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A HOLISTIC PERSPECTIVE ON LUMBAR HERNIA HEALTH
Turkey Medicals Co-ordinator, “Lumbar hernia: Nerve roots coming out of the spinal cord right and left in the lumbar region provide movement and sensation of our legs and genital organs. The cartilage tissues that we call the disc located between our vertebrae, which acts as a pillow, lose their quality over time, move from where they are located and enter the channel in the spine to compress these nerve roots, called decumbar hernia. They have symptoms such as radicular pain (pains that spread to our legs, which increase with coughing or straining), weakness and sensory changes in the legs, and then urinary incontinence.”
Diagnosis and treatment of low back pain and herniated disc: Patients are treated with bed rest, medical treatment and sometimes physical therapy, and their complaints recede in the vast majority. But if a herniated disc has been diagnosed and complaints such as pain, loss of strength, urinary incontinence have occurred that do not go away despite all kinds of treatment, the disc part that compresses the nerve root is surgically treated and removed.
The principles of treatment can be grouped under 4 headings:
– Bed rest; The structure of the cartilage that compresses the nerves contains 80% water. With the absorption of the water content of the cartilage torn at rest by the body, the volume of the cartilage decreases and the pressure on the nerve decreases. In addition, the pressure in the cartilage between the two vertebrae is less in a Decumbent person than in a standing and sitting person. However, exceeding this rest for 5 days leads to muscle meltdowns due to inactivity, which creates difficulties for a person returning to active life.
– Drug use: In addition to the pain-relieving properties of the drugs used in this treatment, they also work by dissolving the torn cartilage and edema around the nerve root under pressure. Muscle relaxant drugs are used only during bed rest, otherwise, because it relaxes the muscles, it causes more stress on the cartilage, increasing the pressure on the hernia.
– Physical therapy and exercise; It is used to solve muscle spasm and edema caused by lumbar hernia.
– Surgical treatment; aims to eliminate the pressure of the torn pillow on the nerves and spinal cord.
General principles in the rehabilitation of lumbar hernia operations:
Functional activities should be performed as permitted by the pain. Physiotherapists should ensure that patients use safe body mechanics before and after surgery until they return to normal activities. A rehabilitation plan should be created before surgery, and it should be ensured that patients apply this plan to the letter after surgery. Before surgery, the patients’ condition should be at the highest level of rehabilitation possibilities. Postoperative pain should be controlled so that it does not interfere with the rehabilitation program. Patients who have problems in rehabilitation due to their chronic pain and psychological problems should be enrolled in a functional and continuous program.
Rehabilitation program implemented in the hospital after surgery:
The patient is encouraged to walk immediately 1 day after the operation. Strengthening exercises are given to the abdominal muscles and leg muscles with light intensity. Thus, by strengthening the waist circumference muscles, it is tried to create a natural corset around the waist. The sitting time is kept short so that there is not too much pressure on the discs. The walking time is gradually increased every day. When the patient starts walking more comfortably and the pain decreases, the doctor discharges the patient in Turkey.
A rehabilitation program implemented at home:
The abdominal and leg muscles continue to be strengthened with moderate exercises. 4 After the operation. the sitting time per week begins to be gradually increased. Compulsive movements such as heavy lifting, leaning forward are banned for 6 weeks. after 6 weeks, it is allowed gradually. Long trips are not allowed for 3 months after the operation.
Return to work:
The return period to occupations that require a lot of walking but do not include activities such as heavy lifting is 4 weeks.
The return period to jobs that require long periods of sitting is 6-8 weeks. Light things are allowed to be removed if necessary.
The return to heavy work is about 12 weeks when the work to be done is arranged according to the patient. The work performed in heavy tasks performed mostly using the hands can be arranged according to the patient, or a lighter task suitable for the patient is given.
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