Lumbar disc herniation


How long does conservative treatment for lumbar disc herniation take?
The main issue in lumbar disc herniation is that the nucleus pulposus ruptures through the annulus fibrosus, causing compression of the nerve roots. These nerve roots at lumbar 4 and sacral 3 form the sciatic nerve, leading to numbness and pain on the posterolateral side of the thigh and the dorsum of the foot. This is a distinctive manifestation of lumbar disc herniation, most commonly seen at the L4-5 and L5-S1 intervertebral spaces, accounting for over 95% of cases in outpatient settings. Conservative treatment primarily involves strict bed rest, local application of heat, sleeping on a firm mattress, pre-warming the lower back, and taking medications to promote blood circulation, relieve pain, and nourish nerves. Generally, symptoms will gradually abate and disappear within approximately 10 to 14 days, with noticeable symptom reduction after about 7 days. For cases where conservative treatment is ineffective and symptoms recur, interventional surgery such as ozone nucleolysis can be sought. Ozone therapy can help reduce the pressure on the intervertebral discs, increase their volume, and relieve nerve compression. Surgical trauma is relatively minor, the procedure is currently well-practiced, and the side effects are relatively low. It may be worthwhile to consult a local hospital for more information.


How to alleviate pain from lumbar disc herniation?
How to alleviate the pain of a herniated lumbar disc. First, once the pain occurs, you should rest initially, lie on a hard bed. You can place a thin pad under your lower back and a soft pillow beneath your knees to keep the knees and hips slightly bent. This helps fully relax the back muscles. Second, take some non-steroidal drugs, specifically non-steroidal anti-inflammatory drugs (NSAIDs). Third, consider using traditional Chinese medicine and herbs. Traditional Chinese medicine has shown significant effects in treating herniated lumbar discs, containing many components that alleviate pain. Additionally, topical application of Chinese herbal medicines, or their plasters, can improve local blood circulation, reduce the release of inflammatory factors, and thereby relieve pain. Fourth, traction, which can be manual or mechanical, aims to reduce pressure on the lumbar discs by stretching them and enlarging the intervertebral foramen, thus alleviating nerve root irritation. Fifth, consider undergoing some physiotherapy treatments, such as heat therapy, shockwave therapy, microwave therapy, and transdermal drug delivery. These methods usually show good results. Finally, it is crucial to wear a lumbar support belt, as it is very important for patients with herniated discs. It can restrict movement of the lumbar spine, controlling the range of lumbar activity and increasing the stability of the lumbar spine, thus reducing the pressure and irritation on the discs. Generally, following the above treatments should significantly relieve the pain—should the pain persist, consider a nerve root block as a further treatment option.


What role does embedding therapy play in lumbar disc herniation?
Thread embedding therapy for lumbar disc herniation is a category of Traditional Chinese Medicine treatment. Its function is similar to acupressure, acupuncture, and moxibustion, primarily involving the insertion of absorbable threads into specific acupoints or meridians to continuously stimulate and regulate these areas. This treatment is based on Traditional Chinese Medicine theory. Some patients may achieve good results, but others may not find it effective. It is advised that patients with lumbar disc herniation should seek treatment at a legitimate hospital. While thread embedding therapy can be attempted, it does not guarantee good results for all patients. Oral medication may be necessary, and in severe cases, surgical intervention might be required.


Is lumbar disc herniation difficult to treat?
Patients with lumbar disc herniation, after standard and regulated treatment, can mostly effectively alleviate symptoms, and even achieve clinical recovery. The treatment for lumbar disc herniation mainly includes non-surgical treatment and surgical treatment. The specific method of treatment to be used should be comprehensively considered based on symptoms, physical examination, imaging studies, and other factors. For non-surgical treatment of lumbar disc herniation, it is recommended that patients protect their lower back in daily life, develop correct habits of using the lower back, and avoid lifting heavy objects partially and other heavy physical activities involving the lower back. During stable periods of the condition, some exercises to strengthen the lower back and spinal functions can be performed. At the same time, when symptoms occur, anti-inflammatory analgesics, neuro-nutritional drugs, and other medications can be used. Treatments can also be combined with hot compresses, physical therapy, massage, and acupuncture. These conservative treatment methods generally can achieve good results. When conservative treatment is ineffective or functional impairment occurs, surgical treatment can also be considered. (Specific medication use should be guided by a doctor.)


Can a herniated lumbar disc be massaged?
Lumbar disc herniation can be treated with massage and is a very important conservative treatment method. The first benefit of this massage is that it can relieve muscle spasms in the lower back. Secondly, through massage, it can dilate blood vessels, increase the speed of blood circulation, and then promote the metabolism of surrounding soft tissues. The treatment techniques primarily include rolling and pushing-grinding methods, supplemented by grasping and grinding methods, avoiding violent pressure. The main acupoints used are the Jiaji points, along with other matching points such as the Yaoyangguan, Mingmen, Shenshu, Huantiao, Yinmen, Chengfu, Weizhong, Chengshan, and Yanglingquan points, mainly selected according to the different conditions of the patients. Many patients experience significant relief in symptoms of lumbar disc herniation after massage therapy.


How to relieve stiffness in the lower back caused by lumbar disc herniation?
Lumbar disc herniation is very common in clinical settings. The peak incidence age is around forty, typically in middle-aged adults, though some cases occur in the elderly due to degenerative lumbar changes, bone proliferation, or osteoporosis-induced herniation. Patients with lumbar disc herniation usually experience discomfort in the lower back, muscle spasms, and sometimes numbness and soreness in the legs. If such stiffness and discomfort occur, one approach is to rest in bed. Additionally, applying heat, gentle massage, and treatments to relieve muscle spasms can be beneficial. Treatments such as acupuncture and physiotherapy can also help alleviate muscle spasms in the lumbar region, thus easing the stiffness.


Is massage useful for lumbar disc herniation?
Can massage be used for lumbar disc herniation? Its clinical effects are quite good. The primary function of massage therapy is to relieve muscle spasms, then dilate blood vessels, increase local blood circulation, and promote peripheral metabolism, thereby achieving the purpose of curing diseases. It mainly uses rolling and pushing techniques, with the main acupoint being the Jiaji acupoint. Auxiliary acupoints generally include Yangguan, Yaoyangguan, Mingmen, Shenshu, Weizhong, Chengshan, and Yanglingquan, among others. Additionally, it includes two board techniques. These board techniques are very effective for minor joint disorders of the lumbar spine. There are two board techniques, one is the slant board technique, and the other is the rotating tube board technique, with the slant board technique being relatively easier to perform. Generally, patients experience varying degrees of symptom relief after proper and effective massage, and many people's symptoms disappear altogether.


Can people with lumbar disc herniation have sexual intercourse?
Appropriate and occasional sexual activity is permissible. During the acute phase of lumbar disc herniation, it is strictly prohibited to engage in excessive physical activities, including sexual activity, as it may trigger or exacerbate symptoms such as increased herniation, nerve compression, and resultant numbness or painful sensations in the lower limbs. However, during the chronic phase of disc herniation, after systematic treatment and significant symptom improvement, sexual activity can be resumed appropriately and occasionally, such as once every two to three weeks, or adjusted according to different age groups to a normal frequency. Additionally, it is important to avoid excessive bending and heavy lifting to prevent worsening the pain and discomfort associated with lumbar disc herniation.


What are the methods for diagnosing lumbar disc herniation?
The diagnostic methods for lumbar disc herniation are essentially three-dimensional; that is, clinical symptoms plus physical examination combined with auxiliary examinations. First, let's talk about clinical manifestations, which include pain, functional impairment, and local sensory abnormalities in cases of lumbar disc herniation. Second, in the physical examination of lumbar disc herniation, the intervertebral disc often shows some deformation, and the most common is a reduction or disappearance of the lumbar spine's forward physiological curvature, referred to colloquially as "flatback," where the back appears flat like a board. Other findings may include spinal scoliosis and specific tender points, usually located next to the protruding vertebrae. Percussing these tender points may induce radiating pain to the buttocks or lower limbs. Additional examinations might reveal abnormalities in the strength or sensation of lower limb muscles at different stages, as various muscles and sensory areas are affected differently. Special tests such as the straight leg raise test, femoral nerve stretch test, and neck flexion test are generally positive. The most routine auxiliary examination involves taking x-ray images, followed by CT scans, which can directly visualize the location and extent of the disc herniation. Currently, magnetic resonance imaging (MRI) is also used, which has significant advantages. MRI provides three-dimensional images, showing the sagittal, coronal, and axial planes, which helps in better assessing the condition of herniated discs. Therefore, these are the areas covered in diagnosing lumbar disc herniation.


What are the symptoms of lumbar disc herniation?
The early symptoms of lumbar disc herniation mainly include back pain and limited mobility. With appropriate conservative treatment at this stage, the symptoms will not worsen. For example, sleeping on a hard bed, resting adequately, and using some physical therapy methods can help alleviate back pain and restricted mobility. If back pain and mobility limitations occur and are not treated correctly, it may lead to mid-to-late-stage symptoms. The patient will typically experience sciatica, with radiating pain and numbness in both lower limbs, caused by the herniated disc compressing the nerve root, leading to impaired nerve function and symptoms of numbness and pain in the lower limbs.