Author: Okan Keles

Is Hernia Treatment Possible?

January 5, 2020

Okan Keleş

Although the degrees and levels of disc herniations are important, many can be treated with manual therapy and osteopathy. However, the nature of the treatment is related to whether there is a tear in the disc. Non-tear disc herniations are small bulges and can be completely treated. In the case of a tear, the size of the tear is important because the torn area does not disappear as if no problem occurred, but the bulged part of the disc can be directed back to its normal position and reduced in size so that it does not cause complaints. In all these cases, one of the most important approaches for permanent treatment is to evaluate and correct or modify the postural habits, ergonomic problems, incorrect uses, or physical characteristics that cause these disc herniations. The success of hernia treatment is related not only to working with an experienced physiotherapist but also to the patient's own efforts. Disc herniations shrink quickly in patients who make the necessary modifications in their daily life and follow their exercise program. In fact, the biggest problem in our country is the assumption that arm or leg pain and local lower back-neck pain are solely due to disc herniations (especially if the patient has an accompanying disc herniation). However, many disc herniations do not cause symptoms at the early stages and do not cause local pain. Most lower back-neck pains are myofascial and facet joint pains. In future posts, we will discuss facet joint pain and myofascial pain, which are very common, in detail...

What is Antalgic Scoliosis?

January 5, 2020

Okan Keleş

Antalgic Scoliosis, which can be translated into our language as pain-induced spinal curvature, typically arises as a result of severe muscle spasm developed as a protective mechanism of the body due to a disc herniation (hernia) that exerts significant pressure on the nerves. This type of scoliosis develops secondary to disc herniations or similar reasons that cause nerve compression. There is no accompanying bone deformity. Simply put, the body uses muscle spasm and especially pain that increases with movement to lock the problematic area and try to prevent movement and thus the problem from worsening. The muscle spasm develops intensely and causes the affected side to shorten, taking on a concave shape. This results in asymmetry of the spine when viewed from the back. It usually returns to normal with the resolution of the issue that triggered the muscle spasm. Manual therapy and osteopathy provide effective solutions for treating such conditions. In such a situation, be sure to consult your physiotherapist...

What is Spinal Stenosis?

January 5, 2020

Okan Keleş

Spinal stenosis is the condition where the spinal canal (the channel through which the spinal cord passes) or foraminal canals (the canals where nerves exit the spine) narrow, causing compression on the nerves. Stenosis is divided into acquired and developmental types. Developmental stenosis is a congenital condition where the canal is narrower than normal for various reasons. Acquired stenosis, which is most common in the 60s and 70s, is divided into foraminal stenosis, which develops with facet joint hypertrophies (joint enlargements) following disk degeneration, and spinal stenosis, which develops due to hypertrophy (enlargement) and loss of elasticity of the ligamentum flavum (yellow ligament) that runs inside the canal. Although acquired stenosis usually develops with age, it can be seen at much younger ages due to excessive use of the spine, poor posture, repetitive flexion (bending forward) movements with insufficient muscle strength that put excessive strain on the ligaments, and prolonged periods in flexion positions. Stenosis patients usually have difficulty standing or walking for long periods and feel the need to sit down shortly. In this respect, sitting in a hunched, poor posture is a flexion posture, which can pull the age of stenosis formation to the 40s, especially in people like office workers who spend 8-9 hours a day sitting. Therefore, poor sitting posture not only causes joint or muscle pain but also leads to chronic spine problems. We will discuss the harmful effects of poor sitting posture and a sedentary lifestyle in future posts... Sit up straight, exercise, and consult your physiotherapist for complaints...

How Do Lumbar and Cervical Hernias Form?

January 5, 2020

Okan Keleş

Between our vertebrae, there are disk structures responsible for shock absorption, providing mobility, and preventing the early deformation of spinal joints. In front of these disks is a wide and strong protective structure called the ALL (anterior longitudinal ligament), which prevents them from bending forward. Similarly, there is a structure called the PLL (posterior longitudinal ligament) that attaches to the disks longitudinally from the back, preventing them from bending backward. Especially in cases where the lordosis (curvature) of the lumbar and cervical regions decreases (lumbar-cervical flattening) and when bending forward, the disks tend to bend backward, creating a risk of pressure on the nerves passing through the channel behind the disks, like electrical cables. As the PLL narrows in the channel as it descends to lower levels, it cannot provide as much protection as the ALL in the front. Therefore, in situations where the lordosis decreases or when bending forward, the disks tend to bend backward, especially from the lateral side of the PLL, towards the nerves. If these bends do not return to their position when the position is corrected, this condition is called a Disk Hernia. If disk hernias grow large enough to press on the nerves, they cause complaints such as pain, numbness, loss of sensation, or loss of strength in the area where the nerve travels. From an osteopathic perspective, organ dysfunctions are also evaluated in the formation of disk hernias. Many disk hernias can be treated without surgery using manual therapy and osteopathy approaches. If you have similar complaints, consult your physiotherapist...

The Sleep-Pain Relationship

January 5, 2020

Okan Keleş

Sleep is a different state of consciousness necessary for the normal and healthy functioning of the human body, involving active and different groups of neurons. Sleep directly affects our general health, primarily for the brain's functions to operate healthily, for the musculoskeletal system to rest, and for the necessary repair mechanisms to function. Approximately one-third of human life is spent sleeping. Sleep is divided into two phases: REM (rapid eye movements) and NREM (non-rapid eye movements). The first REM phase starts about 90 minutes after sleep begins, and then 3-5 REM periods occur at approximately 90-minute intervals throughout the night. REM is the phase where we dream. NREM is divided into light and deep sleep. People who cannot get enough deep sleep phases describe fatigue, tension, and increased stress conditions. Increased tension and stress conditions in the insufficiently rested muscle system lead to complaints. Additionally, sleep disorders can cause serious health problems as they disrupt hormonal balance. Furthermore, sleep disorders have been identified in patients with MAS (myofascial pain syndrome) and fibromyalgia, and it has been determined that they differ hormonally from healthy individuals. In future posts, we will discuss the relationship between sleep disorders, MAS, and fibromyalgia in detail...

Poor Sitting Postures

January 5, 2020

Okan Keleş

Among the pains experienced by people who spend most of their daily time sitting, such as office workers, the most common are neck and lower back-hip pains. Especially in those with asymmetrical sitting habits, sitting by putting the body weight on one hip over time causes decreased mobility in the sacroiliac joint (the junction of the hip and lower back-tail) and lumbar facet joints (the joints between the lumbar vertebrae), degradation of the surfaces of these joints, and osteoarthritis (calcification) over time. Asymmetric load and hypomobility (immobility) also impair the nutrition and properties of the discs. In addition, it affects the balance and health of soft tissue. The harms of poor sitting posture and hypomobility to both the musculoskeletal system and general health will be detailed in our future posts. In the meantime, take care of yourself, move around, and consult your physiotherapist for your complaints.

What is Occipital Neuralgia? (Neck-Origin Headaches Radiating to the Eye and Forehead)

January 5, 2020

Okan Keleş

Occipital neuralgia is a problem that causes pain starting from the back of the skull, originating from the scalp, and radiating to the eye and forehead on the same side due to compression or injury of the occipital nerves passing through the upper levels of the spinal cord. Often mistaken for migraines, this problem causes complaints of headaches starting from the neck and spreading to the eye. The causes of these pains can be blockages in the upper cervical (upper neck) joints, muscle spasms, or myofascial tensions. These can be caused by sleep and sleep position disorders, fatigue, stress, poor sitting posture, or trauma. If you have headaches radiating from your neck to your eye on the same side, consult your physiotherapist. Especially in manual therapy, the causes of this problem are quickly identified and treated with techniques such as manipulation, mobilization, specific stretches, myofascial release, and acupressure.

Is It Possible to Live Pain-Free Without Surgery?

October 13, 2019

Okan Keleş

Of course, it is possible to get rid of your pain without surgery. Pain is one of the body's warning mechanisms and indicates that there is a problem in the area where the pain is felt or in another part of the body that affects it. Therefore, to get rid of these complaints, the source of the problem must be clearly identified. Almost every problem that is clearly identified has a solution. Because our body is a living and self-repairing organism. We just need to direct our body correctly to repair that problem. The best people to do this in the healthcare system are physiotherapists and osteopaths. With a good evaluation, the source of the problem is found, and our body is directed to repair that problem using special techniques (manipulation, mobilization, deep relaxation, nerve mobilizations, taping techniques, fascia treatment techniques, etc.). It is also supported with personalized exercises and nutritional recommendations. Surgery is recommended only in cases where it is absolutely necessary, meaning situations where the body cannot heal itself even with external help. It should be remembered that long rehabilitation periods await patients after every surgery. Trying treatment first is always the most logical approach.

Is a Pain-Free Life Possible?

October 2, 2019

Okan Keleş

Of course, a completely pain-free life is not possible for anyone. Because pain is one of the warning mechanisms of our body. The sensation of pain indicates that there is a problem in that area of the body or in another related area that affects it. In this respect, pain is actually a protective warning mechanism. However, we must also heed this warning mechanism and produce the necessary solutions. If pain becomes chronic (long-term), its treatment becomes difficult. Therefore, the earlier the intervention, the easier the solution. The most important issues for a pain-free and healthy life as much as possible are undoubtedly nutrition, physical activity, proper rest, coping with stress, and taking ergonomic measures according to the work being done. Especially in musculoskeletal disorders that develop due to the work being done, proper ergonomic approaches are very important. Staying in a bad posture for a long time is one of the most important threats to spinal health. In addition, exercises performed without straining the body and without overloading our musculoskeletal system are also very important for a healthy life. Nutrition is already a key topic for general health and, therefore, for our physical health. It is necessary to consult with a specialist on topics such as proper posture, ergonomics, exercise, and nutrition because all of these should be personalized.

Is Every Lower Back and Neck Pain a Hernia?

June 27, 2015

Okan Keleş

Contrary to popular belief, severe hernias in the lower back and neck do not cause pain in these regions. If the hernias in these areas grow large enough to create nerve pressure, they cause complaints such as pain and numbness in the area where the nerve they press on goes. Therefore, the nerves coming out of the neck area go to the shoulder and arm, and the nerves coming out of the lower back go to the hip and leg. Hernias that press on the nerves in these areas cause problems in the shoulder-arm and hip-leg regions. Pain in the neck and lower back areas is mostly due to joint and muscle pain or a combination of these. What misleads us here is that when an MRI scan is performed on a patient who complains of neck or lower back pain, herniations are often seen at certain levels in almost everyone. However, the presence of herniation on an MRI does not indicate that the patient's complaints are due to the hernia. What is important here is to evaluate the patient in detail, find the real cause of the complaints, and treat them. In conclusion, not every neck or lower back pain is a hernia. When the cause of these pains is determined, effective treatment with manual therapy methods is possible.

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