Lumbar disc herniation symptoms

Written by Qiu Xiang Zhong
Orthopedics
Updated on September 26, 2024
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Patients with lumbar disc herniation can exhibit a variety of clinical symptoms which may differ according to age, gender, duration of illness, and the location of the herniation. Among these, back pain is a symptom that occurs in over 90% of the patients. The pain is primarily located in the lower back and the sacral area, most commonly presenting as persistent dull pain. Another common symptom is radiating pain in the lower limbs, which may extend from the lower back and buttocks to the back of the thigh, front or back of the calf, all the way to the heel. The nature of the pain is primarily radiating and piercing. Additionally, there may be reduced sensory and motor functions in the lower limbs as well as cauda equina syndrome symptoms.

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Written by Na Hong Wei
Orthopedics
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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.

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Written by Na Hong Wei
Orthopedics
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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.

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Written by Guan Yu Hua
Orthopedic Surgery
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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.)

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Written by Na Hong Wei
Orthopedics
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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.

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Written by Na Hong Wei
Orthopedics
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Lumbar disc herniation has what manifestations?

Lumbar disc herniation has the following clinical manifestations. First, lower back pain accompanied by unilateral radiating pain in the lower limbs. Second, numbness in the localized area. Third, weakness in the toes. Fourth, decreased temperature in the affected limb. Upon examination, the first finding is a reduced natural anterior curve of the lumbar spine, which we refer to as a flat or board-like back. Second, it can also cause the lumbar spine to bend to one side, possibly toward the affected side or the healthy side, depending on the location of the herniation. Third, there is a fixed tender point beside the lumbar spine, which plays an active role in diagnosis and treatment. Fourth, due to pain, there is a limitation in the movement of the lower back; normally, the lumbar spine can flex 45 degrees forward, extend 20 degrees backward, and bend 30 degrees to each side. If these ranges of motion are not achievable, it indicates a significant limitation in lumbar activity. Fifth is the neurological localization examination, which primarily involves different sensory disturbances, motor disturbances, or muscle atrophy depending on the site of compression. There are also some special tests, like the straight leg raise test, reinforcement test, healthy side leg raise test, as well as the neck flexion test and femoral nerve stretch test. Lastly, additional diagnostic tests like CT or MRI can provide specific information on the location and stage of the lumbar disc herniation.