How is it formed?
Lumbar hernia occurs when the elastic cartilage tissue called disc, located between the vertebrae, slides forward due to the pressure of the vertebrae
and compresses the nerves that come out of the spinal cord sheath and go to various parts of the leg. Sometimes a sudden force, lifting something heavy, a reverse movement or even a cold back can cause a herniated disc. But the most important cause of herniated disc is excessive tension in the muscles after long-term stress and tension.
What are the symptoms?
Pain in one or both legs, numbness in the feet, limitation of movement, difficulty in walking and sitting are the symptoms of herniated disc. If the hernia progresses, symptoms such as impotence, fatigue, urinary incontinence, imbalance and inability to walk may be added.
How is hernia diagnosed?
With today’s modern diagnostic methods, computed tomography and magnetic resonance, the diagnosis of herniated disc can be made easily and its degree can be determined.
How is hernia surgery performed?
With the microsurgery method applied in lumbar hernia, patients can get up and walk six or seven hours after the operation and go home after staying in the hospital for one night. Thanks to this method, only a 1.5-2 cm incision is made and no stitches are placed on the skin surface after the surgery.
Performing the surgery under advanced microscopes enables the nerves in the operating area to be seen at 25 or 40 magnification, thus reducing the risk of nerve damage to zero.
If lumbar hernia has just started
The treatment of lumbar hernia depends on the degree of herniation, that is, the pressure exerted by the elastic substance we call the disc on the nerves going to the leg. If there is only low back and leg pain, if there is no numbness, loss of strength or limitation of movement, it means that herniated disc is in the initial stage. In this case, it is recommended to give the patient muscle relaxants, to rest in bed and to avoid movements that will force the back.
Recommendations to the patient
1) The patient should never lift weights exceeding one or two kilograms.
2) Leaning forward and to the sides, bending of the waist is prohibited. If something is to be taken from the ground, the patient is told to take it by crouching.
3) It is recommended that patients put a pillow behind their waist to eliminate the lumbar cavity while sitting and not sit for more than twenty minutes. If the patient has to sit for a long time due to his profession, it is recommended to walk every twenty minutes. Long-term drivers are advised to park their car and turn around their car several times every twenty minutes.
4) The patient is prohibited from reaching upwards. If he is going to take something from above, he is told to go to the top of a chair or ladder and get it.
5) The patient is reminded to always keep his back warm and to avoid drafts.
6) Patients with low back and leg pain should definitely avoid stress. In addition to increasing the pain, stress can also lead to the progression of herniated disc.
7) It is recommended that the patient take bed rest during his stay at home. Contrary to popular belief, very hard floors are more harmful. It is more suitable for the patient to lie in a quality spring mattress and in the position that is most comfortable for the patient.
If the disease is in an advanced stage
If the patient’s complaints persist despite the above recommendations, rest and muscle relaxants, physical therapy should be applied.
Classification of low back pain
In the past, LBA (Lormbal Low Back Pain) lasting longer than 6 months was considered chronic
Whereas now:
LBA lasting 0-4 weeks is acute
LBA lasting 4-12 weeks is subacute
LBA lasting longer than 12 weeks is considered chronic.
Manipulative therapy and massage are ineffective in the hands of the unqualified
Traction therapy is no longer recommended.
Evidence about acupuncture is insufficient (Definitions are made that it relieves pain but does not cure it) !
Biofeedback, TENS alone are ineffective. It can be used in combination treatments!
TP injections, prolotherapy and botox injections: conflicting results
Epidural steroid injection is insufficient in radicular pain. Controlled studies are insufficient
Cognitive therapy
However, combined treatment with Neural Therapy & Manual Medicine & Magnetic Field Therapy and Acupuncture is very effective.
NEURALTHERAPY: Treatment begins with the examination of Adler Langers points. Positive segments are detected with the modal skin shift test. Local treatment: 1% Lidocaine and procaine are applied to the areas with local problems.
Segmental therapy: It is applied to the irritation points in the segment, especially the trigger points of the gastrocnemius and soleus muscles. Quadell is made between L1-S5. L2 blockade and or canalis sacralis application.
If the patient has constipation and bowel problems, they should be treated.
Candida loading in the intestine causes toxins to accumulate in the connective tissue.
With this Reviqunat- Proqunat or Vega test, the source of the problem should be investigated and revealed.
The interference field must be regulated. Unilateral tendinitis and arthritis are usually caused by interference fields. For more comprehensive articles on this subject, see the neuraltherapy mechanism of action section or see my articles on the www.noraloterapi.com association page or my book published by 201o Nobel Bookstore.
Lower extremity circulation protocol is the first step treatment. Interfering areas within the same segment should be tested kinesiologically and treatment should be planned according to the response.
The patient should be re-evaluated each time they come and necessary changes should be made in the treatment planning. In chronic cases, care should be taken not to fall into the classical perspective and routine.
Situations that require surgery in herniated disc
If the patient’s pain continues despite physical therapy and complementary medicine methods, or if there is a loss of strength that cannot be regressed, thinning of the leg, unbearable pain, if a piece of the disc is detected in the tomography or MR films taken, the solution is surgical intervention. This rate is below 5% of all lumbar hernias in the world. In other words, surgery is a last resort and should be used widely.
Hüseyin NAZLIKUL
President of the Neural Therapy Association
Manual Medicine Association II. President
Complementary Medicine and Regulation Association II. President
Honorary President of the Scientific Acupuncture Society
