If physical and pharmological therapies fail in the treatment of severe pains due to lumbal and servical disc herniations, we may try algological interventions as a last chance before surgery. They are performed at the operating room by fluoroscopic or ultrasound guidance. Transforaminal anterior epidural or sacral caudal injections are techniques to decrease the edema of the spinal nerve roots. Radiofrequency (RF) neurotomy is procedure to help to retrieve chronic spine pain.



Phsical therapy and rehabilitation speciality has a 122 years of history in Turkish Medicine. Heat, electrical stimulation, ultrasound, pneumatic compression therapy, clinical exercises, and manuel therapy are components of physiotherapy. Physiotherapy restore and maintain musculoskeletal disorders, especially osteoarthritis, rheumatic diseases, lympedema, stroke, spinal cord injury and peripheral nerve palsies etc.



Local injections could be very helpfull for the treatment of musculoskletal disorders. Intraarticuler injection, trigger points injection, periarticuler injection, tendon or nerve sheat injection, paravertebral spine injection are examples of local injections, performed in our clinic. We may apply dry needling, neural therapy and intradermal drug injections, according to situation. We could inject dextrose solutions, lidocain solutions or combinations, ozone gas or PRP. We seldom inject corticosteroids. We may aim an antiinflammatory affect or on the contrary to stimute inflamation to strenghten the tendon and ligaments by using different drug combinations.



Ozone is a gas made of three atoms of oxygen with a cyclic structure. It is produced from püre oxygen by medical ozone generator using high voltage electricity. Ozone is ten times more soluble than oxygen. It is very unstable so its third oxygen atom reacts with biomolecules and blood. Inhalation of ozone gas is toxic for pulmonary tract and eyes. Although ozone is the third potent oxidant, it is used for antioxidant therapy. The levels of antioxidant enzymes are upregulated by ozone therapy. Magic formula is dose controlled, short duration acute oxidative stress relieves chronic oxidative stress . This is called as hormesis affect. Ozone therapy may be helpfull as a complimentary treatment on long covid 19 symptoms, metobolic diseases, fibromiyalgia, chronic fatigue syndrome, etc.