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Lumbar disc herniation
Contraindications of Lumbar Disc Herniation
Patients with lumbar disc herniation mainly exhibit symptoms such as discomfort in the lower back, numbness in the lower limbs, and pain. These are primarily symptoms of sciatica, such as numbness and pain along the back and outer sides of the thighs, calves, and dorsum of the foot. Patients may find it difficult to put on shoes and socks in the morning, and sometimes they may feel as if their tendons are short when walking. It is generally recommended that patients strictly rest on a hard bed and warm up the lumbar region. They can also take some blood-activating and pain-relieving medications. The main precautions include avoiding bending over to lift heavy objects, carrying heavy items, and bearing heavy loads. Patients should avoid sitting or squatting for long periods and should try to lie flat or walk upright instead. If conservative treatment for lumbar disc herniation is ineffective, interventional surgical treatment may be sought.
What should I do if I have a lumbar disc herniation flare-up?
Once a herniated disc occurs, the first step should be general treatment, which involves rest and lying on a hard bed. A soft pillow should be placed under the waist and a soft pad behind the knee joints to help with triangular support recovery and reduce spinal pressure. Second, treatment with traditional Chinese medicine and herbs can be considered, which includes both oral and topical medications and usually has good effects. Third, traction and massage therapy can be considered. Traction is notably effective during the acute phase of a herniated disc. It mainly helps by reducing the pressure on the intervertebral discs, adjusting the gaps in the intervertebral foramina, and thus alleviating the irritation and compression on the nerve roots. Fourth, acupuncture and massage can also be considered, as acupuncture is particularly effective in alleviating symptoms of a herniated disc. Other treatments include small-needle scalpel therapy, target disc decompression through radiofrequency, disc intra-injections, or epidural block. If these treatments do not show significant results, or if there is no improvement and symptoms of cauda equina syndrome appear, then surgical treatment may be necessary.
Can lumbar disc herniation be treated with an injection block?
Lumbar disc herniation can be treated with an injection, which mainly uses caudal epidural steroid injections. This approach has a certain therapeutic effect but is limited. For example, it may relieve the patient's pain for about a week, after which symptoms may gradually reappear. I believe that this treatment method is more about addressing the symptoms rather than the root cause. For ineffective conservative treatments, such as resting on a hard bed, applying local heat, minimizing prolonged sitting, and lying down as much as possible except for going to the toilet or eating, symptoms will generally gradually alleviate over about 10-14 days. This can be combined with drugs that promote blood circulation and relieve pain, and drugs that nourish the nerves, as well as some diuretic drugs to relieve the pressure on the intervertebral discs. This can alleviate the stimulation of the nerve roots by the nucleus pulposus of the intervertebral discs, affecting nerves from L4 to S3, which may cause numbness and pain in the back of the thighs, the dorsum of the calves, or feet. The symptoms vary depending on the stage of compression but the difference isn't significantly large. For cases where conservative treatment or injections are ineffective, we can consider interventional surgeries like ozone nucleolysis, which are currently performed skillfully with minimal damage and quick recovery. You can consult a hospital for more information.
What should be noted about traction for lumbar disc herniation?
The main points are reflected in the following two aspects: First, during traction, it is essential to pay attention to the force and duration of the traction. Second, it is best to undergo traction at the acupuncture and massage department of a formal hospital. Formal hospitals are more professional, have a better grasp of indications, and the effects should be more satisfactory. You must not undergo traction in outside massage parlors. Sometimes, excessive force or prolonged duration can cause lumbar spine injuries in patients. For patients with lumbar disc herniation, besides traction, combining acupuncture, massage, electrical therapy, and cupping can effectively alleviate the clinical symptoms of lumbar disc herniation.
Which department should I visit for a lumbar disc herniation?
Lumbar disc herniation can be treated in five different departments. First, since lumbar disc herniation is a spinal surgical disease, the primary choice is to consult the Department of Spinal Surgery. Second, lumbar disc herniation is also a common orthopedic condition, and almost all orthopedic doctors are familiar with this disease, so you can also consult the Department of Orthopedics. Third, current traditional Chinese medicine has very good conservative treatment effects for lumbar disc herniation, so you can also consult the Department of Traditional Chinese Medicine. Fourth, lumbar disc herniation is a long-term chronic disease, and its treatment process often involves rehabilitation, so the Department of Rehabilitation can also be considered. Finally, since the main symptoms of lumbar disc herniation are pain and limited mobility, many hospitals have established pain clinics or even specialized pain departments to address the pain issues associated with lumbar disc herniation. Therefore, you can also consult the Department of Pain Management. Thus, lumbar disc herniation can be treated in these five departments, with Spinal Surgery being the primary choice.
Can lumbar disc herniation heal itself?
In clinical practice, patients with lumbar disc herniation often cannot heal on their own. It requires early diagnosis and the correct treatment methods. Patients may lie flat on a hard bed, use lumbar traction, and combine this with heat therapy, physiotherapy, acupuncture, and moxibustion. Regularly using orthopedic herbal fumigation to treat the waist area can unblock the muscle meridians, accelerate metabolism within the muscles, enhance the strength of the waist muscles, stabilize the lumbar spine, and reduce irritation to the dural sac and nerve roots, which can alleviate clinical symptoms. After conservative treatment, if the condition recurs, the next step can involve minimally invasive surgery at the lumbar region, using techniques like discoscopy or foraminoscopy to perform simple nucleotomy. Post-surgery, functional exercises for the waist can be performed.
Treatment of Chronic Low Back Pain Due to Lumbar Disc Herniation
For the treatment of chronic lower back pain caused by lumbar disc herniation, the following methods need to be applied: 1. It is necessary to strengthen the patient's lower back muscle strength through exercise, which can better protect the lumbar spine and effectively relieve the patient's lower back pain symptoms. For example, exercises like the "small swallow fly", swimming, and lifting the buttocks while lying on the bed can be performed; 2. Avoid sitting or standing for long periods, avoid bending over to lift heavy objects excessively, and it is best to wear a lumbar support belt to protect the lumbar spine, and sleep on a hard bed; 3. Actively perform local hot compresses, and combine them with therapeutic methods such as acupuncture, electrotherapy, cupping, and massage; 4. Apply topical ointments that activate blood circulation and remove blood stasis, and take oral non-steroidal drugs like pain relievers and drugs that improve blood circulation and remove blood stasis for treatment, which can be very effective.
How many days to administer fluids after minimally invasive surgery for lumbar disc herniation?
With the development of medical technology, currently for the treatment of lumbar disc herniation, such as when conservative treatment is ineffective—including lying on a hard bed, pre-heating the waist, taking blood-activating and pain-relieving medication, or drugs that nourish the nerves—some interventional surgeries are chosen if these do not provide relief. The main ones commonly used include ozone ablation, collagenase nucleolysis, percutaneous disc removal, and foraminoscopic technology, etc., all of which carry very low risk. The most commonly used is ozone ablation, which involves instant oxidation of the degenerated protruded nucleus pulposus. This destroys the proteoglycans, thereby making the proteoglycans lose their function. The cells produce proteoglycans, reducing the osmotic pressure of the nucleus tissue, which cannot maintain normal moisture, leading to shrinkage and loss of tissue. This increases the space, thereby reducing the symptoms of nerve compression caused by disc herniation. Usually, antibiotics are used post-surgery to prevent infection, generally for about three days. After the medication is completed, considering discharge and returning home for recovery is possible, followed by oral medication. (Please use medications under the guidance of a physician.)
Conservative treatment methods for lumbar disc herniation
The conservative treatment methods for lumbar disc herniation primarily include the following approaches. First, absolute rest is essential, and one should sleep on a hard bed rather than a soft one. Second, traction is used to alleviate pain symptoms. Third, massage and acupuncture are employed to relieve lower back pain and restricted mobility. Fourth, oral administration of non-steroidal anti-inflammatory and pain-relieving drugs, as well as drugs that promote blood circulation and remove blood stasis, are used to alleviate local pain. These drugs primarily function by reducing local inflammatory responses and decreasing the release of inflammatory factors, thereby easing pain. Fifth, electotherapy and magnetotherapy can also be used to relieve local pain. These are the conservative treatment methods for lumbar disc herniation.
Can I take calcium tablets for lumbar disc herniation?
Lumbar disc herniation is a very common clinical disease, often affecting the lower back and causing discomfort. It frequently presents with numbness, swelling, pain, and even muscle atrophy in one leg. In the elderly, lumbar disc herniation may be associated with osteoporosis, as bone changes following osteoporosis can lead to poor vertebral stability, ultimately causing disc herniation. Elderly patients with both lumbar disc herniation and osteoporosis should take calcium supplements. However, for young and middle-aged adults who do not have accompanying osteoporosis, taking calcium supplements is not particularly beneficial.