disease. In addition to mechanical factors, disc wearing occurring due to aging, genetic degeneration of the cartilage structure and traumas are among the causes of hernia.

Diagnosis

The most important element in lower back and neck hernia diagnosis is the examination by a physician. All imaging methods, primarily MRI, shall be used to either verify the diagnosis or for differential diagnosis only. Diagnosing a patient with hernia solely using imaging methods is not right. However, unfortunately many patients today are misdiagnosed with hernia.

Treatment

It is possible to treat majority of lower back and neck hernia without requiring surgical intervention. Surgical treatments are included for the treatment of very few patients, especially ones manifesting paralysis findings. Medication therapies, physical therapy applications (hot application, electric currents, ultrasound applications, laser, etc.), local injections, manipulation applications, exercise physiotherapy are commonly used nonsurgical therapy options. In addition to the aforementioned traditional therapy methods; new therapy methods are developed in the recent years with more successful results in hernia therapy. One of these methods is the Vertical Traction therapy, applied in our hospital for the first time in Turkey. Application of vertical traction devices on the patient is easy and treats the disease by applying traction on the herniated discs in natural ways. Another method is computer-aided decompression devices . This device is a state-of-the-art product and removes the compression by directly having an effect on the herniated disc and subsequently treats the disease. Patients suffering from lower back and neck hernia are not recommended for surgery anymore. Furthermore, another successful method used in hernia therapy in the recent years is Ozone Applications. It is possible to apply the ozone locally inside the soft tissue in the herniated spine region, as well as injection to herniated disc or spinal cord canal is possible. In conclusion, today the lower back and neck hernia are listed among the diseases that can be treated with nonsurgical methods.

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