Dr. Trendafila Tosheva is the head of the physical therapy and rehabilitation medicine department at Plovdiv UMBAL. He is a specialist in manual therapy, physical and rehabilitation medicine. He graduated in medicine in 1980. In 1985 he acquired the speci alty "Physical and Rehabilitation Medicine". Since 1988, he has been the head of the department
Postgraduate specializations: manual therapy - 1985; laser therapy - 1986; reflexology - 1989. Dr. Tosheva treats diseases of the musculoskeletal system, central and peripheral nervous system, neurological diseases, disc herniation.
Dr. Tosheva, which of the diseases most often worsen in autumn?
- Autumn is the season of disc disease, which manifests itself with stiffness in the spine, neck pain, numbness in the limbs. The pain syndrome is acute, and patients are subject to drug treatment and physical therapy.
Why do our joints hurt when the weather changes?
- The main reasons are two. The first is purely physiological. The body reacts according to the laws of physics, because immediately before the weather breaks, the atmospheric pressure drops, and this directly affects the joint-muscular apparatus. Roughly speaking, it swells due to the lower atmospheric pressure outside. This is at the microstructural level, invisible to the eye and reflected on the senses. It presses on the nerve endings and from there the pain in the joints and muscles intensifies. The other factor in changing weather is humidity. It affects older people, with spikes in the knees and neck, exacerbating the pain. In older people, the moisture penetrates more easily through the pores and from there the pain increases.
The other reason is purely psychological. When time is spoiled, people lose their mood, become more passive, have a preconceived attitude that they will react.
Do older people or younger people turn to you for help more often?
- Recently, a rejuvenation of the disease has been noticed - more and more young people come to me with serious complaints. People who work in offices, on a computer, and in production are the most affected. They stand still for 4-5 hours and sooner or later they get sick. 20 years ago we knew that the disease appeared after the age of 50-55, but now this rule has fallen away because
we also treat 13-year-old children
A teenage patient receives regular treatment in the department, and she also has numbness in one limb. The girl ends up in hospital after straining in physical education class. Since the child does not train, but has to perform strength exercises at school, this incident is provoked.
A 23-year-old boy with a spinal cord hemorrhage is currently being treated in the department. He is a football player and during one of the training sessions, he lifts his head up, gets severe pain in his back and neck, his hands also go numb, but everything goes away in ten minutes. The next day he goes to practice again, kicks with one leg, twists his body and again gets numbness in his arms and legs. At the stadium, they immediately gave him a massage, after which it turned out that he could not move at all, and he was brought urgently by ambulance to the neurology department of UMBAL "Plovdiv". Hemorrhage is found in the cervical region of the spinal cord. The patient is currently undergoing rehabilitation and the physical therapy team is fighting to fully recover because he is so young. There is a huge chance because the disease was also caught in time.
Another patient from Plovdiv, about 30 years old, was brought to the ward in a wheelchair. Since she works in an office for 8 hours every day, she wants to be physically active and enrolls in a yoga class. After the third session, she goes home and suddenly feels numb all over. She called 112, after the examination, she was taken by ambulance and admitted to a hospital, where a hemorrhage in the spinal cord was diagnosed. According to neurologists, the accident was provoked by yoga.- Why yoga can cause such severe injuries? - Staggering into yoga by people over 25-30 years old is a huge mistake because in India they learn yoga from 3 years old, not after as the organism has completed its development.
The exercises are very drastic
for the neck and spine area, twists are also dangerous. It's a good thing the patient was thin and her body weight hadn't led to a more massive accident, because if she'd been even 60kg, we wouldn't have been able to revive her. After 3-4 courses of physical therapy, she got up and started moving on her own, although she still had numbness in her limbs.
What can be the complications of a herniated disc?
- Complications from disc disease are extremely unpleasant - they lead to disability - paresis, paralysis and withdrawal symptoms, which is not desirable at all.
How much rehabilitation can help such patients?
- Through our activity - medical rehabilitation, we achieve maximum functional fitness and successful resocialization of disabled people. Our department has apparatus physiotherapy in the electrotherapy, light therapy, ultra high frequency treatment, inhalation ultrasound treatment and kinesitherapy sector. Early clinical rehabilitation is also carried out here - at the patient's bedside in the other clinics of the Plovdiv UMBAL. We have developed our own algorithms that we are working on.
What methods do you use for spinal block?
- When the spine is blocked, the spinal roots are released through manual therapy, and the muscles are relaxed. If this is not enough, a hardware program is made for 7 days. When the problem is chronic, the therapy should be carried out twice a year.
It is very important for people to understand that they should not overexert their body.
How to prevent a herniated disc from getting worse?
► Complex treatment - 2 times a year. Manual therapy, special massages, laser-acupuncture and osteopathy should be carried out every spring and autumn. The goal of these procedures is to move the damaged areas of a herniated disc. They should be supplied with blood. The choice of spring and autumn is not accidental. The change of seasons and the sudden change in temperatures begins to affect the general physical condition of the patients
► Diet - during therapy, and not only, sufferers of disc herniation should take a large amount of vitamin B-complex, because it has a beneficial effect on the development and nutrition of nerves and nerve endings. In addition to vitamin B-complex tablets, it is obtained with the help of sesame tahini, sprouted wheat and regular consumption of whole grain bread.
► Gymnastics. Special gymnastics should be done all year round so that the body is not immobilized, but is evenly loaded and in proper physical shape. It is mandatory to go on foot, take excursions or at least walks for exercise. Swimming is also very good for general physical condition.
► Mineral baths have a beneficial effect in relieving disc herniation, but those with lukewarm water, because warm and hotter cause swelling of the nerves, while ice water causes muscle spasms.
► You should sleep on a comfortable and slightly firmer mattress.
