Subscribe
Lumbar disc herniation
Is a herniated lumbar disc serious?
Lumbar disc herniation is primarily due to degeneration of the lumbar disc or secondary pathological changes caused by this degeneration, which then stimulate blood vessels, nerve roots, and the spinal cord, leading to a series of clinical symptoms. Lumbar disc herniation is categorized into four types. The mildest type is the bulging type, followed by the protruding type, the more severe extrusion type, and finally the most severe, the sequestration type. Generally, lumbar disc bulging is relatively mild and conservative treatment is usually effective. Depending on the site and degree of compression, lumbar disc herniation may be treated conservatively, but some cases require surgical intervention. Most cases of disc extrusion require surgery because the extrusion leads to spinal stenosis, compressing all or part of the blood vessels, and it can also compress the spine and nerve roots, causing irreversible damage, and medications or massages can't reverse the condition. The fourth point concerns lumbar disc prolapse, meaning the nucleus pulposus falls into the spinal canal through the tear. This is one of the few emergencies seen in spinal surgery. If this occurs, immediate surgical treatment is necessary. Therefore, the severity of lumbar disc herniation mainly depends on the type and degree of the herniation, as well as the location and direction of the herniation, and which treatment method needs to be used.
Precautions for Lumbar Disc Herniation
For patients with lumbar disc herniation, self-prevention and self-treatment are very effective methods. What should be paid attention to in daily life? The first point is to maintain a correct sitting posture, sit upright, do not lean back, and avoid sitting for long periods. It is also necessary to keep the waist warm and prevent it from getting cold. The second point is to engage in some exercises, mainly those that strengthen the muscles of the lower back, such as large swallow flight, small swallow flight, single bridge, and double bridge. The third point is that in daily life, it is important to pay attention to maintaining the correct posture when working, avoiding putting too much pressure on the lumbar spine, and not using brute force. The fourth point is that in terms of rest, it is best to sleep on a hard bed and add a small pad at the waist or a soft pillow under the knee joints. This can keep the knee and hip joints at a certain degree of flexion, allowing the muscles of the lower back to fully relax. The fifth point is to wear a waist brace under the guidance of a doctor. This waist brace is a very common orthopedic support, which functions to immobilize and protect the waist. Moreover, for patients with lumbar disc herniation, it can greatly increase the stability of the lumbar spine and consolidate the effects of previous treatments. Therefore, patients with lumbar disc herniation must pay attention to these details in daily life.
What department should I see for a lumbar disc herniation?
For herniated lumbar discs, you should visit either the Department of Spine Surgery or Orthopedics. The specific department depends on the hospital you choose to visit. If the hospital is a high-level institution, grade three or above, it will certainly have a Department of Spine Surgery, so this would be the first choice. However, if the hospital is a community clinic or a second-tier hospital, it might not have a Spine Surgery department, so you would need to visit the general Orthopedics department. Although herniated lumbar discs are a common orthopedic condition and can be treated in Orthopedics, visiting a specialist in Spine Surgery can often provide more expert care as these doctors may have higher levels of experience and expertise in treatment.
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.
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.
Where to apply moxibustion for lumbar disc herniation?
Where to apply moxibustion for lumbar disc herniation. The main acupoint is the Hua Tuo Jia Ji acupoint at the affected intervertebral disc, along with the adjacent Jia Ji acupoints above and below. Additional acupoints are chosen based on different conditions. If there is significant lower back pain, add the acupoint at the affected side's Yaoyan. If there is muscle tension and tenderness in the buttocks, add Huan Tiao and Yi Bian. If there is tension in the hamstring muscles, add Cheng Fu, Yin Men, and Wei Zhong. If there is numbness on the outer side of the thigh, add Feng Shi; if there is numbness in the lower leg, add Wei Yang, Cheng Shan, Yang Ling Quan, Zu San Li, and Xuan Zhong. If there is numbness in the foot and weakness in dorsiflexion, add Tai Xi, Jie Xi, and Xia Xi.
Can a herniated lumbar disc be massaged?
Lumbar disc herniation can be treated with massage, and as a part of conservative treatment, massage is a very important method with generally good effects. Its role is to relieve muscle spasms, expand blood vessels, increase local blood circulation, and promote cellular metabolism of soft tissues. The techniques primarily include rolling and rubbing, supplemented by grasping and grinding methods. The main acupuncture point targeted is the Jiaji point, centered on the lesion between the two vertebral bodies. Other auxiliary acupuncture points include Yaoyangguan, Mingmen, Shenshu, Bahui, Huanjiao, Yinmen, Fucheng, Weizhong, Chengshan, and Yanglingquan.
How to exercise with lumbar disc herniation
How to exercise with lumbar disc herniation. Patients with lumbar disc herniation should pay attention to the following points if they want to exercise. First, ample preparation is necessary; only with sufficient preparatory work before exercising can injury be avoided during the workout. Second, it is advisable to wear a lumbar belt as much as possible. As an important orthopedic support, the lumbar belt helps to brake and protect the waist, and it limits the amount and range of lumbar spine movement to prevent injuries. The third point is that exercises for lumbar disc herniation should primarily focus on strengthening the muscles of the lower back, specifically exercises like the single bridge, double bridge, large and small swallow movements. By strengthening the back muscles, such as the erector spinae and the multifidus muscles, the stability of the lumbar spine can be enhanced, significantly reducing the risk of further aggravation of the lumbar disc herniation.
Where to apply moxibustion for lumbar disc herniation
After a lumbar disc herniation, if moxibustion treatment is used, there is a concept of main and supplementary acupuncture points. The main point is the Jiaji point at the herniated lumbar disc segment, accompanied by the Jiaji points directly above and below it. For example, for an L4-5 disc herniation, moxibustion would be applied to the Jiaji points of L3-4, L4-5, and L5-S1. Additionally, supplementary points are chosen based on the patient's other symptoms. If there is significant lumbar pain, the Yao Yan (Lumbar Eyes) point on the affected side is used. If there is muscle tension in the buttocks, the Huan Tiao and Yi Bian points are used. If there is tension in the back of the thigh, support would include the Fu Cheng, Yin Men, and Wei Zhong points. If numbness occurs on the outer side of the thigh, the Feng Shi point is used. For numbness in the calf, the Wei Yang, Cheng Shan, Yang Ling Quan, Zu San Li, and Xuan Zhong points are used. For numbness on the dorsum or sole of the foot, the Tai Xi, Jie Xi, and Xia Xi points are included.