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Na Hong Wei
Orthopedics
About me
Yanshou County People's Hospital, Orthopedics Department, Chief Physician, engaged in clinical work in orthopedics for many years.
Proficient in diseases
Specializes in: Orthopedics, general surgery, and minimally invasive treatment.
Voices
How to treat a lumbar disc herniation?
Clinically, the treatment of lumbar disc herniation usually involves the following three aspects. The first is conservative treatment, which is mainly for those patients whose lumbar disc herniation is not very severe and does not cause substantial compression of the nerve roots and spinal cord. The first step includes general treatment, that is, after developing a lumbar disc herniation, one needs to lie flat in bed, rest on a hard bed, and then rest. The second is treatment with Chinese herbal medicine, the third with Western medicine, and the fourth is traditional Chinese medicine rehabilitation treatment, which includes traction, massage, acupuncture, and others. There is also physical therapy, which includes treatments like shockwave thermotherapy and microwave therapy. Often, some patients experience symptom relief after conservative treatment. There are also some patients whose symptoms do not improve during treatment, and even worsen, at which point surgical treatment is needed. Surgical treatment has its strict indications. However, once within the range of these indications, surgical treatment should be considered. Surgical treatment now is divided into minimally invasive therapy and conventional surgical treatment. The third is other treatments, which are also numerous, including ozone therapy, sacral canal treatment, intradiscal injections, and so on. Therefore, the treatment of lumbar disc herniation mainly depends on the degree of protrusion and clinical symptoms, which are analyzed comprehensively to select a suitable treatment method.
How to assist in the examination of lumbar muscle strain?
How should lumbar muscle strain be assessed through auxiliary examinations? What auxiliary examinations are needed for lumbar muscle strain? Clinically, lumbar muscle strain is quite common; out of every ten people, at least two or three have it. The characteristic of these patients is that their symptoms are severe but their physical signs are mild. Therefore, when encountering such patients, a screening process is generally required, which involves a method of exclusion. After examination, an X-ray is usually taken first to check for obvious lumbar spondylolisthesis, the severity of bone hyperplasia, and any traumas, whether fresh or old, that might have caused vertebral fractures. Then, some people might need a CT scan, which aims to exclude lumbar disc herniation. Many patients do not have herniated discs, or only have slight bulging, but their symptoms are severe, making them restless. Generally, there is no need for an MRI, but some patients strongly request an MRI examination. After the MRI, sometimes high-density shadows can be seen in the muscles of the lower back, which might be caused by injuries within these muscles. Therefore, the auxiliary examinations for lumbar muscle strain are usually negative, with few positive findings, which is a characteristic of this condition.
Symptoms of lumbar disc herniation
The symptoms of a herniated lumbar disc are 1. back pain 2. leg pain 3. both back and leg pain. The essence of a herniated lumbar disc is that, after the disc protrudes, it compresses the surrounding nerve roots or the spine, leading to a series of clinical symptoms. Depending on the area of compression, different symptoms may occur; some people experience back pain, others leg pain, and in more severe cases, both back and leg pain. Therefore, pain is the primary symptom of a herniated lumbar disc. However, following the pain, there often occurs a restriction of movement. If a certain posture is not correct, it triggers pain. In severe cases, it may cause numbness or weakness in both legs, or result in urinary or bowel dysfunction.
Symptoms of intercostal neuralgia
Intercostal neuralgia is essentially caused by inherent reasons, or pathological changes in the thoracic vertebrae, ribs, and pleura, leading to an inflammatory symptom involving the intercostal nerves. Therefore, the primary symptom of intercostal neuralgia is pain, but this pain has certain characteristics. First, the pain commonly occurs in the left second rib and the right second, third, and fourth ribs. Second, the range of the pain is usually semicircular; it does not extend beyond the anterior midline at the front or the posterior midline at the back, forming a semicircular pain along the ribs. Third, there are often fixed tender points, which sometimes are located in the costal cartilage or corresponding thoracic vertebrae and paraspinal area; these points, when pressed or tapped, can cause radiating pain. Fourth, many times the examination results are negative, so intercostal neuralgia tends to be a condition where the symptoms are severe, but physical examination often yields very few positive signs.
Can tendinitis be treated with an injection?
Tendonitis can be treated with injections, which provide both anti-inflammatory and pain-relieving effects, often resulting in a very satisfactory therapeutic outcome. However, there are some considerations to keep in mind when performing these injections: First, the injection site must be free of infection and dermatitis; the skin must be clean and intact. Second, it is best to avoid injecting the medication near the attachment points of muscles or tendons on bones. In some cases, such as with femoral condyle osteoarthritis, injections near these points are necessary, but care should be taken not to inject directly into the attachment points to prevent tendon rupture at those sites, which are currently irreplaceable with current scientific techniques. Third, do not exceed three tendonitis injections. Many patients may recover after one or two injections, but some might go for a third if they do not feel significant improvement. If there is no noticeable benefit after three injections, or if the treatment is ineffective, the injection therapy might not be suitable for you, and other treatments should be considered. Therefore, while tendon injections can be an option for tendonitis, it is essential to apply the correct methods.
What should I do about cervical spondylosis?
Having cervical spondylosis is not a big deal as long as you understand two things, which basically suffices. The first point is to determine the specific type of cervical spondylosis, as the treatment depends on the type, and different strategies are adopted for different types. The second point is to have a clear concept that once cervical spondylosis occurs, it is basically incurable. Therefore, it is essential to understand the concepts of healthcare and prevention. Let's discuss the types of cervical spondylosis. Clinically, cervical spondylosis is categorized into six types: cervical type, nerve root type, spinal type, sympathetic type, vertebral artery type, and mixed type. Cervical type cervical spondylosis generally does not require surgical treatment. The nerve root type responds best to traction. The spinal type generally requires surgical treatment. Vertebral artery type treatment involves treating both the cervical spine and arteriosclerosis. The mixed type involves the coexistence of two or more types of cervical spondylosis, and they are treated together. As for prevention, which is crucial for cervical spondylosis, it is important to pay attention to rest, maintain good sitting and standing postures, protect the cervical spine from cold, and perform appropriate cervical spine exercises to strengthen neck muscles. If cervical spondylosis episodes occur, remember not to self-medicate and seek proper treatment plans from a hospital.
Symptoms of Sciatica
Symptoms of sciatica: First, sciatica often occurs in the lumbar 4 and lumbar 5, or between lumbar 5 and sacral 1 disc herniation. Second, the primary symptom of sciatica is pain, which typically originates in the lower back and can radiate to the buttock, posterior thigh, the lateral side of the calf, and the lateral edge of the foot sole. Pain usually has a triggering factor, such as coughing, sneezing, defecation, etc., basically any activity that increases abdominal pressure can cause radiating pain of the sciatic nerve. Third, the area innervated by the sciatic nerve may become hypersensitive, with some people feeling pain, others feeling heat, and still others feeling cold, until the later stages where it generally becomes numbness and dullness. Fourth, there are limitations in movement of the lower back or limbs, with many patients reporting a feeling as if there’s a shortened tendon at the back of the thigh, restricting movement. These are the primary symptoms of sciatica.
How to relieve sciatic nerve pain
How to alleviate sciatica pain. First, it is necessary to rest in bed absolutely, especially sleeping on a firm bed. While sleeping on a firm bed, you can also pad a soft pad in the lumbar area and place a soft pillow under the knee joints. The main purpose is to keep the knee and hip joints in a flexed state, allowing the muscles in the lower back to fully relax. Second, you can take some non-steroidal anti-inflammatory painkillers orally. Third, you can use traction therapy. Traction therapy is very effective for relieving sciatica pain as it can reduce the pressure inside the disc and expand the volume of the spinal canal, thus alleviating the stimulation and compression of the nerve roots. Fourth, you can consider undergoing physiotherapy, massage, and manipulation. However, aggressive massage is not recommended. Fifth, you can undergo intradiscal blockade or sacral canal injections. Sixth, you can perform nucleoplasty, which involves injecting collagenase into the intervertebral disc, or between the dura mater and the protruding nucleus pulposus. This often requires the intervention of a pain specialist. Therefore, after the aforementioned treatments, sciatica pain should generally be alleviated. If there is no relief or if symptoms worsen, then surgical treatment may be necessary.
Symptoms of ankylosing spondylitis
The main symptom of ankylosing spondylitis is pain, characterized by pain in the lower back and lumbar region. The pain occurs during rest and diminishes with activity; it is especially severe at night, often waking the sufferer, who then finds mild activity alleviates the pain enough to return to sleep. As the disease progresses, chest pain and restricted rib cage movement begin, due to the disease spreading to the thoracic vertebrae and eventually reaching the cervical vertebrae in later stages, resulting in difficulty moving the neck. Early physical signs include tenderness in the sacroiliac joints and paraspinal muscles. X-rays can reveal that the sacroiliac joints are often the first to be affected, usually showing sacroiliitis. Additionally, there is a particularly high positivity rate for HLA-B27, the human leukocyte antigen B27, which can reach up to 90%, whereas it is typically around 4%-9% in the general population.
How to cure periarthritis of the shoulder using the arm-swinging method?
In the treatment of periarthritis of the shoulder, there is a method called "arm-swinging". The main technique of arm-swinging involves swinging the shoulder joint inward, outward, forward, and backward, forming a circle with the shoulder joint. This circle is actually two circles: one from the front to the back, and another from the back to the front. The arm-swinging method should be very effective for treating periarthritis of the shoulder, but the following issues need to be noted: First, it is crucial to exclude any rotator cuff injuries, especially tears in the supraspinatus or infraspinatus muscles. If tears in the supraspinatus or infraspinatus muscles occur, the arm-swinging method is not recommended due to its "zipper effect." This refers to a small initial tear that could further enlarge through improper exercise, eventually becoming a large tear. Thus, the first point is to rule out rotator cuff injuries. Second, when performing the arm-swinging method, one should not rush and should progress gradually. Initially, the range may be very small or the movement may not be possible to perform, but with consistent and persistent practice, the range of motion will gradually increase, making arm-swinging easier. However, rushing may lead to muscle tears around the shoulder joint or tear injuries to the joint capsule. Third, although the arm-swinging method can have a beneficial effect in treating periarthritis of the shoulder, starting the exercise can be very painful. Therefore, it may be necessary to use other methods initially, such as taking non-steroidal anti-inflammatory drugs orally, or undergoing massage or physiotherapy, to relax the muscles and ligaments around the shoulder joint. This can reduce pain during the arm-swinging exercises and enhance effectiveness.