What is lumbar disc herniation?

Written by Lv Yao
Orthopedics
Updated on September 28, 2024
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Lumbar disc herniation is a condition caused by the rupture of the fibrous ring of the intervertebral disc, protrusion of the central nucleus pulposus, which compresses the nerve roots or the spinal cord, resulting in a series of symptoms. For example, it can cause pain in the lower limbs and instability in the lumbar spine, leading to pain in the waist, as well as pain in the waist when walking or standing, and even sensations of numbness and tingling in the lower limbs. In severe cases, it can cause symptoms affecting urination and defecation.

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Written by Na Hong Wei
Orthopedics
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How to exercise with lumbar disc herniation

For patients with lumbar disc herniation, self-exercise is a very important and effective treatment method. First, it is important to maintain the correct sitting posture, sit up straight without leaning sideways, and avoid sitting for extended periods. It is also necessary to keep the waist warm to prevent catching cold. Second, it is necessary to strengthen the exercise of the back muscles, especially the erector spinae and multifidus, with exercises such as single-leg bridges, double-leg bridges, and the "little swallow" exercise. Third, maintain the correct posture in daily life, such as when lifting or holding objects, to avoid increasing tension in the waist and causing unnecessary damage. Fourth, regarding rest, it is crucial to lie on a firm bed and possibly add a thin pad under the waist to keep the hips and knees in a certain alignment, ensuring the waist muscles can fully relax. Fifth, always wear a waist belt during exercise. The waist belt is one of the most important orthopedic supports, serving to immobilize and protect the waist, limiting movement during activity to solidify the effects of earlier treatments. Therefore, patients with lumbar disc herniation must develop a complete and reasonable treatment plan at a regular medical institution and normal physiotherapy institution.

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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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Orthopedics
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Where to press for lumbar disc herniation

Massage for lumbar disc herniation involves main and auxiliary acupoints. The main acupoint is the Jiaji acupoint at the affected disc side, followed by the Jiaji acupoints immediately above and below it. Auxiliary acupoints are chosen based on the patient's specific symptoms. Typically, if there is significant lower back pain, the affected side's Yaoyan acupoint is used. For tense gluteal muscles with tenderness, the Huanjiao acupoint is selected. If there is muscle tension on the back of the thigh, the Yinmen and Hebei acupoints are advisable. If numbness occurs on the outer side of the thigh, the Fengsi acupoint should be used. For numbness in the lower legs, the Yanglingquan acupoint is suitable. If numbness affects the foot, the Taixi and Yibian acupoints are recommended.

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Lumbar disc herniation L5-S1 symptoms

You may experience abnormal sensations in the buttocks, lower limbs, and soles of the feet, such as numbness, soreness, and even reduced muscle strength. Additionally, mild to moderate lumbar disc herniation can cause soreness and abnormal sensations in the buttocks, and even abnormal sensations in the perineal region. It is recommended that when symptoms of nerve compression in the lower limbs and buttocks occur, strict bed rest should be enforced, especially on a hard bed, and exposure to cold should be avoided. Consider lumbar traction if appropriate, but if symptoms worsen during traction, it should be stopped immediately. Also, if the disc herniation is localized to a single segment, minimally invasive surgery may be considered.

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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.