After being diagnosed with a herniated disc, patients are filled with question marks in their minds and flounder in an environment of fear and uncertainty. Some patients are afraid of both surgery and being worse than before after surgery. For this reason, the quality of life of patients who avoid situations that require surgery and postpone the process is impaired, their treatment is delayed, and worse, permanent damage may occur. Some patients who have problems that do not require surgery, their beliefs, perceptions and knowledge that they cannot recover without surgery lead them to resort to unnecessary surgical operations.
It should be known that; The diagnosis of a herniated disc cannot be made only by looking at radiological images or by interpreting the symptoms only. The patient's disease history and process, neurological examination and radiological imaging should support each other. It would be much more accurate medically to determine the possible surgical decision in the light of these findings.
Which conditions require physical therapy in a herniated disc?
We can say that the treatment of a herniated disc has four stages. If the patient does not have a condition that requires urgent surgery, such as urinary incontinence or loss of strength in standing, the treatment is carried out in accordance with this order. The first stage is rest and medication. If the patient's complaints do not improve with this treatment, physical therapy can be started as the second stage. Patients whose complaints have decreased but have not completely resolved after the herniated disc surgery can gradually start physical therapy after at least 2-3 months after the operation, if there is no recurrence requiring a second surgery. Patients who have undergone surgery due to serious herniated discs that cause droopy feet, commonly known as ruptured hernias, should start physical therapy early if their weakness persists even though their pain is relieved due to being late for the operation (if surgery is not performed within the first 72 hours). In the third stage, interventional pain treatments can be applied to patients who do not benefit from physical therapy but do not have neurological deterioration that requires surgery. In the final stage, even if there is no loss of strength in patients who do not benefit from non-surgical procedures, surgery must be performed if the surgical focus that is the source of the problem is detected, as the process becomes chronic.
The essence of the treatment is. What are its benefits?
In order to relieve the painful edema and muscle spasm, which we call inflammation caused by the herniated disc in the sensitive structures and nerves of the waist, low-frequency electrical currents such as TENS, vacuum interference, as well as various physical therapies such as laser, ultrasound, shortwave and radar are used. Traction agents are applied depending on the situation. Exercises are also given during the treatment.
What is the role of exercises in the treatment of herniated disc?
Exercise is an integral part of the treatment of herniated disc. However, it is important that the exercise is planned specifically for the patient and given together with proper posture training. In addition to strengthening the trunk and leg muscles with exercises, we aim to reduce the loads on the spine by stretching the muscles.
Are there any physical therapy exercises to be done at home?
The exercises we plan specifically for the patient during the treatment are also regularly performed at home by our patients. We want them to continue for at least 3 months after the treatment, and if possible for life.
Is physical therapy addictive?
Physical therapy is not addictive, but for muscle, bone and joint pain, we want it to be addictive. Since it is a good option as a treatment method that has no side effects compared to surgery, our patients may want to undergo physical therapy again for their recurring problems. If the patient has gone through a period that requires rest, he can go to work, do sports, and does not need to restrict his activities.
Are there situations where physical therapy does not work?
Physical therapy is definitely not applied in cases such as infection and cancer. In addition, it would be wrong to insist on physical therapy if the complaints have started to worsen, if there is a loss of strength that was not there before, or if the process exceeds 6-8 weeks.
It is not applied if there is advanced spinal damage accompanied by neurological disorders such as muscle weakness and urinary incontinence. should not be applied. The effectiveness of physical therapy or whether it will work depends on the correct diagnosis and the personalized physical therapy program.
Does physical therapy prevent the hernia from recurring?
Physical therapy relieves pain, painful edema and muscle spasm like drugs, it is therapeutic, but it does not have a protective effect from recurrences. To protect herniated disc patients from recurrence; physical It is necessary for them to continue the exercises taught during treatment regularly for at least 3 months after treatment and to do waist-friendly sports such as swimming and walking throughout their lives.
Avoiding excess weight, avoiding movements that strain the waist while working in the kitchen or office in daily life, It is important to be careful when lifting weights. Exercise and proper posture training are also given during treatment to prevent recurrences of hernia.
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