The body activates certain mechanisms to protect the damaged or problematic area. The main mechanisms are spasm and edema. The body tries to immobilize the problematic area, resulting in edema or muscle spasm depending on the situation. In fact, pain is one of these mechanisms. A person does not want to move the painful area or finds the body position where the pain is less. These mentioned mechanisms are interconnected.

From a physical perspective, the prolonged activation of these mechanisms can result in delayed healing or the formation of other problems. Due to the protein-rich nature of edema, it can cause adhesions in the tissues if it remains for a long time. Prolonged spasm, especially in spinal problems, reduces the movement of the facet joints responsible for movement and causes them to lock. This increases the load on the discs. Additionally, the effort to stay in a painless position causes postural (alignment) disorders in the body. As a result, these mechanisms create a vicious cycle.

In manual therapy, effective treatments are performed using techniques such as manipulation-mobilization, myofascial release, special stretching techniques, and muscle-energy techniques to drain the edema, effectively treat muscle spasm, and unlock locked joints.

Causes and Manual Treatment of Muscle Spasms and Cramps

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 It Possible to Live Pain-Free Without Surgery?

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.

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

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.

Poor Sitting Postures

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...

The Sleep-Pain Relationship

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...

How Do Lumbar and Cervical Hernias Form?

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...

What is Spinal Stenosis?

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 Antalgic Scoliosis?

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...

Is Hernia Treatment Possible?

In today's world, daily life stress is one of the most significant factors affecting human health both physically and psychologically. Stress causes muscles to tense and harden. When factors such as inactivity during the day, lack of exercise, eating habits, and sleep disturbances are added to this situation, serious problems can occur in the spine. Therefore, early manual treatment is necessary for those who have one or more of the factors mentioned above. After the symptoms are treated, personalized exercise programs are applied to individuals by a physiotherapist. These programs include types of exercises such as flexibility, strengthening, relaxation, proper breathing, and postural (alignment) exercises, which are selected and applied individually by the physiotherapist.

Stress-Related Pains

In daily life, back and neck pains are seen in almost everyone, and effective and quick results can be achieved with manual therapy. Especially in professions where people have to sit for long periods during the day or those who lead a sedentary (inactive) lifestyle, spinal problems are common. In these cases, pain and movement restrictions are often attributed to spinal disc herniations (slipped discs). In fact, if the disc herniations are not large enough to press on the nerves, they usually do not cause symptoms. Therefore, the majority of spinal pains are of mechanical origin. In individuals whose muscles are not strong enough to support the spine, those exposed to intense stress during the day, those with disturbed sleep patterns, and those who remain static for long periods during the day due to their work, pain caused by prolonged muscle contraction and the locking of facet joints in the spine due to immobility occurs. If this condition is not treated, it can become chronic and lead to other spinal problems. Today, manual therapy provides a fast, effective, and permanent treatment for these types of spinal problems without the need for any medication or device, surpassing all traditional methods.

Are Back and Neck Pains Our Fate?

A small percentage of disc herniations (slipped discs) cause numbness, loss of sensation, and reduced reflexes in the arms and legs. The most important factor in herniations is their degree, or size. The majority of numbness in the arms and legs is not actually due to herniations, but rather due to tissues compressing the nerves passing through them for various reasons. Certain muscles, in particular, can easily compress the nerves passing through them. In such cases, if a herniation is also present, the symptoms are usually attributed to the herniation.

In manual therapy, all factors that could cause the patient's complaints are evaluated using various techniques and tests. The tissues compressing the nerve are relieved using special relaxation techniques, thus eliminating the complaints.

If the complaints are due to a herniation, the canal through which the nerve passes in the herniation area, along with the structures adjacent to the canal, are relaxed using special techniques to relieve the nerve.

Arm and Leg Numbness

Contrary to popular belief, not all headaches originate from the brain or other intracranial structures. In fact, when headache cases, which are not only neurological but also orthopedic, are evaluated, it is seen that the majority originate from the neck region. The positions and angles of the cervical vertebrae, the shortness or tightness of the neck muscles, myofascial pains in the neck region, and spasms caused by fatigue all contribute to headaches. Headaches can be evaluated and treated with manual therapy. Patients feel relief after a treatment session.

Manual Treatment of Headaches

Today, a large number of office workers experience chronic pain over time in many joint areas, especially in the lower back, neck, and back regions. Due to reasons such as static posture, poor ergonomic conditions, and lack of exercise habits, joint pain that initially starts vaguely becomes more serious over time if not treated. Staying in the same position for a long time causes spasms in the muscles and the formation of hard-painful points (trigger points). The spasming muscle locks the joints in the area, causing blocks. These blocks lead to joint pain and, over time, to dysfunction (loss of function) of the joints. With manual therapy, these joint blocks are opened, and muscle spasms are treated using special relaxation methods. When the opened joint starts to perform its normal function, the pain and the feeling of difficulty in movement disappear.

Joint Pains in Office Workers

Precautions are taken by evaluating the daily activities of individuals. Physiotherapists help individuals prevent diseases by modifying factors that may cause physical problems. Additionally, they plan exercise programs to reduce the negative effects of the work individuals do. This control mechanism also helps individuals establish habits such as regular exercise and balanced nutrition.

Precautions and Recommendations for Preventing Musculoskeletal Disorders

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.

Is Every Lower Back and Neck Pain a Hernia?

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.

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Manual Treatment of Headaches