Nöral Terapinin Servikal Diskopatiye Bağlı Kronik Boyun Ağrısına Etkisi

Yıl 2022, Cilt: 16 Sayı: 4, 779 - 785, 23.12.2022

İbrahim Başhan Gülşah Yaşa Öztürk

https://doi.org/10.21763/tjfmpc.1118848

Öz

Giriş: Bu çalışmanın amacı, servikal diskopatisiye bağlı kronik boyun ağrısı ve/veya fonksiyon kaybı olan hastalarda uygulanan, nöral terapötik ajanlardan biri olan %1’lik prokain enjeksiyon tedavisinin, ağrı ve boyun disfonksiyonu üzerine etkisini araştırmaktır. Yöntem: Servikal diskopati tanısı alan 58 hastanın kayıtları incelendi. Hareket Açıklığı değerleri, Boyun Özürlülük Anketi ve Vizüel Analog Skala skorları başlangıçta ve nöral terapiden bir ay sonra karşılaştırıldı. p<0,05 değerleri istatistiksel olarak anlamlı kabul edildi. Bulgular: Nöral Terapi sonrası Hareket Açıklığı değerlerinde boynun tüm hareketlerinde istatistiksel olarak anlamlı bir artış gözlendi ve Vizüel Analog Skala ve Boyun Özürlülük İndeksi puan ortalamalarındaki azalma hem protrüzyon hem de bulging gruplarında istatistiksel olarak anlamlı bulundu. Sonuç: Bu çalışma, cerrahi kararı alınmamış medikal tedaviye dirençli kronik boyun ağrısı olan servikal diskopatili (protrüzyon ve bulging) erişkin hastalarda nöral terapi uygulamasının sonuçlarını gösteren ilk çalışmadır.

Anahtar Kelimeler

Nöral terapi, prokain, servikal diskopati

Destekleyen Kurum

Yok

Proje Numarası

Yok

Effect of Neural Therapy on Cervical Discopathy-Related Chronic Neck Pain

Öz

Introduction: To investigate how 1% procaine injection therapy, one of the neural therapeutic agents, affects neck disability and pain intensity in patients who have cervical discopathies that are causing chronic neck pain and/or functional limitations Methods: The records of 58 patients diagnosed with cervical discopathy were examined. The Range of Motion values, Neck Disability Questionnaire and Visual Analog Scale scores were compared at baseline and one month after neural therapy. The results of cervical magnetic resonance imaging were analyzed, and the mean scores were compared between the protrusion and bulging. P values of <0.05 were considered statistically significant. Results: A statistically significant increase was observed in Range of Motion values after NT in all movements of the neck and the decrease in the mean Visual Analog Scale and Neck Disability Index scores after neural therapy were found to be statistically significant in both the protrusion and bulging groups. Conclusion: This is the first study providing evidence of the effects of neural therapy on neck pain severity and neck disability in adult patients with cervical discopathies (protrusion and bulging) presenting with chronic neck pain resistant to medical treatment, who had not yet made a surgical decision.

Anahtar Kelimeler

Neural therapy, procaine, cervical discopathy, neck pain

Proje Numarası

Yok

Kaynakça

• 1. Brobyn TL, Chung MK, LaRiccia PJ. Neural Therapy: An Overlooked Game Changer for Patients Suffering Chronic Pain? J Pain Relief. 2015;4:184. https://doi.org/10.4172/2167-0846.1000184.
• 2. Harris GR. Effective treatment of chronic pain by the integration of neural therapy and prolotherapy. Journal of Prolotherapy. 2010;2:377–386. Available from: https://www.journalofprolotherapy.com/pdfs/issue_06/issue_06_07_neural_therapy.pdf
• 3. Frank BL. Neural therapy. Phys Med Rehabil Clin N Am. 1999;10(3);573-82. viii. PMID: 10516978.
• 4. Altınbilek T, Terzi R, Başaran A, Tolu S, Küçüksaraç S. Evaluation of the effects of neural therapy in patients diagnosed with fibromyalgia. Turk J Phys Med Rehabil. 2019;65(1):1-8. https://doi.org/10.5606/tftrd.2019.1931.
• 5. Koopman FA, Stoof SP, Straub RH, Van Maanen MA, Vervoordeldonk MJ, Tak PP. Restoring the balance of the autonomic nervous system as an innovative approach to the treatment of rheumatoid arthritis. Mol Med. 2011;17(9-10):937-48. https://doi.org/10.2119/molmed.2011.00065.
• 6. Egli S, Pfister M, Ludin SM, Puente de la Vega K, Busato A, Fisceher L Long-term results of therapeutic local anesthesia (neural therapy) in 280 referred refractory chronic pain patients. BMC Complement Altern Med. 2015;15(1):1-9. https://doi.org/10.1186/s12906-015-0735-z.
• 7. Sillevis R, Shamus E. The Effects of Neural Therapy Using 1% Procaine Injections on Pain and Autonomic Nervous System in Patients with Neck Pain. J Rehab Pract Res. 2020;1(2):111. https://doi.org/10.33790/jrpr1100111.
• 8. Weinschenk S. Neural therapy a review of the therapeutic use of local anesthetics. Acupuncture and Related Therapies. 2012;1:5–9. https://doi.org/:10.1016/j.arthe.2012.12.004.
• 9. Atalay NS, Sahin F, Atalay A, Akkaya N. Comparison of efficacy of neural therapy and physical therapy in chronic low back pain. Afr J Tradit Complement Altern Med. 2013;10:431–5. https://doi.org/:10.4314/ajtcam.v10i3.8.
• 10. Özkan N. The Efficiency of Neural Therapy in Resistive Musculoskeletal Disorders. Journal of Complementary Medicine, Regulation and Neural Therapy. 2014;8(2),14-18. Available from: https://dergipark.org.tr/tr/download/article-file/621082
• 11. Cleland JA, Childs JD, McRae M, Palmer JA, Stowell T. Immediate effects of thoracic manipulation in patients with neck pain: a randomized clinical trial. Man Ther. 2005;10(2):127-35. https://doi.org/10.1016/j.math.2004.08.005.
• 12. Mermod J, Fischer L, Staub L, Busato A. Patient satisfaction of primary care for musculoskeletal diseases: a comparison between Neural Therapy and conventional medicine. BMC Complement Altern Med. 2008;8:33. https://doi.org/10.1186/1472-6882-8-33.
• 13. Subasi V, Kucuk MO. Neural Therapy Protocols in Musculoskeletal Disorders: Review. Turk J Osteoporos. 2018;24:1-4. https://doi.org/10.4274/tod.64935.
• 14. Carroll LJ, Hurwitz EL, Côté P, Côté P, Hogg-Johnson S, Carragee EJ, Nordin M, et al. Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Research priorities and methodological implications: The Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Spine. 2008;15;33(4 Suppl): S214-20. https://doi.org/10.1097/BRS.0b013e318164462c.
• 15. Yang L, Yang C, Pang X, Li D, Yang H, Zhang X, et al. Mechanoreceptors in Diseased Cervical Intervertebral Disc and Vertigo. Spine. 2017;42(8):540–546. https://doi.org/10.1097/BRS.0000000000001801.
• 16. Evans G. Identifying and treating the causes of neck pain. Med Clin North Am. 2014;98(3):645–661. https://doi.org/10.1016/j.mcna.2014.01.015.
• 17. Navone SE, Marfia G, Giannoni A, Beretta M, Guarnaccia L, Gualtierotti R, et al. Inflammatory mediators and signalling pathways controlling intervertebral disc degeneration. Histol Histopathol. 2017;32(6):523–542. https://doi.org/10.14670/HH-11-846.
• 18. Risbud MV, Shapiro IM. Role of cytokines in intervertebral disc degeneration: pain and disc content. Nat Rev Rheumatol. 2014;10(1):44–56. https://doi.org/10.1038/nrrheum.2013.160.
• 19. Peng B, DePalma MJ. Cervical disc degeneration and neck pain. J Pain Res. 2018;11:2853-2857. https://doi.org/10.2147/JPR.S180018.
• 20. Bashan I, Yasa Ozturk G. (2022). Effect of Neural Therapy on shoulder dysfunction and pain in supraspinatus tendinopathy. PJMS. 2022; 38(3). https://doi.org/10.12669/pjms.38.3.482321.
• 21. Robertson JA, Kendall FP, McCreary EK. 'Muscles, Testing and Function' (Third Edition). Br J Sports Med. 1984;18(1):25. PMCID: PMC1858872.
• 22. Kesiktas, N, Ozcan, E, Vernon H. Clinimetric properties of the Turkish translation of a modified neck disability index. BMC Musculoskelet Disord. 2012;3-25. https://doi.org/10.1186/1471-2474-13-25.
• 23. Freyd M. The graphic rating scale. Journal of Educational Psychology. 1923;14:83-102. https://doi.org/10.1037/h0074329.
• 24. Cassuto D, Sinclair R, Bonderovic M. Anti-inflammatory properties of local anesthetics and their present and potential clinical implications. Acta Anaesthesiol Scand. 2006;50:265–282. https://doi.org/10.1111/j.1399-6576.2006.00936.x.
• 25. Watkins LR, Hutchinson MR, Milligan ED, Maier SF. 'Listening' and 'talking' to neurons: Implications of immune activation for pain control and increasing the efficacy of opioids. Brain Res Rev. 2007;56:148-169. https://doi.org/10.1016/j.brainresrev.2007.06.006.
• 26. Uğurlu FG. Coexistance of Piriformis Syndrome and Lumbar Disc Herniation Treated with Neural Therapy. Journal of Complementary Medicine Regulation and Neural Therapy. 2017;11:28-30. https://doi.org/10.1111/j.1533-2500.2008.00177.x.
• 27. Nishizawa S, Yokoyama T, Yokota N, Kaneko M. High cervical disc lesiones in elderly patients-presentation and surgical approach. Acta Neurochir. 1999;141:119–126. https://doi.org/10.1007/s007010050275.
• 28. Arana E, Martí-Bonmatí L, Mollá E, Costa S. Upper thoracic-spine disc degeneration in patients with cervical pain. Skeletal Radiol. 2004;33(1):29-33. https://doi.org/10.1007/s00256-003-0699-9.
• 29. Johnson AJ, Godges JJ, Zimmerman GJ, Ounanian LL. The effect of anterior versus posterior glide joint mobilization on external rotation range of motion in patients with shoulder adhesive capsulitis. J Orthop Sports Phys Ther. 2007;37(3):88-99. https://doi.org/10.2519/jospt.2007.2307.