Eastern Mediterranean University (EMU) Dr. Fazıl Küçük Faculty of Medicine and Marmara University Faculty of Medicine, Department of Physical Medicine and Rehabilitation academician Prof. Dr.Hakan Gündüz put forward new approaches and protection methods in the treatment of herniated disks. Prof. Dr. Gündüz emphasized that over 80 percent of the society suffer from back pains at least once in their lifetime and that the pain is due to mechanic injury or straining of the muscles. According to Prof. Dr. Gündüz “ Problems caused by a herniated disk often occur in middle-aged people”, and lifting heavy objects, working in the same position for long hours, trauma, long-lasting stress, redundant weight, having multiple parturiencies, lack of physical activity, usage of cigarettes and alcohol, chronic coughing and genetical reasons can lead to the disk becoming herniated. Prof. Dr. Gündüz stated his views as follows:
“The most important symptom of a herniated disk is the aching of the back and/or the leg. Power dissipation and numbness of the leg may occur. Deterioration of the illness may cause sexual disorders and gastrointestinal problems. Suffering from an irremediable herniated disk affects both the social and business life of a patient. It is necessary to take some precautions in order to be protected from having a herniated disc. These precautions are;
- Always back up your waist while seated.
- Do not lift heavy objects. When it is absolutely necessary to lift heavy materials, do not do this with one hand.
- Whilst picking up something from the ground, always crouch down by bending your knees, not your back.
- Lie flat on your back instead of lying on your left or right side. Be careful not to have a bed which is too soft.
- If you are an office worker, always sit in an upright position. It is good to stand up and do some stretching exercises every 30 minutes
- Prefer using a back pack instead of a handbag.
- When you have a back pain; instead of lying in the bed all day, be active and do some exercises. Inaction through the painful hours causes the pain to occur more often.
- Do not wear high-heels.
- Always stand upright. A good positioning of the body will reduce the amount of force on the spinal cord and herniated disk.
- Get rid of excess weight in your body. The heavier you are the more strained your spinal cord becomes.
- Most important of all, regularly carry out exercises that will strengthen your waist by working on your abdominal muscles.
Professions that involve heavy physical activity and heavy lifting (For example, construction workers),constantly leaning forward, exposing the body to constant vibrations by driving vehicles such as cars, buses and trucks, standing or staying seated for long hours, playing football, lifting weights, rowing and wrestling tend to increase the risk of having back pains and a herniated disk.
Office workers must take the following precautions to protect themselves from herniated disks;
- In an office environment, the table-chair-computer relationship should be suited to the appropriate measurements. When sitting opposite a computer and when sitting on a chair or armchair one must be in an upright position.
- In the correct sitting position the knee joints must be higher up than the hip joints and the soles of your feet should be fully in contact with the floor. When seated, periodically changing position is recommended. When standing up, one of your feet should be in front of the other, you must push yourself up with your leg muscles and the help of your arms whilst keeping your back in an upright position.
- Do not remain in the same seated position for more than 30-40 minutes.
Precautions we take in our daily lives can reduce our risk of a herniated disk however taking these precautions doesn’t mean that we definitely won’t get a herniated disk as genetic factors and personal situations can also play a part in the development of a herniated disk.
A large amount of herniated disk cases do not require surgical treatment. Medical treatment and short term rest is beneficial for many of patients. For patients who have continuing pain, physiotherapy and a rehabilitation program in the control of an expert doctor can be implemented as well as epidural injections. If patient complaints still remain after all of this and if these complaints are affecting the patient’s way of life, surgical treatment can be recommended.
This is an effective method for only %50-75 of patients that have continual numbness in the foot, visible strength and reflex loss. The patient isn’t put to sleep with narcosis. The process takes approximately 10-20 minutes. Rest is advised on the day of the surgery. For the two days following the surgery, one must restrain from movement that could put strain on one’s back and act according to the doctor’s advice.
Epidural injections are an effective method. They should be given in a sterile and aseptic environment in special centers with operating theatres. The injections are applied to the area where the pressure forming the pain is located. The aim is to reduce the liquid accumulation that takes place as a result of the oedema which leads to the disk applying pressure on the nerve hence reducing the pressure on the nerve.
The hernia is completely removed after the process is completed. The patient is educated on how to move, how to act and how to lift objects. In addition, an exercise program is designed. If the education provided is correct and the patient does not ignore the advice received, the epidural steroid injections are effective for a longer period of time and the possibility of repetition is decreased.
Epidural injections aren’t given to patients with infections, blood coagulation problems, those taking blood diluents such as Aspirin or Coumadin or those who are pregnant. The risks and side-effects of the process are rare.