Ionela-Florina TUDOSIE, Emilian TARCAU, Theodora URSU, Adrian Titus SERSENIUC URZICA

Manual therapy, herniated cervical disk, trigger points, pain.

Introduction: Musculoskeletal disorders that affect the functionality of different body segments, associated with certain comorbidities, can lead to different imbalances in body systems and apparatus. One of the most common musculoskeletal pathologies, with a huge impact on the physical, social, psychological and quality of life aspects of the individual, as well as on society as a whole, is pain, caused by herniated cervical disc. The importance of recovery is given by the large number of people with disabilities related to neck pain, so that a total of 223 million people are affected worldwide and 22 million live with it for years. One of the most effective and important means of treating neck pain is manual therapy. The forms of manual therapy, used in the treatment of cervical hernias, are joint-oriented (mobilization, manipulation, traction), soft tissue-oriented (forms of massage), neural tissue-oriented (neurodynamic) or mixed (specific exercises). Purpose: The aim of this study was to show the effects of instrumented manual therapy and kinesiotherapy in relieving the symptoms of cervical disc herniation. Material and Method: The study was carried out over 6 weeks on a 54-year-old patient diagnosed with left latero-posterior disk herniation at C3/C4 level of 1.5 mm and at C4/C5 level of 2 mm, he also had hypertension - essential GR II, tricuspid insufficiency GR ½, mean systolic dysfunction VS, mitral insufficiency GR II and sleep apnea, obstructive form, as associated pathologies. The patient was evaluated for cervical pain using VAS scale, cervical spine mobility, functional tests (Appley Test, Spurling Test, Shoulder Abduction Test, Scalen Test, Traction Test and Barre-Lieou Test), Neck Disability Index, as well as the presence of active trigeer points and their pain intensity. The 6-week treatment plan was carried out in 2 stages, the first (for 3 weeks) consisting of relaxation massage, cervical and scapular belt mobilizations, and the second consisting of myofascial instrumented therapy, cervical manual therapy, global postural re-education exercises (Souchard Method) and cervical and scapular belt mobilizations, 3 times a week for 90 minutes. Results: In the first part of the recovery (first 3 weeks) there was little improvement in all the parameters evaluated, but with the introduction of myofascial therapy, manual therapy, postural exercises and mobilizations in the recovery program, the results were significantly improved. Conclusions: The recovery program based on manual therapy techniques had positive effects in treating neck pain, improving joint mobility, deactivation of trigger points, and positive effects on neck disability index in the cervical disc herniation patient studied.

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