Physical medicine as a conservative aspect of treatment is one of key segments in treating spine ailments.

Physical medicine team is lead by a specialist of physical medicine and rehabilitation and physical therapists who evaluate functional capacity, body type and patients’ level of activity in order to be able to implement a suitable rehabilitation treatment intended for increasing function and relieving the pain.

By properly developing therapeutic procedures individually for each patient, they get feedback from the patient and therefore can adjust the physical treatment to his individual needs. 
The principles of physical therapy in our centre are:

• continuity (rehabilitation procedure begins with establishing a diagnosis)

• team work (for success you need a team comprised of experts from diverse medical fields and full cooperation of the patient because his active participation is crucial for the outcome of the treatment).

KINESITHERAPY

Kinesitherapy is a type of physical therapy that uses movement i.e. exercise with the purpose of treating and preventing diseases. It is used for relieving and treating different pathological states and their consequences.
Synonyms are: therapeutic gymnastics, medical gymnastics, treatment by movement.

Kinesitherapy is based on the principles of kinesiology and biomechanics, sciences that study and analyze movement and motion. There are special exercises intended for strengthening of back muscles and the people who experience recurring back pain should start doing them regularly.

For these particular exercises it is highly recommended to consult your doctor who specializes in physical medicine because not all types of exercises are meant for everyone and it depends on patient’s condition.
 
Individual exercise on medicine ball
Ball exercises according to the functional assessment with different goals – strength exercises, balance exercises, posture exercises.
Stretches for unburdening of the spine

Method of spine stretching where the patient is turned at an angle of maximum 45* and consequently the body slowly stretches with its own weight.

McKenzie concept
Concept extension exercises with the aim to centralize the pain. Symptoms of herniation are back pain and radicular pain, and the one that is especially serious, the spreading of symptoms on the perifery.

Flexion exercises
Concepts according to Williarms, Regan,  Brukovljev

MASSAGE

Massage is a method of physical therapy that uses a series of systematic movements on body surface in order to manipulate body tissue. It is used for removing muscle pain, faster recovery and wound healing.
It is performed with hands in order to directly or indirectly influence muscle and nervous system as well as blood and lymph circulation. Massage is very useful for people with back pain that lasts longer than two weeks (subacute and chronic back pain).

TRACTION

Traction is a passive kinesitherapeutic method which consists of lifting certain body parts by using mechanical force. Stretching creates a sense of relief, reduction of pressure in the joints and segments of the spine, paravertebral muscles relax and the pressure to the nerve roots is relieved.
Vertebral traction is painless technique of treating spine diseases by applying strictly defined mechanical force (in intensity and duration).

Principle of activity - in traction of the spine different force is being applied: for the cervical part 5-8 kPa, for lumbar part 12-13 kPa, which leads to increasing the intervertebral gap for 1-2 mm.

This causes deblocking of intervertebral joints and stretching of ligaments. There is also a possibility of positive influence of the incurred negative pressure in intervertebral space (repositioning of nucleus pulposus)
 
Indication for traction:
-  discoradicular conflict
-  degenerative joints disease with narrowing of space
-  discogenic pain with spasm of paravertebral musculature
-  hypomobility of the joint

With traction you can achieve spacing between apophyseal joints (intervertebral joints), decreasing in disc protrusion, stretching of soft tissue, relaxation of paravertebral musculature, mobility of joints.

Distraction of apophyseal joints reduces pressure to the joint surfaces, causes widening of intervertebral gaps, resulting in reduction of clamping and irritation of the roots of spinal nerves and blood vessels and reduces the pain.

By applying extended moderate pulling force the muscles, tendons, ligaments and discs are being stretched, which relieves the compression on intervertebral joints nerve roots and increases spine movement. Vertebral traction stimulates relaxation of paravertebral musculature.

On the other hand, a risk when undergoing chiropractic manipulation is very certain. During the manipulation, significant mechanical force (to 500 N) is being used.

After this treatment, about half of the patients experience slight or moderate discomfort, mostly localized pain. Furthermore, there are reports of dramatic complications mainly related to blood vessels incidents (bursting of blood vessels, stroke) directly connected with manipulation of the upper part of the spine.

The causes of the risk still have not been discovered which means that everyone undergoing chiropractic treatment is under risk.

ELECTROTHERAPY

Electrotherapy can be used to treat pain and improve circulation. Therefore different types of current are being used (TENS, IFS, DDS and Compex). Therapy is programmed beforehand and during the treatment types and frequencies alternate to better suit certain ailments.

Muscle electro stimulation is conducted after atrophy (muscle weakness), when there is weakened nerve sensitivity (interferent, kotz, diadynamic and compex).
The duration of the treatment is programmed in advance, as well as type of stimulation and frequency that produce best results in muscle stimulation without putting a strain on the muscle.

Compex electro stimulator sends off signals to the motor muscle nerves. Due to the unique shape of electro signal, level of its sensitive strength, its precision and comfort Compex stimulator mobilizes a maximum number of muscle fibers.
Muscles are stimulated effectively, without mental or cardiac tension and without putting pressure on joints and tendons. 

Electromagnetotherapy 
Magnetotherapy is applied to improve production of collagen (healing) in bones and soft tissue, reduce inflammatory processes, neuralgia or painful rheumatic states.
It is used in treating sports injuries and degenerative disease of the joints and spine. It is indicated in healing of bone fractures, reducing osteoporosis and improving blood flow thru tissue, nerve regeneration.

ULTRASOUND

The utilized effects of the ultrasound are thermal, mechanical, physical- chemical and biological.
Ultrasound increases tissue temperature and enhances circulation and nerve conduction.
Ultrasound is used for contractures, pain reduction and muscle spasms in bursitis and tendinitis for decreasing calsification.

LASER

Light, Amplification by Stimulated Emission of Radiation
The effects of LASER are biostimulative: increased synthesis of collagen, increased tissue healing, accelerated nerve regeneration, reduced pain and edema
Impulse: crystal lasers, depth of penetration to 5 cm
Continued: gas lasers, less energy needed, depth of penetration (to 0,5 cm)

MEDIOTAPING

Supports the muscles, enhances muscle contraction in weakened muscles, decreases muscle fatigue, relieves overstretching and muscle strain, reduces spasms and the occurrence of muscle injuries, increases array of movement and relieves pain, enhances flow of body fluids, improves blood and lymph circulation, diminishes inflammatory processes, improves cell metabolism.

Activates spinal and descending inhibitory systems, adjusts the position of the joints, corrects the disproportion caused by spasm and shortening of the muscles, normalizes muscle tonus, improves array of movement and reduces pain.